2005 Minnesota Statutes

     256B.19 Division of cost. 

    Subdivision 1.    Division of cost.  The state and 
 county share of medical assistance costs not paid by federal 
 funds shall be as follows:  

    (1) beginning January 1, 1992, 50 percent state funds and 
 50 percent county funds for the cost of placement of severely 
 emotionally disturbed children in regional treatment centers; 

    (2) beginning January 1, 2003, 80 percent state funds and 
 20 percent county funds for the costs of nursing facility 
 placements of persons with disabilities under the age of 65 that 
 have exceeded 90 days.  This clause shall be subject to chapter 
 256G and shall not apply to placements in facilities not 
 certified to participate in medical assistance; 

    (3) beginning July 1, 2004, 90 percent state funds and ten 
 percent county funds for the costs of placements that have 
 exceeded 90 days in intermediate care facilities for persons 
 with mental retardation or a related condition that have seven 
 or more beds.  This provision includes pass-through payments 
 made under section 256B.5015; and 

    (4) beginning July 1, 2004, when state funds are used to 
 pay for a nursing facility placement due to the facility's 
 status as an institution for mental diseases (IMD), the county 
 shall pay 20 percent of the nonfederal share of costs that have 
 exceeded 90 days.  This clause is subject to chapter 256G. 

    For counties that participate in a Medicaid demonstration 
 project under sections 256B.69 and 256B.71, the division of the 
 nonfederal share of medical assistance expenses for payments 
 made to prepaid health plans or for payments made to health 
 maintenance organizations in the form of prepaid capitation 
 payments, this division of medical assistance expenses shall be 
 95 percent by the state and five percent by the county of 
 financial responsibility.  

    In counties where prepaid health plans are under contract 
 to the commissioner to provide services to medical assistance 
 recipients, the cost of court ordered treatment ordered without 
 consulting the prepaid health plan that does not include 
 diagnostic evaluation, recommendation, and referral for 
 treatment by the prepaid health plan is the responsibility of 
 the county of financial responsibility. 

    Subd. 1a. Repealed, 2002 c 277 s 34 

    Subd. 1b. Repealed, 1Sp2001 c 9 art 2 s 76 

    Subd. 1c.    Additional portion of nonfederal share.  (a)
 Hennepin County shall be responsible for a monthly transfer 
 payment of $1,500,000, due before noon on the 15th of each month 
 and the University of Minnesota shall be responsible for a 
 monthly transfer payment of $500,000 due before noon on the 15th 
 of each month, beginning July 15, 1995.  These sums shall be 
 part of the designated governmental unit's portion of the 
 nonfederal share of medical assistance costs. 

    (b) Beginning July 1, 2001, Hennepin County's payment under 
 paragraph (a) shall be $2,066,000 each month. 

    (c) Beginning July 1, 2001, the commissioner shall increase 
 annual capitation payments to the metropolitan health plan under 
 section 256B.69 for the prepaid medical assistance program by 
 approximately $3,400,000, plus any available federal matching 
 funds, to recognize higher than average medical education costs. 

    (d) Effective August 1, 2005, Hennepin County's payment 
 under paragraphs (a) and (b) shall be reduced to $566,000, and 
 the University of Minnesota's payment under paragraph (a) shall 
 be reduced to zero. 

    Subd. 1d.    Portion of nonfederal share to be paid by 
 certain counties.  (a) In addition to the percentage 
 contribution paid by a county under subdivision 1, the 
 governmental units designated in this subdivision shall be 
 responsible for an additional portion of the nonfederal share of 
 medical assistance cost.  For purposes of this subdivision, 
 "designated governmental unit" means the counties of Becker, 
 Beltrami, Clearwater, Cook, Dodge, Hubbard, Itasca, Lake, 
 Pennington, Pipestone, Ramsey, St. Louis, Steele, Todd, 
 Traverse, and Wadena. 

    (b) Beginning in 1994, each of the governmental units 
 designated in this subdivision shall transfer before noon on May 
 31 to the state Medicaid agency an amount equal to the number of 
 licensed beds in any nursing home owned and operated by the 
 county on that date, with the county named as licensee, 
 multiplied by $5,723.  If two or more counties own and operate a 
 nursing home, the payment shall be prorated.  These sums shall 
 be part of the designated governmental unit's portion of the 
 nonfederal share of medical assistance costs. 

    (c) Beginning in 2002, in addition to any transfer under 
 paragraph (b), each of the governmental units designated in this 
 subdivision shall transfer before noon on May 31 to the state 
 Medicaid agency an amount equal to the number of licensed beds 
 in any nursing home owned and operated by the county on that 
 date, with the county named as licensee, multiplied by $10,784.  
 The provisions of paragraph (b) apply to transfers under this 
 paragraph. 

    (d) Beginning in 2003, in addition to any transfer under 
 paragraphs (b) and (c), each of the governmental units 
 designated in this subdivision shall transfer before noon on May 
 31 to the state Medicaid agency an amount equal to the number of 
 licensed beds in any nursing home owned and operated by the 
 county on that date, with the county named as licensee, 
 multiplied by $2,230.  The provisions of paragraph (b) apply to 
 transfers under this paragraph. 

    (e) The commissioner may reduce the intergovernmental 
 transfers under paragraphs (c) and (d) based on the 
 commissioner's determination of the payment rate in section 
 256B.431, subdivision 23, paragraphs (c), (d), and (e).  Any 
 adjustments must be made on a per-bed basis and must result in 
 an amount equivalent to the total amount resulting from the rate 
 adjustment in section 256B.431, subdivision 23, paragraphs (c), 
 (d), and (e). 

    Subd. 2.    Distribution of federal funds.  Federal 
 funds available for administrative purposes shall be distributed 
 between the state and the county in the same proportion that 
 expenditures were made, except as provided for in section 
 256.017.  

    Subd. 2a.    Division of costs.  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. 

    Subd. 2b.    Pilot project reimbursement.  In counties 
 where a pilot or demonstration project is operated under the 
 medical assistance program, the state may pay 100 percent of the 
 administrative costs for the pilot or demonstration project 
 after June 30, 1990.  

    Subd. 2c.    Obligation of local agency to investigate and 
 determine eligibility for medical assistance.  (a) When the 
 commissioner receives information that indicates that a general 
 assistance medical care recipient or MinnesotaCare program 
 enrollee may be eligible for medical assistance, the 
 commissioner may notify the appropriate local agency of that 
 fact.  The local agency must investigate eligibility for medical 
 assistance and take appropriate action and notify the 
 commissioner of that action within 90 days from the date notice 
 is issued.  If the person is eligible for medical assistance, 
 the local agency must find eligibility retroactively to the date 
 on which the person met all eligibility requirements. 

    (b) When a prepaid health plan under a contract with the 
 state to provide medical assistance services notifies the 
 commissioner that an infant has been or will be born to an 
 enrollee under the contract, the commissioner may notify the 
 appropriate local agency of that fact.  The local agency must 
 investigate eligibility for medical assistance for the infant, 
 take appropriate action, and notify the commissioner of that 
 action within 90 days from the date notice is issued.  If the 
 infant would have been eligible on the date of birth, the local 
 agency must establish eligibility retroactively to that month. 

    (c) For general assistance medical care recipients and 
 MinnesotaCare program enrollees, if the local agency fails to 
 comply with paragraph (a), the local agency is responsible for 
 the entire cost of general assistance medical care or 
 MinnesotaCare program services provided from the date the 
 commissioner issues the notice until the date the local agency 
 takes appropriate action on the case and notifies the 
 commissioner of the action.  For infants, if the local agency 
 fails to comply with paragraph (b), the commissioner may 
 determine eligibility for medical assistance for the infant for 
 a period of two months, and the local agency shall be 
 responsible for the entire cost of medical assistance services 
 provided for that infant, in addition to a fee of $100 for 
 processing the case.  The commissioner shall deduct any 
 obligation incurred under this paragraph from the amount due to 
 the local agency under subdivision 1. 

    Subd. 3.    Study of medical assistance financial 
 participation.  The commissioner shall study the feasibility 
 and outcomes of implementing a variable medical assistance 
 county financial participation rate for long-term care services 
 to mentally retarded persons in order to encourage the 
 utilization of alternative services to long-term intermediate 
 care for the mentally retarded.  The commissioner shall submit 
 findings and recommendations to the legislature by January 20, 
 1984.  

    HIST: Ex1967 c 16 s 19; 1971 c 547 s 1; 1975 c 437 art 2 s 7; 
 1982 c 640 s 7; 1983 c 312 art 9 s 6; 1984 c 534 s 24; 1Sp1985 c 
 9 art 2 s 46; 1986 c 444; 1987 c 403 art 2 s 85; 1988 c 719 art 
 8 s 16,17; 1Sp1989 c 1 art 16 s 8,9; 1990 c 568 art 3 s 64; 1991 
 c 292 art 4 s 51-53; 1992 c 513 art 7 s 82; 1993 c 13 art 1 s 
 32; 1Sp1993 c 1 art 5 s 84-86; 1995 c 207 art 6 s 82-84; 1995 c 
 234 art 8 s 56; 1997 c 203 art 11 s 7; 1998 c 386 art 2 s 80; 
 1Sp2001 c 9 art 2 s 45; 2002 c 220 art 14 s 7,8; 2002 c 277 s 
 20-23; 2002 c 375 art 2 s 34; 2002 c 379 art 1 s 113; 2003 c 9 s 
 1; 1Sp2003 c 14 art 3 s 43; 1Sp2005 c 4 art 2 s 14; art 8 s 48