1.1.................... moves to amend S.F. No. 2995, the first unofficial engrossment, as follows:
1.2Page 121, line 19, delete "144.593" and insert "145D.01"
1.3Page 174, delete section 76
1.4Page 228, after line 27, insert:

1.5    "Sec. .... [145D.01] REQUIREMENTS FOR CERTAIN HEALTH CARE ENTITY
1.6TRANSACTIONS.
1.7    Subdivision 1. Definitions. (a) For purposes of this section, the following terms have
1.8the meanings given.
1.9(b) "Captive professional entity" means a professional corporation, limited liability
1.10company, or other entity formed to render professional services in which a beneficial owner
1.11is a health care provider employed by, controlled by, or subject to the direction of a hospital
1.12or hospital system.
1.13(c) "Commissioner" means the commissioner of health.
1.14(d) "Health care entity" means:
1.15(1) a hospital;
1.16(2) a hospital system;
1.17(3) a captive professional entity;
1.18(4) a medical foundation;
1.19(5) a health care provider group practice;
1.20(6) an entity organized or controlled by an entity listed in clauses (1) to (5); or
2.1(7) an entity that owns or exercises substantial control over an entity listed in clauses
2.2(1) to (5).
2.3(e) "Health care provider" means a physician licensed under chapter 147, a physician
2.4assistant licensed under chapter 147A, or an advanced practice registered nurse as defined
2.5in section 148.171, subdivision 3, who provides health care services, including but not
2.6limited to medical care, consultation, diagnosis, or treatment.
2.7(f) "Health care provider group practice" means two or more health care providers legally
2.8organized in a partnership, professional corporation, limited liability company, medical
2.9foundation, nonprofit corporation, faculty practice plan, or other similar entity:
2.10(1) in which each health care provider who is a member of the group provides
2.11substantially the full range of services that a health care provider routinely provides, including
2.12but not limited to medical care, consultation, diagnosis, and treatment, through the joint use
2.13of shared office space, facilities, equipment, or personnel;
2.14(2) for which substantially all services of the health care providers who are group
2.15members are provided through the group and are billed in the name of the group practice
2.16and amounts so received are treated as receipts of the group; or
2.17(3) in which the overhead expenses of, and the income from, the group are distributed
2.18in accordance with methods previously determined by members of the group.
2.19An entity that otherwise meets the definition of health care provider group practice in this
2.20paragraph shall be considered a health care provider group practice even if its shareholders,
2.21partners, or owners include single health care provider professional corporations, limited
2.22liability companies formed to render professional services, or other entities in which
2.23beneficial owners are individual health care providers.
2.24(g) "Hospital" means a health care facility licensed as a hospital under sections 144.50
2.25to 144.56.
2.26(h) "Medical foundation" means a nonprofit legal entity through which physicians or
2.27other health care providers perform research or provide medical services.
2.28(i)(1) "Transaction" means a single action, or a series of actions within a five-year period,
2.29that constitutes:
2.30(i) a merger or exchange of a health care entity with another entity;
2.31(ii) the sale, lease, or transfer of 40 percent or more of the assets of a health care entity
2.32to another entity;
3.1(iii) the granting of a security interest of 40 percent or more of the property and assets
3.2of a health care entity to another entity;
3.3(iv) the transfer of 40 percent or more of the shares or other ownership of a health care
3.4entity to another entity;
3.5(v) a transfer of control, responsibility for, or governance of a health care entity, including
3.6any transfer of membership interests that effectively constitutes such a transfer;
3.7(vi) the creation of a new health care entity; or
3.8(vii) substantial investment of 40 percent or more in a health care entity that results in
3.9sharing of revenues without a change in ownership or voting shares.
3.10(2) "Transaction" does not include:
3.11(i) a mortgage or other secured loan for business improvement purposes entered into by
3.12a health care entity that does not directly affect delivery of health care or governance of the
3.13health care entity;
3.14(ii) a clinical affiliation of health care entities formed solely for the purpose of
3.15collaborating on clinical trials or providing graduate medical education;
3.16(iii) the mere offer of employment to, or hiring of, a physician or other individual provider
3.17by a health care entity;
3.18(iv) a transaction between entities under common ownership or control, either directly
3.19or indirectly through one or more intermediaries; or
3.20(v) a single action or series of actions within a five-year period involving only entities
3.21that operate solely as a nursing home licensed under chapter 144A; a boarding care home
3.22licensed under sections 144.50 to 144.56; a supervised living facility licensed under sections
3.23144.50 to 144.56; an assisted living facility licensed under chapter 144G; a foster care setting
3.24licensed under Minnesota Rules, parts 9555.5105 to 9555.6265, for a physical location that
3.25is not the primary residence of the license holder; a community residential setting as defined
3.26in section 245D.02, subdivision 4a; or a home care provider licensed under sections 144A.471
3.27to 144A.483.
3.28    Subd. 2. Notice required. (a) This subdivision applies to all transactions where:
3.29(1) the health care entity involved in the transaction has average revenue of at least
3.30$40,000,000 per year; or
3.31(2) an entity created by the transaction is projected to have average revenue of at least
3.32$40,000,000 per year once the entity is operating at full capacity.
4.1(b) A health care entity must provide notice to the attorney general and the commissioner
4.2and comply with this subdivision before entering into a transaction. Notice must be provided
4.3at least 90 days before the proposed completion date of the transaction.
4.4(c) As part of the notice required under this subdivision, at least 90 days before the
4.5proposed completion date of the transaction, a health care entity must affirmatively disclose
4.6the following to the attorney general and the commissioner:
4.7(1) the entities involved in the transaction;
4.8(2) the leadership of the entities involved in the transaction, including all directors, board
4.9members, and officers;
4.10(3) the services provided by each entity and the attributed revenue for each entity by
4.11location;
4.12(4) the primary service area for each location;
4.13(5) the proposed service area for each location;
4.14(6) the current relationships between the entities and the affected health care providers
4.15and practices, the locations of affected health care providers and practices, the services
4.16provided by affected health care providers and practices, and the proposed relationships
4.17between the entities and the affected health care providers and practices;
4.18(7) the terms of the transaction agreement or agreements;
4.19(8) the acquisition price;
4.20(9) markets in which the entities expect postmerger synergies to produce a competitive
4.21advantage;
4.22(10) potential areas of expansion, whether in existing markets or new markets;
4.23(11) plans to close facilities, reduce workforce, or reduce or eliminate services;
4.24(12) the experts and consultants used to evaluate the transaction;
4.25(13) the number of full-time equivalent positions at each location before and after the
4.26transaction by job category, including administrative and contract positions; and
4.27(14) any other information requested by the attorney general or commissioner.
4.28(d) As part of the notice required under this subdivision, at least 90 days before the
4.29proposed completion date of the transaction, a health care entity must affirmatively submit
4.30the following to the attorney general and the commissioner:
5.1(1) the current governing documents for all entities involved in the transaction and any
5.2amendments to these documents;
5.3(2) the transaction agreement or agreements and all related agreements;
5.4(3) any collateral agreements related to the principal transaction, including leases,
5.5management contracts, and service contracts;
5.6(4) all expert or consultant reports or valuations conducted in evaluating the transaction,
5.7including any valuation of the assets that are subject to the transaction prepared within three
5.8years preceding the anticipated transaction completion date and any reports of financial or
5.9economic analysis conducted in anticipation of the transaction;
5.10(5) the results of any projections or modeling of health care utilization or financial
5.11impacts related to the transaction, including but not limited to copies of reports by appraisers,
5.12accountants, investment bankers, actuaries, and other experts;
5.13(6) for a transaction as defined in subdivision 1, paragraph (i), clause (1), item (i) or (v),
5.14a financial and economic analysis and report prepared by an independent expert or consultant
5.15on the effects of the transaction;
5.16(7) for a transaction as defined in subdivision 1, paragraph (i), clause (1), item (i) or (v),
5.17an impact analysis report prepared by an independent expert or consultant on the effects of
5.18the transaction on communities and the workforce, including any changes in availability or
5.19accessibility of services;
5.20(8) all documents reflecting the purposes of or restrictions on any related nonprofit
5.21entity's charitable assets;
5.22(9) copies of all filings submitted to federal regulators, including any Hart-Scott-Rodino
5.23filing the entities submitted to the Federal Trade Commission in connection with the
5.24transaction;
5.25(10) a certification sworn under oath by each board member and chief executive officer
5.26for any nonprofit entity involved in the transaction containing the following: an explanation
5.27of how the completed transaction is in the public interest, addressing the factors in subdivision
5.285, paragraph (a); a disclosure of each declarant's compensation and benefits relating to the
5.29transaction for the three years following the transaction's anticipated completion date; and
5.30a disclosure of any conflicts of interest;
5.31(11) audited and unaudited financial statements from all entities involved in the
5.32transaction and tax filings for all entities involved in the transaction covering the preceding
5.33five fiscal years; and
6.1(12) any other information or documents requested by the attorney general or
6.2commissioner.
6.3(e) The attorney general may extend the notice and waiting period required under
6.4paragraph (b) for an additional 90 days by notifying the health care entity in writing of the
6.5extension.
6.6(f) The attorney general may waive all or any part of the notice and waiting period
6.7required under paragraph (b).
6.8(g) The attorney general or the commissioner may hold public listening sessions or
6.9forums to obtain input on the transaction from providers or community members who may
6.10be impacted by the transaction.
6.11(h) The attorney general or the commissioner may bring an action in district court to
6.12compel compliance with the notice requirements in this subdivision.
6.13    Subd. 3. Prohibited transactions. No health care entity may enter into a transaction
6.14that will:
6.15(1) substantially lessen competition; or
6.16(2) tend to create a monopoly or monopsony.
6.17    Subd. 4. Additional requirements for nonprofit health care entities. A health care
6.18entity that is incorporated under chapter 317A or organized under section 322C.1101, or
6.19that is a subsidiary of any such entity, must, before entering into a transaction, ensure that:
6.20(1) the transaction complies with chapters 317A and 501B and other applicable laws;
6.21(2) the transaction does not involve or constitute a breach of charitable trust;
6.22(3) the nonprofit health care entity will receive full and fair value for its public benefit
6.23assets. This clause does not apply to a transaction with a public entity or an organization
6.24that is exempt under section 501(c)(3) of the Internal Revenue Code of 1986, or any successor
6.25section, where the discount between the fair value of the assets and the transaction price
6.26will further the charitable purposes of the nonprofit health care entity;
6.27(4) the value of the public benefit assets to be transferred has not been manipulated in
6.28a manner that causes or has caused the value of the assets to decrease;
6.29(5) the proceeds of the transaction will be used in a manner consistent with the public
6.30benefit for which the assets are held by the nonprofit health care entity;
6.31(6) the transaction will not result in a breach of fiduciary duty; and
7.1(7) there are procedures and policies in place to prohibit any officer, director, trustee,
7.2or other executive of the nonprofit health care entity from directly or indirectly benefiting
7.3from the transaction.
7.4    Subd. 5. Attorney general enforcement and supplemental authority. (a) The attorney
7.5general may bring an action in district court to enjoin or unwind a transaction or seek other
7.6equitable relief necessary to protect the public interest if a health care entity or transaction
7.7violates this section, if the transaction is contrary to the public interest, or if both a health
7.8care entity or transaction violates this section and the transaction is contrary to the public
7.9interest. Factors informing whether a transaction is contrary to the public interest include
7.10but are not limited to whether the transaction:
7.11(1) will harm public health;
7.12(2) will reduce the affected community's continued access to affordable and quality care
7.13and to the range of services historically provided by the entities or will prevent members
7.14of the affected community from receiving a comparable or better patient experience;
7.15(3) will have a detrimental impact on competing health care options within primary and
7.16dispersed service areas;
7.17(4) will have a negative impact on wages paid by, or the number of employees employed
7.18by, a health care entity involved in a transaction;
7.19(5) will reduce delivery of health care to disadvantaged, uninsured, underinsured, and
7.20underserved populations and to populations enrolled in public health care programs;
7.21(6) will have a substantial negative impact on medical education and teaching programs,
7.22health care workforce training, or medical research;
7.23(7) will have a negative impact on the market for health care services, health insurance
7.24services, or skilled health care workers;
7.25(8) will have a negative impact on wages, collective bargaining units, and collective
7.26bargaining agreements of existing or future workers employed by a health care entity
7.27involved in a transaction;
7.28(9) will increase health care costs for patients; or
7.29(10) will adversely impact provider cost trends and containment of total health care
7.30spending.
7.31(b) The attorney general may enforce this section under section 8.31.
8.1(c) Failure of the entities involved in a transaction to provide timely information as
8.2required by the attorney general or the commissioner shall be an independent and sufficient
8.3ground for a court to enjoin the transaction or provide other equitable relief, provided the
8.4attorney general notified the entities of the inadequacy of the information provided and
8.5provided the entities with a reasonable opportunity to remedy the inadequacy.
8.6(d) The commissioner shall provide to the attorney general, upon request, data and
8.7research on broader market trends, impacts on prices and outcomes, public health and
8.8population health considerations, and health care access, for the attorney general to use
8.9when evaluating whether a transaction is contrary to the public interest.
8.10    Subd. 6. Supplemental authority of commissioner. (a) Notwithstanding any law to
8.11the contrary, the commissioner may use data or information submitted under this section,
8.12section 62U.04, and sections 144.695 to 144.703 to conduct analyses of the aggregate impact
8.13of health care transactions on access to or the cost of health care services, health care market
8.14consolidation, and health care quality.
8.15(b) The commissioner shall issue periodic public reports on the number and types of
8.16transactions subject to this section and on the aggregate impact of transactions on health
8.17care cost, quality, and competition in Minnesota.
8.18    Subd. 7. Classification of data. (a) Data provided by a health care entity to the attorney
8.19general and the commissioner under this section is classified as protected nonpublic data
8.20as defined in section 13.02, subdivision 13, in the case of data not on individuals or
8.21confidential data on individuals as defined in section 13.02, subdivision 3, in the case of
8.22data on individuals. The attorney general or the commissioner may make any data classified
8.23as confidential or protected nonpublic under this paragraph accessible to any person, agency,
8.24or the public if the attorney general or the commissioner determines that the access will aid
8.25the law enforcement process, promote public health or safety, or dispel widespread rumor
8.26or unrest.
8.27(b) Any information exchanged between the attorney general and the commissioner
8.28according to subdivision 5 is classified as confidential data on individuals as defined in
8.29section 13.02, subdivision 3, or protected nonpublic data as defined in section 13.02,
8.30subdivision 13. The commissioner may share with the attorney general, according to section
8.3113.05, subdivision 9, any not public data, as defined in section 13.02, subdivision 8a, held
8.32by the Department of Health to aid in the investigation and review of the transaction, and
8.33the attorney general must maintain this data with the same classification according to section
8.3413.03, subdivision 4, paragraph (d).
9.1    Subd. 8. Relation to other law. (a) The powers and authority under this section are in
9.2addition to, and do not affect or limit, all other rights, powers, and authority of the attorney
9.3general or the commissioner under chapters 8, 309, 317A, 325D, and 501B, or other law.
9.4(b) Nothing in this section shall suspend any obligation imposed under chapters 8, 309,
9.5317A, 325D, and 501B, or other law on the entities involved in a transaction.
9.6EFFECTIVE DATE.This section is effective the day following final enactment and
9.7applies to transactions completed on or after that date. In determining whether a transaction
9.8was completed on or after the effective date, any actions or series of actions necessary to
9.9the completion of the transaction must be considered."
9.10Page 261, after line 19, insert:

9.11    "Sec. .... [309.715] CHARITABLE ASSETS; RETURN TO GENERAL FUND;
9.12OWNERSHIP OR CONTROL OF UNIVERSITY OF MINNESOTA HEALTH CARE
9.13FACILITIES.
9.14    Subdivision 1. Return of charitable assets. If a nonprofit health maintenance
9.15organization licensed under chapter 62D, or a health system organized as a charitable
9.16organization, sells or transfers control to an out-of-state, nonprofit entity or to any for-profit
9.17entity, the health maintenance organization or health system must return to the general fund
9.18an amount equal to the value of any charitable assets the health maintenance organization
9.19or health system received from the state.
9.20    Subd. 2. University of Minnesota health care facilities; ownership or control. The
9.21importance of the University of Minnesota health care facilities, which are the academic
9.22health care facilities licensed by the commissioner of health as M Health Fairview University,
9.23or any successor name, to the state of Minnesota shall be recognized based on their status
9.24as publicly supported academic health care facilities; their relationship with the University
9.25of Minnesota Medical School, a public entity dedicated to medical education, research, and
9.26public service; the status of the University of Minnesota as a constitutionally autonomous
9.27state entity; and the university's mission as a land grant institution. The University of
9.28Minnesota health care facilities, as charitable assets, must remain dedicated to the university's
9.29public health care mission. As such, the University of Minnesota health care facilities shall
9.30not be owned or controlled, directly or indirectly, in whole or in part, by a for-profit entity
9.31or an out-of-state entity, unless the attorney general determines that ownership or control
9.32by a for-profit entity or out-of-state entity is in the public interest. A determination under
9.33this subdivision must be made using the procedures and authority in section 145D.01 and
10.1in consultation with the commissioner of health and the Board of Regents of the University
10.2of Minnesota.
10.3EFFECTIVE DATE.This section is effective the day following final enactment and
10.4applies to transactions by a health maintenance organization or health system related to
10.5selling or transferring control to an out-of-state nonprofit entity or for-profit entity, and to
10.6transactions related to transferring ownership or control of the University of Minnesota
10.7health care facilities, that are completed on or after that date."
10.8Page 264, line 28, reinstate the stricken language
10.9Page 286, delete section 194
10.10Page 288, line 2, after "and" insert "determining"
10.11Page 520, delete section 5
10.12Page 528, after line 23, insert:

10.13    "Sec. .... Minnesota Statutes 2022, section 256B.69, subdivision 5a, is amended to read:
10.14    Subd. 5a. Managed care contracts. (a) Managed care contracts under this section and
10.15section 256L.12 shall be entered into or renewed on a calendar year basis. The commissioner
10.16may issue separate contracts with requirements specific to services to medical assistance
10.17recipients age 65 and older.
10.18    (b) A prepaid health plan providing covered health services for eligible persons pursuant
10.19to chapters 256B and 256L is responsible for complying with the terms of its contract with
10.20the commissioner. Requirements applicable to managed care programs under chapters 256B
10.21and 256L established after the effective date of a contract with the commissioner take effect
10.22when the contract is next issued or renewed.
10.23    (c) The commissioner shall withhold five percent of managed care plan payments under
10.24this section and county-based purchasing plan payments under section 256B.692 for the
10.25prepaid medical assistance program pending completion of performance targets. Each
10.26performance target must be quantifiable, objective, measurable, and reasonably attainable,
10.27except in the case of a performance target based on a federal or state law or rule. Criteria
10.28for assessment of each performance target must be outlined in writing prior to the contract
10.29effective date. Clinical or utilization performance targets and their related criteria must
10.30consider evidence-based research and reasonable interventions when available or applicable
10.31to the populations served, and must be developed with input from external clinical experts
10.32and stakeholders, including managed care plans, county-based purchasing plans, and
11.1providers. The managed care or county-based purchasing plan must demonstrate, to the
11.2commissioner's satisfaction, that the data submitted regarding attainment of the performance
11.3target is accurate. The commissioner shall periodically change the administrative measures
11.4used as performance targets in order to improve plan performance across a broader range
11.5of administrative services. The performance targets must include measurement of plan
11.6efforts to contain spending on health care services and administrative activities. The
11.7commissioner may adopt plan-specific performance targets that take into account factors
11.8affecting only one plan, including characteristics of the plan's enrollee population. The
11.9withheld funds must be returned no sooner than July of the following year if performance
11.10targets in the contract are achieved. The commissioner may exclude special demonstration
11.11projects under subdivision 23.
11.12(d) The commissioner shall require that managed care plans:
11.13(1) use the assessment and authorization processes, forms, timelines, standards,
11.14documentation, and data reporting requirements, protocols, billing processes, and policies
11.15consistent with medical assistance fee-for-service or the Department of Human Services
11.16contract requirements for all personal care assistance services under section 256B.0659 and
11.17community first services and supports under section 256B.85; and
11.18(2) by January 30 of each year that follows a rate increase for any aspect of services
11.19under section 256B.0659 or 256B.85, inform the commissioner and the chairs and ranking
11.20minority members of the legislative committees with jurisdiction over rates determined
11.21under section 256B.851 of the amount of the rate increase that is paid to each personal care
11.22assistance provider agency with which the plan has a contract.; and
11.23(3) use a six-month timely filing standard and provide an exemption to the timely filing
11.24timelines for the resubmission of claims where there has been a denial, request for more
11.25information, or system issue.
11.26(e) Effective for services rendered on or after January 1, 2012, the commissioner shall
11.27include as part of the performance targets described in paragraph (c) a reduction in the health
11.28plan's emergency department utilization rate for medical assistance and MinnesotaCare
11.29enrollees, as determined by the commissioner. For 2012, the reduction shall be based on
11.30the health plan's utilization in 2009. To earn the return of the withhold each subsequent
11.31year, the managed care plan or county-based purchasing plan must achieve a qualifying
11.32reduction of no less than ten percent of the plan's emergency department utilization rate for
11.33medical assistance and MinnesotaCare enrollees, excluding enrollees in programs described
11.34in subdivisions 23 and 28, compared to the previous measurement year until the final
12.1performance target is reached. When measuring performance, the commissioner must
12.2consider the difference in health risk in a managed care or county-based purchasing plan's
12.3membership in the baseline year compared to the measurement year, and work with the
12.4managed care or county-based purchasing plan to account for differences that they agree
12.5are significant.
12.6The withheld funds must be returned no sooner than July 1 and no later than July 31 of
12.7the following calendar year if the managed care plan or county-based purchasing plan
12.8demonstrates to the satisfaction of the commissioner that a reduction in the utilization rate
12.9was achieved. The commissioner shall structure the withhold so that the commissioner
12.10returns a portion of the withheld funds in amounts commensurate with achieved reductions
12.11in utilization less than the targeted amount.
12.12The withhold described in this paragraph shall continue for each consecutive contract
12.13period until the plan's emergency room utilization rate for state health care program enrollees
12.14is reduced by 25 percent of the plan's emergency room utilization rate for medical assistance
12.15and MinnesotaCare enrollees for calendar year 2009. Hospitals shall cooperate with the
12.16health plans in meeting this performance target and shall accept payment withholds that
12.17may be returned to the hospitals if the performance target is achieved.
12.18(f) Effective for services rendered on or after January 1, 2012, the commissioner shall
12.19include as part of the performance targets described in paragraph (c) a reduction in the plan's
12.20hospitalization admission rate for medical assistance and MinnesotaCare enrollees, as
12.21determined by the commissioner. To earn the return of the withhold each year, the managed
12.22care plan or county-based purchasing plan must achieve a qualifying reduction of no less
12.23than five percent of the plan's hospital admission rate for medical assistance and
12.24MinnesotaCare enrollees, excluding enrollees in programs described in subdivisions 23 and
12.2528, compared to the previous calendar year until the final performance target is reached.
12.26When measuring performance, the commissioner must consider the difference in health risk
12.27in a managed care or county-based purchasing plan's membership in the baseline year
12.28compared to the measurement year, and work with the managed care or county-based
12.29purchasing plan to account for differences that they agree are significant.
12.30The withheld funds must be returned no sooner than July 1 and no later than July 31 of
12.31the following calendar year if the managed care plan or county-based purchasing plan
12.32demonstrates to the satisfaction of the commissioner that this reduction in the hospitalization
12.33rate was achieved. The commissioner shall structure the withhold so that the commissioner
12.34returns a portion of the withheld funds in amounts commensurate with achieved reductions
12.35in utilization less than the targeted amount.
13.1The withhold described in this paragraph shall continue until there is a 25 percent
13.2reduction in the hospital admission rate compared to the hospital admission rates in calendar
13.3year 2011, as determined by the commissioner. The hospital admissions in this performance
13.4target do not include the admissions applicable to the subsequent hospital admission
13.5performance target under paragraph (g). Hospitals shall cooperate with the plans in meeting
13.6this performance target and shall accept payment withholds that may be returned to the
13.7hospitals if the performance target is achieved.
13.8(g) Effective for services rendered on or after January 1, 2012, the commissioner shall
13.9include as part of the performance targets described in paragraph (c) a reduction in the plan's
13.10hospitalization admission rates for subsequent hospitalizations within 30 days of a previous
13.11hospitalization of a patient regardless of the reason, for medical assistance and MinnesotaCare
13.12enrollees, as determined by the commissioner. To earn the return of the withhold each year,
13.13the managed care plan or county-based purchasing plan must achieve a qualifying reduction
13.14of the subsequent hospitalization rate for medical assistance and MinnesotaCare enrollees,
13.15excluding enrollees in programs described in subdivisions 23 and 28, of no less than five
13.16percent compared to the previous calendar year until the final performance target is reached.
13.17The withheld funds must be returned no sooner than July 1 and no later than July 31 of
13.18the following calendar year if the managed care plan or county-based purchasing plan
13.19demonstrates to the satisfaction of the commissioner that a qualifying reduction in the
13.20subsequent hospitalization rate was achieved. The commissioner shall structure the withhold
13.21so that the commissioner returns a portion of the withheld funds in amounts commensurate
13.22with achieved reductions in utilization less than the targeted amount.
13.23The withhold described in this paragraph must continue for each consecutive contract
13.24period until the plan's subsequent hospitalization rate for medical assistance and
13.25MinnesotaCare enrollees, excluding enrollees in programs described in subdivisions 23 and
13.2628, is reduced by 25 percent of the plan's subsequent hospitalization rate for calendar year
13.272011. Hospitals shall cooperate with the plans in meeting this performance target and shall
13.28accept payment withholds that must be returned to the hospitals if the performance target
13.29is achieved.
13.30(h) Effective for services rendered on or after January 1, 2013, through December 31,
13.312013, the commissioner shall withhold 4.5 percent of managed care plan payments under
13.32this section and county-based purchasing plan payments under section 256B.692 for the
13.33prepaid medical assistance program. The withheld funds must be returned no sooner than
13.34July 1 and no later than July 31 of the following year. The commissioner may exclude
13.35special demonstration projects under subdivision 23.
14.1(i) Effective for services rendered on or after January 1, 2014, the commissioner shall
14.2withhold three percent of managed care plan payments under this section and county-based
14.3purchasing plan payments under section 256B.692 for the prepaid medical assistance
14.4program. The withheld funds must be returned no sooner than July 1 and no later than July
14.531 of the following year. The commissioner may exclude special demonstration projects
14.6under subdivision 23.
14.7(j) A managed care plan or a county-based purchasing plan under section 256B.692 may
14.8include as admitted assets under section 62D.044 any amount withheld under this section
14.9that is reasonably expected to be returned.
14.10(k) Contracts between the commissioner and a prepaid health plan are exempt from the
14.11set-aside and preference provisions of section 16C.16, subdivisions 6, paragraph (a), and
14.127.
14.13(l) The return of the withhold under paragraphs (h) and (i) is not subject to the
14.14requirements of paragraph (c).
14.15(m) Managed care plans and county-based purchasing plans shall maintain current and
14.16fully executed agreements for all subcontractors, including bargaining groups, for
14.17administrative services that are expensed to the state's public health care programs.
14.18Subcontractor agreements determined to be material, as defined by the commissioner after
14.19taking into account state contracting and relevant statutory requirements, must be in the
14.20form of a written instrument or electronic document containing the elements of offer,
14.21acceptance, consideration, payment terms, scope, duration of the contract, and how the
14.22subcontractor services relate to state public health care programs. Upon request, the
14.23commissioner shall have access to all subcontractor documentation under this paragraph.
14.24Nothing in this paragraph shall allow release of information that is nonpublic data pursuant
14.25to section 13.02.
14.26EFFECTIVE DATE.This section is effective January 1, 2024."
14.27Page 553, line 22, delete "This appropriation" and insert "This is a onetime appropriation
14.28and"
14.29Page 562, line 28, delete "22,373,000" and insert "12,428,000" and delete "34,810,000"
14.30and insert "19,195,000"
14.31Renumber the sections in sequence and correct the internal references
14.32Amend the title accordingly