2006 Minnesota Statutes

256B.27 MEDICAL ASSISTANCE; COST REPORTS.
    Subdivision 1. Reports and audits. In the interests of efficient administration of the medical
assistance to the needy program and incident to the approval of rates and charges therefor, the
commissioner of human services may require any reports, information, and audits of medical
vendors which the commissioner deems necessary.
    Subd. 2. Verification of report. All reports as to the costs of operations or of medical care
provided which are submitted by vendors of medical care for use in determining their rates or
reimbursement shall be submitted under oath as to the truthfulness of their contents by the vendor
or an officer or authorized representative of the vendor.
    Subd. 2a. On-site audits. Each year the commissioner shall provide for the on-site audit
of the cost reports of nursing homes participating as vendors of medical assistance. The
commissioner shall select for audit at least 15 percent of these nursing homes at random or using
factors including, but not limited to: change in ownership; frequent changes in administration
in excess of normal turnover rates; complaints to the commissioner of health about care, safety,
or rights; where previous inspections or reinspections under section 144A.10 have resulted in
correction orders related to care, safety, or rights; or where persons involved in ownership or
administration of the facility have been indicted for alleged criminal activity.
    Subd. 3. Access to medical records. The commissioner of human services, with the written
consent of the recipient, on file with the local welfare agency, shall be allowed access to all
personal medical records of medical assistance recipients solely for the purposes of investigating
whether or not: (a) a vendor of medical care has submitted a claim for reimbursement, a cost report
or a rate application which is duplicative, erroneous, or false in whole or in part, or which results
in the vendor obtaining greater compensation than the vendor is legally entitled to; or (b) the
medical care was medically necessary. The vendor of medical care shall receive notification from
the commissioner at least 24 hours before the commissioner gains access to such records. The
determination of provision of services not medically necessary shall be made by the commissioner.
The commissioner may consult with an advisory task force of vendors the commissioner may
appoint, on the recommendation of appropriate professional organizations. The task force expires
as provided in section 15.059, subdivision 6. Notwithstanding any other law to the contrary, a
vendor of medical care shall not be subject to any civil or criminal liability for providing access to
medical records to the commissioner of human services pursuant to this section.
    Subd. 4. Authorization of commissioner to examine records. A person determined to be
eligible for medical assistance shall be deemed to have authorized the commissioner of human
services in writing to examine, for the investigative purposes identified in subdivision 3, all
personal medical records developed while receiving medical assistance.
    Subd. 5. Private data. Medical records obtained by the commissioner of human services
pursuant to this section are private data, as defined in section 13.02, subdivision 12.
History: 1971 c 961 s 24; 1976 c 188 s 3; 1977 c 326 s 11; 1980 c 349 s 7,8; 1981 c 311 s
39; 1982 c 476 s 1; 1982 c 545 s 24; 1982 c 640 s 8; 1983 c 312 art 5 s 25,26; 1984 c 654 art 5 s
58; 1986 c 444; 1987 c 370 art 1 s 5,6; 1988 c 629 s 53; 1995 c 207 art 11 s 6