2006 Minnesota Statutes

256B.73 DEMONSTRATION PROJECT FOR UNINSURED LOW-INCOME PERSONS.
    Subdivision 1. Purpose. The purpose of the demonstration project is to determine the need
for and the feasibility of establishing a statewide program of medical insurance for uninsured
low-income persons.
    Subd. 2. Establishment; geographic area. The commissioner of human services shall
cooperate with a local coalition to establish a demonstration project to provide low cost medical
insurance to uninsured low-income persons in Cook, Crow Wing, Lake, St. Louis, Carlton,
Aitkin, Pine, Itasca, and Koochiching Counties except an individual county may be excluded
as determined by the county board of commissioners. The coalition shall work with the
commissioners of human services, commerce, and health and potential demonstration providers
as well as other public and private organizations to determine program design, including enrollee
eligibility requirements, benefits, and participation.
    Subd. 3. Definitions. For the purposes of this section, the following terms have the meanings
given:
(1) "coalition" means an organization comprised of members representative of small
business, health care providers, county social service departments, health consumer groups, and
the health industry, established to serve the purposes of this demonstration;
(2) "demonstration provider" means a corporation regulated under chapter 62A, 62C, or 62D;
(3) "individual provider" means a medical provider under contract to the demonstration
provider to provide medical care to enrollees; and
(4) "enrollee" means a person eligible to receive coverage according to subdivision 4.
    Subd. 4. Enrollee eligibility requirements. To be eligible for participation in the
demonstration project, an enrollee must:
(1) not be eligible for Medicare, medical assistance, or general assistance medical care; and
(2) have no medical insurance or health benefits plan available through employment or
other means that would provide coverage for the same medical services as provided by this
demonstration.
    Subd. 5. Enrollee benefits. (a) Eligible persons enrolled by a demonstration provider shall
receive a health services benefit package that includes health services which the enrollees might
reasonably require to be maintained in good health, including emergency care, inpatient hospital
and physician care, outpatient health services, and preventive health services.
(b) Services related to chemical dependency, mental illness, vision care, dental care, and
other benefits may be excluded or limited upon approval by the commissioners. The coalition
may petition the commissioner of commerce or health, whichever is appropriate, for waivers that
allow these benefits to be excluded or limited.
(c) The commissioners, the coalition, and demonstration providers shall work together to
design a package of benefits or packages of benefits that can be provided to enrollees for an
affordable monthly premium.
    Subd. 6. Enrollee participation. The demonstration provider may terminate the coverage
for an enrollee who has not made payment within the first ten calendar days of the month for
which coverage is being purchased. The termination for nonpayment shall be retroactive to
the first day of the month for which no payment has been made by the enrollee. The coalition
will assure that participants receive adequate information about the demonstration nature of the
project. The coalition will assist enrollees with finding alternative coverage at the conclusion of
the demonstration project.
    Subd. 7. Contract with coalition. The commissioner of human services shall contract
with the coalition to administer and direct the demonstration project and to select and retain the
demonstration provider for the duration of the project. This contract shall be for 24 months with
an option to renew for no more than 12 months. This contract may be canceled without cause by
the commissioner upon 90 days' written notice to the coalition or by the coalition with 90 days'
written notice to the commissioner. The commissioner shall assure the cooperation of the county
human services or social services staff in all counties participating in the project.
    Subd. 8. Medical assistance and general assistance medical care coordination. To
assure enrollees of uninterrupted delivery of health care services, the commissioner may pay the
premium to the demonstration provider for persons who become eligible for medical assistance
or general assistance medical care. To determine eligibility for medical assistance, any medical
expenses for eligible services incurred by the demonstration provider shall be considered as
evidence of satisfying the medical expense requirements of section 256B.056, subdivisions 4 and
5 . To determine eligibility for general assistance medical care, any medical expenses for eligible
services incurred by the demonstration provider shall be considered as evidence of satisfying the
medical expense requirements of section 256D.03, subdivision 3.
    Subd. 9. Waiver required. No part of the demonstration project shall become operational
until any required waivers of appropriate federal regulations are obtained from the Centers for
Medicare and Medicaid Services.
    Subd. 10.[Repealed, 1988 c 689 art 2 s 269]
History: 1987 c 337 s 123; 1988 c 689 art 2 s 184,268; 1990 c 454 s 1; 1990 c 568 art 3 s
85; 2002 c 277 s 32