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2007 Minnesota Statutes

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256D.03 RESPONSIBILITY TO PROVIDE GENERAL ASSISTANCE.
    Subdivision 1. County administration. Every county agency shall provide general
assistance to persons residing within its jurisdiction who meet the need requirements of sections
256D.01 to 256D.21. General assistance shall be administered by the county agencies according
to law and rules promulgated by the commissioner pursuant to sections 14.001 to 14.69.
    Subd. 2. Assistance standards. State aid shall be paid for all general assistance and grants
up to the standards of section 256D.01, subdivision 1a, and according to procedures established
by the commissioner, except as provided for under section 256.017.
    Subd. 2a. County agency options. Any county agency may, from its own resources, make
payments of general assistance: (a) at a standard higher than that established by the commissioner
without reference to the standards of section 256D.01, subdivision 1; or (b) to persons not meeting
the eligibility standards set forth in section 256D.05, subdivision 1, but for whom the aid would
further the purposes established in the general assistance program according to rules adopted by
the commissioner according to the Administrative Procedure Act. The Minnesota Department
of Human Services may maintain client records and issue these payments, providing the cost of
benefits is paid by the counties to the Department of Human Services according to section 256.01.
    Subd. 3. General assistance medical care; eligibility. (a) General assistance medical care
may be paid for any person who is not eligible for medical assistance under chapter 256B,
including eligibility for medical assistance based on a spenddown of excess income according
to section 256B.056, subdivision 5, or MinnesotaCare as defined in paragraph (b), except as
provided in paragraph (c), and:
    (1) who is receiving assistance under section 256D.05, except for families with children who
are eligible under Minnesota family investment program (MFIP), or who is having a payment
made on the person's behalf under sections 256I.01 to 256I.06; or
    (2) who is a resident of Minnesota; and
    (i) who has gross countable income not in excess of 75 percent of the federal poverty
guidelines for the family size, using a six-month budget period and whose equity in assets is
not in excess of $1,000 per assistance unit. General assistance medical care is not available for
applicants or enrollees who are otherwise eligible for medical assistance but fail to verify their
assets. Enrollees who become eligible for medical assistance shall be terminated and transferred
to medical assistance. Exempt assets, the reduction of excess assets, and the waiver of excess
assets must conform to the medical assistance program in section 256B.056, subdivision 3,
with the following exception: the maximum amount of undistributed funds in a trust that could
be distributed to or on behalf of the beneficiary by the trustee, assuming the full exercise of the
trustee's discretion under the terms of the trust, must be applied toward the asset maximum;
    (ii) who has gross countable income above 75 percent of the federal poverty guidelines
but not in excess of 175 percent of the federal poverty guidelines for the family size, using a
six-month budget period, whose equity in assets is not in excess of the limits in section 256B.056,
subdivision 3c
, and who applies during an inpatient hospitalization; or
    (iii) the commissioner shall adjust the income standards under this section each July 1 by
the annual update of the federal poverty guidelines following publication by the United States
Department of Health and Human Services.
    (b) Effective for applications and renewals processed on or after September 1, 2006, general
assistance medical care may not be paid for applicants or recipients who are adults with dependent
children under 21 whose gross family income is equal to or less than 275 percent of the federal
poverty guidelines who are not described in paragraph (e).
    (c) Effective for applications and renewals processed on or after September 1, 2006, general
assistance medical care may be paid for applicants and recipients who meet all eligibility
requirements of paragraph (a), clause (2), item (i), for a temporary period beginning the date
of application. Immediately following approval of general assistance medical care, enrollees
shall be enrolled in MinnesotaCare under section 256L.04, subdivision 7, with covered services
as provided in section 256L.03 for the rest of the six-month general assistance medical care
eligibility period, until their six-month renewal.
    (d) To be eligible for general assistance medical care following enrollment in MinnesotaCare
as required by paragraph (c), an individual must complete a new application.
    (e) Applicants and recipients eligible under paragraph (a), clause (1); who have applied for
and are awaiting a determination of blindness or disability by the state medical review team or
a determination of eligibility for Supplemental Security Income or Social Security Disability
Insurance by the Social Security Administration; who fail to meet the requirements of section
256L.09, subdivision 2; who are homeless as defined by United States Code, title 42, section
11301, et seq.; who are classified as end-stage renal disease beneficiaries in the Medicare program;
who are enrolled in private health care coverage as defined in section 256B.02, subdivision 9; who
are eligible under paragraph (j); or who receive treatment funded pursuant to section 254B.02 are
exempt from the MinnesotaCare enrollment requirements of this subdivision.
    (f) For applications received on or after October 1, 2003, eligibility may begin no earlier
than the date of application. For individuals eligible under paragraph (a), clause (2), item (i),
a redetermination of eligibility must occur every 12 months. Individuals are eligible under
paragraph (a), clause (2), item (ii), only during inpatient hospitalization but may reapply if there is
a subsequent period of inpatient hospitalization.
    (g) Beginning September 1, 2006, Minnesota health care program applications and renewals
completed by recipients and applicants who are persons described in paragraph (c) and submitted
to the county agency shall be determined for MinnesotaCare eligibility by the county agency.
If all other eligibility requirements of this subdivision are met, eligibility for general assistance
medical care shall be available in any month during which MinnesotaCare enrollment is pending.
Upon notification of eligibility for MinnesotaCare, notice of termination for eligibility for
general assistance medical care shall be sent to an applicant or recipient. If all other eligibility
requirements of this subdivision are met, eligibility for general assistance medical care shall be
available until enrollment in MinnesotaCare subject to the provisions of paragraphs (c), (e),
and (f).
    (h) The date of an initial Minnesota health care program application necessary to begin a
determination of eligibility shall be the date the applicant has provided a name, address, and
Social Security number, signed and dated, to the county agency or the Department of Human
Services. If the applicant is unable to provide a name, address, Social Security number, and
signature when health care is delivered due to a medical condition or disability, a health care
provider may act on an applicant's behalf to establish the date of an initial Minnesota health care
program application by providing the county agency or Department of Human Services with
provider identification and a temporary unique identifier for the applicant. The applicant must
complete the remainder of the application and provide necessary verification before eligibility can
be determined. The county agency must assist the applicant in obtaining verification if necessary.
    (i) County agencies are authorized to use all automated databases containing information
regarding recipients' or applicants' income in order to determine eligibility for general assistance
medical care or MinnesotaCare. Such use shall be considered sufficient in order to determine
eligibility and premium payments by the county agency.
    (j) General assistance medical care is not available for a person in a correctional facility
unless the person is detained by law for less than one year in a county correctional or detention
facility as a person accused or convicted of a crime, or admitted as an inpatient to a hospital on a
criminal hold order, and the person is a recipient of general assistance medical care at the time the
person is detained by law or admitted on a criminal hold order and as long as the person continues
to meet other eligibility requirements of this subdivision.
    (k) General assistance medical care is not available for applicants or recipients who do not
cooperate with the county agency to meet the requirements of medical assistance.
    (l) In determining the amount of assets of an individual eligible under paragraph (a), clause
(2), item (i), there shall be included any asset or interest in an asset, including an asset excluded
under paragraph (a), that was given away, sold, or disposed of for less than fair market value
within the 60 months preceding application for general assistance medical care or during the
period of eligibility. Any transfer described in this paragraph shall be presumed to have been for
the purpose of establishing eligibility for general assistance medical care, unless the individual
furnishes convincing evidence to establish that the transaction was exclusively for another
purpose. For purposes of this paragraph, the value of the asset or interest shall be the fair market
value at the time it was given away, sold, or disposed of, less the amount of compensation
received. For any uncompensated transfer, the number of months of ineligibility, including partial
months, shall be calculated by dividing the uncompensated transfer amount by the average
monthly per person payment made by the medical assistance program to skilled nursing facilities
for the previous calendar year. The individual shall remain ineligible until this fixed period has
expired. The period of ineligibility may exceed 30 months, and a reapplication for benefits after
30 months from the date of the transfer shall not result in eligibility unless and until the period of
ineligibility has expired. The period of ineligibility begins in the month the transfer was reported
to the county agency, or if the transfer was not reported, the month in which the county agency
discovered the transfer, whichever comes first. For applicants, the period of ineligibility begins
on the date of the first approved application.
    (m) When determining eligibility for any state benefits under this subdivision, the income
and resources of all noncitizens shall be deemed to include their sponsor's income and resources
as defined in the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, title
IV, Public Law 104-193, sections 421 and 422, and subsequently set out in federal rules.
    (n) Undocumented noncitizens and nonimmigrants are ineligible for general assistance
medical care. For purposes of this subdivision, a nonimmigrant is an individual in one or more
of the classes listed in United States Code, title 8, section 1101(a)(15), and an undocumented
noncitizen is an individual who resides in the United States without the approval or acquiescence
of the United States Citizenship and Immigration Services.
    (o) Notwithstanding any other provision of law, a noncitizen who is ineligible for medical
assistance due to the deeming of a sponsor's income and resources, is ineligible for general
assistance medical care.
    (p) Effective July 1, 2003, general assistance medical care emergency services end.
    Subd. 3a. Claims; assignment of benefits. Claims must be filed pursuant to section
256D.16. General assistance medical care applicants and recipients must apply or agree to apply
third party health and accident benefits to the costs of medical care. They must cooperate with
the state in establishing paternity and obtaining third party payments. By accepting general
assistance, a person assigns to the Department of Human Services all rights to medical support or
payments for medical expenses from another person or entity on their own or their dependent's
behalf and agrees to cooperate with the state in establishing paternity and obtaining third party
payments. The application shall contain a statement explaining the assignment. Any rights or
amounts assigned shall be applied against the cost of medical care paid for under this chapter. An
assignment is effective on the date general assistance medical care eligibility takes effect.
    Subd. 3b. Cooperation. (a) General assistance or general assistance medical care applicants
and recipients must cooperate with the state and local agency to identify potentially liable
third-party payors and assist the state in obtaining third-party payments. Cooperation includes
identifying any third party who may be liable for care and services provided under this chapter to
the applicant, recipient, or any other family member for whom application is made and providing
relevant information to assist the state in pursuing a potentially liable third party. General
assistance medical care applicants and recipients must cooperate by providing information about
any group health plan in which they may be eligible to enroll. They must cooperate with the state
and local agency in determining if the plan is cost-effective. For purposes of this subdivision,
coverage provided by the Minnesota Comprehensive Health Association under chapter 62E shall
not be considered group health plan coverage or cost-effective by the state and local agency. If the
plan is determined cost-effective and the premium will be paid by the state or local agency or is
available at no cost to the person, they must enroll or remain enrolled in the group health plan.
Cost-effective insurance premiums approved for payment by the state agency and paid by the
local agency are eligible for reimbursement according to subdivision 6.
(b) Effective for all premiums due on or after June 30, 1997, general assistance medical
care does not cover premiums that a recipient is required to pay under a qualified or Medicare
supplement plan issued by the Minnesota Comprehensive Health Association. General assistance
medical care shall continue to cover premiums for recipients who are covered under a plan issued
by the Minnesota Comprehensive Health Association on June 30, 1997, for a period of six months
following receipt of the notice of termination or until December 31, 1997, whichever is later.
    Subd. 4. General assistance medical care; services. (a)(i) For a person who is eligible
under subdivision 3, paragraph (a), clause (2), item (i), general assistance medical care covers,
except as provided in paragraph (c):
    (1) inpatient hospital services;
    (2) outpatient hospital services;
    (3) services provided by Medicare certified rehabilitation agencies;
    (4) prescription drugs and other products recommended through the process established in
section 256B.0625, subdivision 13;
    (5) equipment necessary to administer insulin and diagnostic supplies and equipment for
diabetics to monitor blood sugar level;
    (6) eyeglasses and eye examinations provided by a physician or optometrist;
    (7) hearing aids;
    (8) prosthetic devices;
    (9) laboratory and X-ray services;
    (10) physician's services;
    (11) medical transportation except special transportation;
    (12) chiropractic services as covered under the medical assistance program;
    (13) podiatric services;
    (14) dental services as covered under the medical assistance program;
    (15) mental health services covered under chapter 256B;
    (16) prescribed medications for persons who have been diagnosed as mentally ill as
necessary to prevent more restrictive institutionalization;
    (17) medical supplies and equipment, and Medicare premiums, coinsurance and deductible
payments;
    (18) medical equipment not specifically listed in this paragraph when the use of the
equipment will prevent the need for costlier services that are reimbursable under this subdivision;
    (19) services performed by a certified pediatric nurse practitioner, a certified family
nurse practitioner, a certified adult nurse practitioner, a certified obstetric/gynecological nurse
practitioner, a certified neonatal nurse practitioner, or a certified geriatric nurse practitioner in
independent practice, if (1) the service is otherwise covered under this chapter as a physician
service, (2) the service provided on an inpatient basis is not included as part of the cost for
inpatient services included in the operating payment rate, and (3) the service is within the scope of
practice of the nurse practitioner's license as a registered nurse, as defined in section 148.171;
    (20) services of a certified public health nurse or a registered nurse practicing in a public
health nursing clinic that is a department of, or that operates under the direct authority of, a unit of
government, if the service is within the scope of practice of the public health nurse's license as a
registered nurse, as defined in section 148.171;
    (21) telemedicine consultations, to the extent they are covered under section 256B.0625,
subdivision 3b
;
    (22) care coordination and patient education services provided by a community health
worker according to section 256B.0625, subdivision 49; and
    (23) regardless of the number of employees that an enrolled health care provider may have,
sign language interpreter services when provided by an enrolled health care provider during the
course of providing a direct, person-to-person covered health care service to an enrolled recipient
who has a hearing loss and uses interpreting services.
    (ii) Effective October 1, 2003, for a person who is eligible under subdivision 3, paragraph
(a), clause (2), item (ii), general assistance medical care coverage is limited to inpatient hospital
services, including physician services provided during the inpatient hospital stay. A $1,000
deductible is required for each inpatient hospitalization.
    (b) Effective August 1, 2005, sex reassignment surgery is not covered under this subdivision.
    (c) In order to contain costs, the commissioner of human services shall select vendors of
medical care who can provide the most economical care consistent with high medical standards
and shall where possible contract with organizations on a prepaid capitation basis to provide
these services. The commissioner shall consider proposals by counties and vendors for prepaid
health plans, competitive bidding programs, block grants, or other vendor payment mechanisms
designed to provide services in an economical manner or to control utilization, with safeguards to
ensure that necessary services are provided. Before implementing prepaid programs in counties
with a county operated or affiliated public teaching hospital or a hospital or clinic operated by the
University of Minnesota, the commissioner shall consider the risks the prepaid program creates
for the hospital and allow the county or hospital the opportunity to participate in the program in
a manner that reflects the risk of adverse selection and the nature of the patients served by the
hospital, provided the terms of participation in the program are competitive with the terms of
other participants considering the nature of the population served. Payment for services provided
pursuant to this subdivision shall be as provided to medical assistance vendors of these services
under sections 256B.02, subdivision 8, and 256B.0625. For payments made during fiscal year
1990 and later years, the commissioner shall consult with an independent actuary in establishing
prepayment rates, but shall retain final control over the rate methodology.
    (d) Effective January 1, 2008, drug coverage under general assistance medical care is limited
to prescription drugs that:
    (i) are covered under the medical assistance program as described in section 256B.0625,
subdivisions 13
and 13d; and
    (ii) are provided by manufacturers that have fully executed general assistance medical care
rebate agreements with the commissioner and comply with the agreements. Prescription drug
coverage under general assistance medical care must conform to coverage under the medical
assistance program according to section 256B.0625, subdivisions 13 to 13g.
     (e) Recipients eligible under subdivision 3, paragraph (a), shall pay the following
co-payments for services provided on or after October 1, 2003, and before January 1, 2009:
    (1) $25 for eyeglasses;
    (2) $25 for nonemergency visits to a hospital-based emergency room;
    (3) $3 per brand-name drug prescription and $1 per generic drug prescription, subject to
a $12 per month maximum for prescription drug co-payments. No co-payments shall apply to
antipsychotic drugs when used for the treatment of mental illness; and
    (4) 50 percent coinsurance on restorative dental services.
    (f) Recipients eligible under subdivision 3, paragraph (a), shall include the following
co-payments for services provided on or after January 1, 2009:
    (1) $25 for nonemergency visits to a hospital-based emergency room; and
    (2) $3 per brand-name drug prescription and $1 per generic drug prescription, subject to
a $7 per month maximum for prescription drug co-payments. No co-payments shall apply to
antipsychotic drugs when used for the treatment of mental illness.
    (g) Co-payments shall be limited to one per day per provider for nonpreventive visits,
eyeglasses, and nonemergency visits to a hospital-based emergency room. Recipients of general
assistance medical care are responsible for all co-payments in this subdivision. The general
assistance medical care reimbursement to the provider shall be reduced by the amount of the
co-payment, except that reimbursement for prescription drugs shall not be reduced once a
recipient has reached the $12 per month maximum for prescription drug co-payments. The
provider collects the co-payment from the recipient. Providers may not deny services to recipients
who are unable to pay the co-payment. This paragraph expires January 1, 2009.
    (h) Effective January 1, 2009, co-payments shall be limited to one per day per provider
for nonemergency visits to a hospital-based emergency room. Recipients of general assistance
medical care are responsible for all co-payments in this subdivision. The general assistance
medical care reimbursement to the provider shall be reduced by the amount of the co-payment,
except that reimbursement for prescription drugs shall not be reduced once a recipient has
reached the $7 per month maximum for prescription drug co-payments. The provider collects the
co-payment from the recipient. Providers may not deny services to recipients who are unable to
pay the co-payment.
    (i) General assistance medical care reimbursement to fee-for-service providers and payments
to managed care plans shall not be increased as a result of the removal of the co-payments
effective January 1, 2009.
    (j) Any county may, from its own resources, provide medical payments for which state
payments are not made.
    (k) Chemical dependency services that are reimbursed under chapter 254B must not be
reimbursed under general assistance medical care.
    (l) The maximum payment for new vendors enrolled in the general assistance medical care
program after the base year shall be determined from the average usual and customary charge of
the same vendor type enrolled in the base year.
    (m) The conditions of payment for services under this subdivision are the same as the
conditions specified in rules adopted under chapter 256B governing the medical assistance
program, unless otherwise provided by statute or rule.
     (n) Inpatient and outpatient payments shall be reduced by five percent, effective July 1, 2003.
This reduction is in addition to the five percent reduction effective July 1, 2003, and incorporated
by reference in paragraph (l).
    (o) Payments for all other health services except inpatient, outpatient, and pharmacy services
shall be reduced by five percent, effective July 1, 2003.
    (p) Payments to managed care plans shall be reduced by five percent for services provided
on or after October 1, 2003.
    (q) A hospital receiving a reduced payment as a result of this section may apply the unpaid
balance toward satisfaction of the hospital's bad debts.
    (r) Fee-for-service payments for nonpreventive visits shall be reduced by $3 for services
provided on or after January 1, 2006. For purposes of this subdivision, a visit means an episode of
service which is required because of a recipient's symptoms, diagnosis, or established illness, and
which is delivered in an ambulatory setting by a physician or physician ancillary, chiropractor,
podiatrist, advance practice nurse, audiologist, optician, or optometrist.
    (s) Payments to managed care plans shall not be increased as a result of the removal of the
$3 nonpreventive visit co-payment effective January 1, 2006.
    (t) Payments for mental health services added as covered benefits after December 31, 2007,
are not subject to the reductions in paragraphs (l), (n), (o), and (p).
    Subd. 5. Certain county agencies to pay state for county share. The county agencies that
contract with the commissioner of human services for state administration of general assistance
medical care payments shall make payment to the state for the county share of those payments in
the manner described for medical assistance advances in section 256B.041, subdivision 5.
    Subd. 6. Division of costs. The state share of county agency expenditures for general
assistance medical care shall be 100 percent. Payments made under this subdivision shall be made
according to sections 256B.041, subdivision 5 and 256B.19, subdivision 1. In counties where a
pilot or demonstration project is operated for general assistance medical care services, the state
may pay 100 percent of the costs of administering the pilot or demonstration project.
Notwithstanding any provision to the contrary, beginning July 1, 1991, the state shall pay
100 percent of the costs for centralized claims processing by the Department of Administration
relative to claims beginning January 1, 1991, and submitted on behalf of general assistance
medical care recipients by vendors in the general assistance medical care program.
Beginning July 1, 1991, the state shall reimburse counties up to the limit of state
appropriations for general assistance medical care common carrier transportation and related
travel expenses provided for medical purposes after December 31, 1990. For purposes of this
subdivision, transportation shall have the meaning given it in Code of Federal Regulations, title
42, section 440.170(a), as amended through October 1, 1987, and travel expenses shall have
the meaning given in Code of Federal Regulations, title 42, section 440.170(a)(3), as amended
through October 1, 1987.
The county shall ensure that only the least costly most appropriate transportation and travel
expenses are used. The state may enter into volume purchase contracts, or use a competitive
bidding process, whenever feasible, to minimize the costs of transportation services. If the
state has entered into a volume purchase contract or used the competitive bidding procedures
of chapter 16C to arrange for transportation services, the county may be required to use such
arrangements to be eligible for state reimbursement for general assistance medical care common
carrier transportation and related travel expenses provided for medical purposes.
In counties where prepaid health plans are under contract to the commissioner to provide
services to general assistance medical care recipients, the cost of court ordered treatment that does
not include diagnostic evaluation, recommendation, or referral for treatment by the prepaid health
plan is the responsibility of the county of financial responsibility.
    Subd. 7. Duties of the commissioner. The commissioner shall promulgate rules as necessary
to establish:
(a) standards of eligibility, utilization of services, and payment levels;
(b) standards for quality assurance, surveillance, and utilization review procedures that
conform to those established for the medical assistance program pursuant to chapter 256B,
including general criteria and procedures for the identification and prompt investigation of
suspected fraud, theft, abuse, presentment of false or duplicate claims, presentment of claims for
services not medically necessary, or false statements or representations of material facts by a
vendor or recipient of general assistance medical care, and for the imposition of sanctions against
such vendor or recipient of medical care. The rules relating to sanctions shall be consistent with
the provisions of section 256B.064, subdivisions 1a and 2; and
(c) administrative and fiscal procedures for payment of the state share of the medical costs
incurred by the counties under section 256D.02, subdivision 4a. Rules promulgated pursuant to
this clause may include: (1) procedures by which state liability for the costs of medical care
incurred pursuant to section 256D.02, subdivision 4a may be deducted from county liability to the
state under any other public assistance program authorized by law; (2) procedures for processing
claims of counties for reimbursement by the state for expenditures for medical care made by the
counties pursuant to section 256D.02, subdivision 4a; and (3) procedures by which the county
agencies may contract with the commissioner of human services for state administration of
general assistance medical care payments.
    Subd. 8. Private insurance policies. (a) Private accident and health care coverage for
medical services is primary coverage and must be exhausted before general assistance medical
care is paid. When a person who is otherwise eligible for general assistance medical care has
private accident or health care coverage, including a prepaid health plan, the private health care
benefits available to the person must be used first and to the fullest extent. General assistance
medical care payment will not be made when either covered charges are paid in full by a third
party or the provider has an agreement to accept payment for less than charges as payment in full.
Payment for patients that are simultaneously covered by general assistance medical care and a
liable third party other than Medicare will be determined as the lesser of clauses (1) to (3):
(1) the patient liability according to the provider/insurer agreement;
(2) covered charges minus the third party payment amount; or
(3) the general assistance medical care rate minus the third party payment amount.
A negative difference will not be implemented.
(b) When a parent or a person with an obligation of support has enrolled in a prepaid health
care plan under section 518A.41, subdivision 1, the commissioner of human services shall limit
the recipient of general assistance medical care to the benefits payable under that prepaid health
care plan to the extent that services available under general assistance medical care are also
available under the prepaid health care plan.
(c) Upon furnishing general assistance medical care or general assistance to any person
having private accident or health care coverage, or having a cause of action arising out of an
occurrence that necessitated the payment of assistance, the state agency shall be subrogated, to
the extent of the cost of medical care, subsistence, or other payments furnished, to any rights the
person may have under the terms of the coverage or under the cause of action. For purposes of this
subdivision, "state agency" includes prepaid health plans under contract with the commissioner
according to subdivision 4, paragraph (c), and sections 256B.69 and 256L.12; children's mental
health collaboratives under section 245.493; demonstration projects for persons with disabilities
under section 256B.77; nursing homes under the alternative payment demonstration project under
section 256B.434; and county-based purchasing entities under section 256B.692.
This right of subrogation includes all portions of the cause of action, notwithstanding any
settlement allocation or apportionment that purports to dispose of portions of the cause of action
not subject to subrogation.
(d) To recover under this section, the attorney general may institute or join a civil action to
enforce the subrogation rights the commissioner established under this section.
Any prepaid health plan providing services under subdivision 4, paragraph (c), and
sections 256B.69 and 256L.12; children's mental health collaboratives under section 245.493;
demonstration projects for persons with disabilities under section 256B.77; nursing homes under
the alternative payment demonstration project under section 256B.434; or the county-based
purchasing entity providing services under section 256B.692 may retain legal representation to
enforce the subrogation rights created under this section or, if no action has been brought, may
initiate and prosecute an independent action on their behalf against a person, firm, or corporation
that may be liable to the person to whom the care or payment was furnished.
(e) The state agency must be given notice of monetary claims against a person, firm, or
corporation that may be liable in damages, or otherwise obligated to pay part or all of the costs
related to an injury when the state agency has paid or become liable for the cost of care or
payments related to the injury. Notice must be given as follows:
(i) Applicants for general assistance or general assistance medical care shall notify the
state or county agency of any possible claims when they submit the application. Recipients of
general assistance or general assistance medical care shall notify the state or county agency of
any possible claims when those claims arise.
(ii) A person providing medical care services to a recipient of general assistance medical
care shall notify the state agency when the person has reason to believe that a third party may be
liable for payment of the cost of medical care.
(iii) A person who is party to a claim upon which the state agency may be entitled to
subrogation under this section shall notify the state agency of its potential subrogation claim
before filing a claim, commencing an action, or negotiating a settlement. A person who is a party
to a claim includes the plaintiff, the defendants, and any other party to the cause of action.
Notice given to the county agency is not sufficient to meet the requirements of paragraphs
(b) and (c).
(f) Upon any judgment, award, or settlement of a cause of action, or any part of it,
upon which the state agency has a subrogation right, including compensation for liquidated,
unliquidated, or other damages, reasonable costs of collection, including attorney fees, must be
deducted first. The full amount of general assistance or general assistance medical care paid to or
on behalf of the person as a result of the injury must be deducted next and paid to the state agency.
The rest must be paid to the public assistance recipient or other plaintiff. The plaintiff, however,
must receive at least one-third of the net recovery after attorney fees and collection costs.
    Subd. 9. Payment for ambulance services. Effective for services rendered on or after July
1, 1999, general assistance medical care payments for ambulance services shall be increased
by five percent.
History: 1973 c 650 art 21 s 3; 1975 c 437 art 2 s 8; 1976 c 186 s 1; 1979 c 303 art 2 s 2;
1980 c 349 s 9; 1980 c 536 s 8-10; 1980 c 607 art 2 s 3; 1981 c 360 art 2 s 2 subd 4,34; 1Sp1981
c 2 s 16 subd 2; 1Sp1981 c 4 art 4 s 21; 1982 c 424 s 130; 1982 c 623 s 2; 1983 c 312 art 5 s
29-33; 1984 c 640 s 32; 1984 c 654 art 5 s 30,58; 1Sp1985 c 9 art 2 s 57,58; 1Sp1985 c 14 art 9 s
29; 1986 c 394 s 19; 1987 c 370 art 2 s 15; 1987 c 384 art 2 s 1; 1987 c 403 art 2 s 103-105; art 3
s 30; 1988 c 689 art 2 s 188,268; 1988 c 719 art 8 s 18,19; 1989 c 209 art 1 s 24; 1989 c 282 art
3 s 91,92; art 5 s 49; 1Sp1989 c 1 art 16 s 10,11; 1990 c 422 s 10; 1990 c 568 art 3 s 86-89; art 4
s 25,84; 1991 c 292 art 4 s 68,69; art 5 s 30,31; 1992 c 513 art 7 s 127,128; art 8 s 17; 1993 c
345 art 9 s 15; 1Sp1993 c 1 art 5 s 113,114; art 6 s 28; art 8 s 3; 1995 c 178 art 2 s 28; art 6 s 17;
1995 c 207 art 6 s 104-106; 1996 c 451 art 5 s 33; 1996 c 465 art 3 s 29-31; 1997 c 7 art 5 s 32;
1997 c 85 art 3 s 29; 1997 c 203 art 4 s 57; art 11 s 8-10; art 12 s 4; 1997 c 225 art 1 s 19; art 6 s
6,8; 1998 c 386 art 2 s 81; 1998 c 407 art 4 s 55,56; art 5 s 6; 1999 c 245 art 4 s 86-88; art 10 s
10; 2000 c 340 s 14; 2000 c 488 art 11 s 8; 2001 c 203 s 15; 1Sp2001 c 9 art 2 s 56; art 10 s
66; 2002 c 277 s 32; 2002 c 379 art 1 s 113; 1Sp2003 c 14 art 2 s 41; art 12 s 68,69; 1Sp2003 c
23 s 30; 2004 c 228 art 1 s 43; 2004 c 288 art 6 s 23,24; 2005 c 98 art 2 s 14; 2005 c 164 s 29;
1Sp2005 c 4 art 2 s 15; art 8 s 52,53; 1Sp2005 c 7 s 28; 2006 c 280 s 46; 2006 c 282 art 16 s
11; 2007 c 13 art 1 s 25; 2007 c 147 art 5 s 16,17; art 8 s 28
NOTE:The amendment to subdivision 4, paragraph (a), clause (i), item (15), by Laws
2007, chapter 147, article 8, section 28, is effective January 1, 2009. Laws 2007, chapter 147,
article 8, section 28, the effective date.

700 State Office Building, 100 Rev. Dr. Martin Luther King Jr. Blvd., St. Paul, MN 55155 ♦ Phone: (651) 296-2868 ♦ TTY: 1-800-627-3529 ♦ Fax: (651) 296-0569