2026 Minnesota Statutes

256B.0759 SUBSTANCE USE DISORDER DEMONSTRATION PROJECT.

Subdivision 1.Establishment.

The commissioner shall develop and implement a medical assistance demonstration project to test reforms of Minnesota's substance use disorder treatment system to ensure individuals with substance use disorders have access to a full continuum of high-quality care.

Subd. 2.

MS 2024 [Repealed, 2026 c 95 art 5 s 40]

Subd. 3.Provider standards.

(a) The following programs that receive payment for substance use disorder treatment services under section 256B.0625 must enroll as a Minnesota Health Care Programs provider, meet the requirements established by the commissioner, and certify that the program meets the applicable American Society of Addiction Medicine (ASAM) levels of care according to section 254B.19:

(1) nonresidential substance use disorder treatment programs and residential treatment programs licensed under chapter 245G as licensed substance use disorder treatment facilities;

(2) withdrawal management programs licensed under chapter 245F; and

(3) out-of-state residential substance use disorder treatment programs.

Programs that do not meet the requirements of this paragraph are ineligible for payment for services provided under section 256B.0625.

(b) Programs licensed by the commissioner as residential treatment programs according to section 245G.21 that (1) receive payment under this chapter, (2) are licensed as a hospital under sections 144.50 to 144.581, and (3) provide only ASAM level 3.7 medically monitored inpatient level of care are not required to certify the ASAM 3.7 level of care. If a program described in this paragraph provides any additional ASAM levels of care, the program must certify those levels of care according to section 254B.19. Programs meeting the criteria in this paragraph must submit evidence of providing the required level of care to the commissioner to be exempt from enrolling in the demonstration.

(c) Tribally licensed programs that otherwise meet the requirements of this subdivision may elect to participate in the demonstration project. The commissioner must consult with Tribal Nations to discuss participation in the substance use disorder demonstration project.

(d) Programs subject to this section must:

(1) deliver services in accordance with section 254B.19; and

(2) offer substance use disorder treatment services with medications for opioid use disorder on site or facilitate timely access to medications for opioid use disorder off site.

Subd. 4.Provider payment rates.

(a) Providers must be reimbursed at rates according to section 254B.0505, subdivision 1.

(b) Effective January 1, 2021, and contingent on annual federal approval, managed care plans and county-based purchasing plans must reimburse providers of the substance use disorder services meeting the requirements of section 254B.19 that are employed by or under contract with the plan an amount that is at least equal to the fee-for-service base rate payment for the substance use disorder services described in paragraph (a). The commissioner must monitor the effect of this requirement on the rate of access to substance use disorder services and residential substance use disorder rates. Capitation rates paid to managed care organizations and county-based purchasing plans must reflect the impact of this requirement. This paragraph expires if federal approval is not received at any time as required under this paragraph.

(c) Effective July 1, 2021, contracts between managed care plans and county-based purchasing plans and providers to whom paragraph (b) applies must allow recovery of payments from those providers if, for any contract year, federal approval for the provisions of paragraph (b) is not received, and capitation rates are adjusted as a result. Payment recoveries must not exceed the amount equal to any decrease in rates that results from this provision.

(d) For substance use disorder services with medications for opioid use disorder under section 254B.0505, subdivision 1, clause (7), provided on or after January 1, 2021, payment rates must be increased by 20 percent over the rates in effect on December 31, 2020. Upon implementation of new rates according to section 254B.121, the 20 percent increase will no longer apply.

Subd. 5.

MS 2024 [Repealed, 2026 c 95 art 5 s 40]

Subd. 6.

MS 2022 [Repealed, 2023 c 61 art 4 s 28]

Subd. 7.Public access.

The state shall post the final documents, for example, monitoring reports, close out report, approved evaluation design, interim evaluation report, and summative evaluation report, on the state's Medicaid website within 30 calendar days of approval by CMS.

Subd. 8.Federal approval; demonstration project extension.

The commissioner shall seek a five-year extension of the demonstration project under this section and to receive enhanced federal financial participation.

Subd. 9.Demonstration project evaluation work group.

Beginning October 1, 2021, the commissioner shall assemble a work group of relevant stakeholders, including but not limited to demonstration project participants and the Minnesota Association of Resources for Recovery and Chemical Health, that shall meet at least quarterly for the duration of the demonstration to evaluate the long-term sustainability of any improvements to quality or access to substance use disorder treatment services caused by participation in the demonstration project. The work group shall also determine how to implement successful outcomes of the demonstration project once the project expires.

History:

1Sp2019 c 9 art 6 s 67; 2020 c 74 art 3 s 5,6; 1Sp2021 c 7 art 11 s 18-23; 2022 c 98 art 6 s 25; 2023 c 50 art 4 s 5; 2023 c 61 art 4 s 16; 2024 c 108 art 4 s 25,26; 1Sp2025 c 9 art 4 s 55; 2026 c 95 art 5 s 29,30