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256B.195 INTERGOVERNMENTAL TRANSFERS; HOSPITAL PAYMENTS.
    Subdivision 1. Federal approval required. Sections 145.9268, 256.969, subdivision 26, and
this section are contingent on federal approval of the intergovernmental transfers and payments to
safety net hospitals and community clinics authorized under this section. These sections are also
contingent on current payment, by the government entities, of intergovernmental transfers under
section 256B.19 and this section.
    Subd. 2. Payments from governmental entities. (a) In addition to any payment required
under section 256B.19, effective July 15, 2001, the following government entities shall make
the payments indicated before noon on the 15th of each month:
(1) Hennepin County, $2,000,000; and
(2) Ramsey County, $1,000,000.
(b) These sums shall be part of the designated governmental unit's portion of the nonfederal
share of medical assistance costs. Of these payments, Hennepin County shall pay 71 percent
directly to Hennepin County Medical Center, and Ramsey County shall pay 71 percent directly
to Regions Hospital. The counties must provide certification to the commissioner of payments
to hospitals under this subdivision.
    Subd. 3. Payments to certain safety net providers. (a) Effective July 15, 2001, the
commissioner shall make the following payments to the hospitals indicated after noon on the
15th of each month:
(1) to Hennepin County Medical Center, any federal matching funds available to match the
payments received by the medical center under subdivision 2, to increase payments for medical
assistance admissions and to recognize higher medical assistance costs in institutions that provide
high levels of charity care; and
(2) to Regions Hospital, any federal matching funds available to match the payments received
by the hospital under subdivision 2, to increase payments for medical assistance admissions and
to recognize higher medical assistance costs in institutions that provide high levels of charity care.
(b) Effective July 15, 2001, the following percentages of the transfers under subdivision 2
shall be retained by the commissioner for deposit each month into the general fund:
(1) 18 percent, plus any federal matching funds, shall be allocated for the following purposes:
(i) during the fiscal year beginning July 1, 2001, of the amount available under this clause,
39.7 percent shall be allocated to make increased hospital payments under section 256.969,
subdivision 26
; 34.2 percent shall be allocated to fund the amounts due from small rural hospitals,
as defined in section 144.148, for overpayments under section 256.969, subdivision 5a, resulting
from a determination that medical assistance and general assistance payments exceeded the
charge limit during the period from 1994 to 1997; and 26.1 percent shall be allocated to the
commissioner of health for rural hospital capital improvement grants under section 144.148; and
(ii) during fiscal years beginning on or after July 1, 2002, of the amount available under this
clause, 55 percent shall be allocated to make increased hospital payments under section 256.969,
subdivision 26
, and 45 percent shall be allocated to the commissioner of health for rural hospital
capital improvement grants under section 144.148; and
(2) 11 percent shall be allocated to the commissioner of health to fund community clinic
grants under section 145.9268.
(c) This subdivision shall apply to fee-for-service payments only and shall not increase
capitation payments or payments made based on average rates. The allocation in paragraph
(b), clause (1), item (ii), to increase hospital payments under section 256.969, subdivision 26,
shall not limit payments under that section.
(d) Medical assistance rate or payment changes, including those required to obtain federal
financial participation under section 62J.692, subdivision 8, shall precede the determination
of intergovernmental transfer amounts determined in this subdivision. Participation in the
intergovernmental transfer program shall not result in the offset of any health care provider's
receipt of medical assistance payment increases other than limits resulting from hospital-specific
charge limits and limits on disproportionate share hospital payments.
(e) Effective July 1, 2003, if the amount available for allocation under paragraph (b) is greater
than the amounts available during March 2003, after any increase in intergovernmental transfers
and payments that result from section 256.969, subdivision 3a, paragraph (c), are paid to the
general fund, any additional amounts available under this subdivision after reimbursement of the
transfers under subdivision 2 shall be allocated to increase medical assistance payments, subject to
hospital-specific charge limits and limits on disproportionate share hospital payments, as follows:
(1) if the payments under subdivision 5 are approved, the amount shall be paid to the largest
ten percent of hospitals as measured by 2001 payments for medical assistance, general assistance
medical care, and MinnesotaCare in the nonstate government hospital category. Payments shall be
allocated according to each hospital's proportionate share of the 2001 payments; or
(2) if the payments under subdivision 5 are not approved, the amount shall be paid to the
largest ten percent of hospitals as measured by 2001 payments for medical assistance, general
assistance medical care, and MinnesotaCare in the nonstate government category and to the
largest ten percent of hospitals as measured by payments for medical assistance, general assistance
medical care, and MinnesotaCare in the nongovernment hospital category. Payments shall be
allocated according to each hospital's proportionate share of the 2001 payments in their respective
category of nonstate government and nongovernment. The commissioner shall determine which
hospitals are in the nonstate government and nongovernment hospital categories.
    Subd. 4. Adjustments permitted. (a) The commissioner may adjust the intergovernmental
transfers under subdivision 2 and the payments under subdivision 3, and payments and transfers
under subdivision 5, based on the commissioner's determination of Medicare upper payment
limits, hospital-specific charge limits, and hospital-specific limitations on disproportionate share
payments. Any adjustments must be made on a proportional basis. If participation by a particular
hospital under this section is limited, the commissioner shall adjust the payments that relate to
that hospital under subdivisions 2, 3, and 5 on a proportional basis in order to allow the hospital to
participate under this section to the fullest extent possible and shall increase other payments under
subdivisions 2, 3, and 5 to the extent allowable to maintain the overall level of payments under this
section. The commissioner may make adjustments under this subdivision only after consultation
with the counties and hospitals identified in subdivisions 2 and 3, and, if subdivision 5 receives
federal approval, with the hospital and educational institution identified in subdivision 5.
(b) The ratio of medical assistance payments specified in subdivision 3 to the
intergovernmental transfers specified in subdivision 2 shall not be reduced except as provided
under paragraph (a).
    Subd. 5. Inclusion of Fairview University Medical Center. (a) Upon federal approval of the
payments in paragraph (b), the commissioner shall establish an intergovernmental transfer with
the University of Minnesota in an amount determined by the commissioner based on the amount of
Medicare upper payment limit available for nongovernment hospitals adjusted by hospital-specific
charge limits and the amount available under the hospital-specific disproportionate share limit.
(b) Effective July 1, 2003, the commissioner shall increase payments for medical assistance
admissions at Fairview University Medical Center by 71 percent of the transfer plus any federal
matching payments on that amount, to increase payments for medical assistance admissions and
to recognize higher medical assistance costs in institutions that provide high levels of charity
care. Twenty-nine percent of the transfer plus federal matching funds available as a result of the
transfers in subdivision 5 shall be paid to the largest ten percent of hospitals in the nongovernment
hospital category as measured by 2001 payments for medical assistance, general assistance
medical care, and MinnesotaCare. Payments shall be allocated according to each hospital's
proportionate share of the 2001 payments. The commissioner shall determine which hospitals
are in the nongovernment hospital category.
History: 1Sp2001 c 9 art 2 s 46; 2002 c 379 art 1 s 113; 1Sp2003 c 14 art 12 s 53,54;
1Sp2005 c 4 art 8 s 49