1.1    .................... moves to amend H.F. No. 3222 as follows:
1.2Delete everything after the enacting clause and insert:

1.3    "Section 1. Minnesota Statutes 2007 Supplement, section 256B.055, subdivision 14,
1.4is amended to read:
1.5    Subd. 14. Persons detained by law. (a) Medical assistance may be paid for an
1.6inmate of a correctional facility who is conditionally released as authorized under section
1.7241.26 , 244.065, or 631.425, if the individual does not require the security of a public
1.8detention facility and is housed in a halfway house or community correction center, or
1.9under house arrest and monitored by electronic surveillance in a residence approved
1.10by the commissioner of corrections, and if the individual meets the other eligibility
1.11requirements of this chapter.
1.12    (b) An individual who is enrolled in medical assistance, and who is charged with a
1.13crime and incarcerated for less than 12 months shall be suspended from eligibility at the
1.14time of incarceration until the individual is released. Upon release, medical assistance
1.15eligibility is reinstated without reapplication using a reinstatement process and form, if the
1.16individual is otherwise eligible.
1.17    (c) An individual, regardless of age, who is considered an inmate of a public
1.18institution as defined in Code of Federal Regulations, title 42, section 435.1009 435.1010,
1.19is not eligible for medical assistance.

1.20    Sec. 2. Minnesota Statutes 2006, section 256B.056, subdivision 2, is amended to read:
1.21    Subd. 2. Homestead exclusion and homestead equity limit for institutionalized
1.22persons residing in a long-term care facility. (a) The homestead shall be excluded
1.23for the first six calendar months of a person's stay in a long-term care facility and shall
1.24continue to be excluded for as long as the recipient can be reasonably expected to return to
1.25the homestead. For purposes of this subdivision, "reasonably expected to return to the
1.26homestead" means the recipient's attending physician has certified that the expectation
2.1is reasonable, and the recipient can show that the cost of care upon returning home will
2.2be met through medical assistance or other sources. The homestead shall continue to
2.3be excluded for persons residing in a long-term care facility if it is used as a primary
2.4residence by one of the following individuals:
2.5    (1) the spouse;
2.6    (2) a child under age 21;
2.7    (3) a child of any age who is blind or permanently and totally disabled as defined in
2.8the supplemental security income program;
2.9    (4) a sibling who has equity interest in the home and who resided in the home for at
2.10least one year immediately before the date of the person's admission to the facility; or
2.11    (5) a child of any age, or, subject to federal approval, a grandchild of any age, who
2.12resided in the home for at least two years immediately before the date of the person's
2.13admission to the facility, and who provided care to the person that permitted the person to
2.14reside at home rather than in an institution.
2.15    (b) Effective for applications filed on or after July 1, 2006, and for renewals after
2.16July 1, 2006, for persons who first applied for payment of long-term care services on
2.17or after January 2, 2006, the equity interest in the homestead of an individual whose
2.18eligibility for long-term care services is determined on or after January 1, 2006, shall not
2.19exceed $500,000, unless it is the lawful residence of the individual's spouse or child
2.20who is under age 21, blind, or disabled. The amount specified in this paragraph shall be
2.21increased beginning in year 2011, from year to year based on the percentage increase in
2.22the Consumer Price Index for all urban consumers (all items; United States city average),
2.23rounded to the nearest $1,000. This provision may be waived in the case of demonstrated
2.24hardship by a process to be determined by the secretary of health and human services
2.25pursuant to section 6014 of the Deficit Reduction Act of 2005, Public Law 109-171.

2.26    Sec. 3. Minnesota Statutes 2006, section 256B.056, is amended by adding a
2.27subdivision to read:
2.28    Subd. 2a. Home equity limit for medical assistance payment of long-term
2.29care services. (a) Effective for requests of medical assistance payment of long-term
2.30care services filed on or after July 1, 2006, and for renewals on or after July 1, 2006,
2.31for persons who received payment of long-term care services under a request filed on
2.32or after January 1, 2006, the equity interest in the home of a person whose eligibility
2.33for long-term care services is determined on or after January 1, 2006, shall not exceed
2.34$500,000, unless it is the lawful residence of the person's spouse or child who is under
2.35age 21, or a child of any age who is blind or permanently and totally disabled as defined
3.1in the Supplemental Security Income program. The amount specified in this paragraph
3.2shall be increased beginning in year 2011, from year to year based on the percentage
3.3increase in the Consumer Price Index for all urban consumers (all items; United States city
3.4average), rounded to the nearest $1,000.
3.5    (b) For purposes of this subdivision, a "home" means any real or personal property
3.6interest, including an interest in an agricultural homestead as defined under section
3.7273.124, subdivision 1, that, at the time of the request for medical assistance payment of
3.8long-term care services, is the primary dwelling of the person or was the primary dwelling
3.9of the person before receipt of long-term care services began outside of the home.
3.10    (c) A person denied or terminated from medical assistance payment of long-term
3.11care services because the person's home equity exceeds the home equity limit may seek
3.12a waiver based upon a hardship by filing a written request with the county agency.
3.13Hardship is an imminent threat to the person's health and well-being that is demonstrated
3.14by documentation of no alternatives for payment of long-term care services. The county
3.15agency shall make a decision regarding the written request to waive the home equity limit
3.16within 30 days if all necessary information has been provided. The county agency shall
3.17send the person and the person's representative a written notice of decision on the request
3.18for a demonstrated hardship waiver that also advises the person of appeal rights under the
3.19fair hearing process of section 256.045.

3.20    Sec. 4. Minnesota Statutes 2006, section 256B.056, subdivision 4a, is amended to read:
3.21    Subd. 4a. Asset verification. For purposes of verification, the value of an individual
3.22is not required to make a good faith effort to sell a life estate that is not excluded under
3.23subdivision 2 and the life estate shall be considered deemed not salable unless the owner
3.24of the remainder interest intends to purchase the life estate, or the owner of the life estate
3.25and the owner of the remainder sell the entire property. This subdivision applies only for
3.26the purpose of determining eligibility for medical assistance, and does not apply to the
3.27valuation of assets owned by either the institutional spouse or the community spouse
3.28under section 256B.059, subdivision 2.

3.29    Sec. 5. Minnesota Statutes 2006, section 256B.056, subdivision 11, is amended to read:
3.30    Subd. 11. Treatment of annuities. (a) Any individual applying for or seeking
3.31recertification of eligibility for person requesting medical assistance payment of long-term
3.32care services shall provide a complete description of any interest either the individual
3.33person or the individual's person's spouse has in annuities on a form designated by the
3.34department. The form shall include a statement that the state becomes a preferred
3.35remainder beneficiary of annuities or similar financial instruments by virtue of the receipt
4.1of medical assistance payment of long-term care services. The individual person and the
4.2individual's person's spouse shall furnish the agency responsible for determining eligibility
4.3with complete current copies of their annuities and related documents for review as part
4.4of the application process on disclosure forms provided by the department as part of
4.5their application and complete the form designating the state as the preferred remainder
4.6beneficiary for each annuity in which the person or the person's spouse has an interest.
4.7    (b) The disclosure form shall include a statement that the department becomes the
4.8remainder beneficiary under the annuity or similar financial instrument by virtue of the
4.9receipt of medical assistance. The disclosure form department shall include a provide
4.10notice to the issuer of the department's right under this section as a preferred remainder
4.11beneficiary under the annuity or similar financial instrument for medical assistance
4.12furnished to the individual person or the individual's person's spouse, and require the
4.13issuer to provide confirmation that a remainder beneficiary designation has been made
4.14and to notify the county agency when there is a change in the amount of the income or
4.15principal being withdrawn from the annuity or other similar financial instrument at the
4.16time of the most recent disclosure required under this section. The individual and the
4.17individual's spouse shall execute separate disclosure forms for each annuity or similar
4.18financial instrument that they are required to disclose under this section and in which they
4.19have an interest. provide notice of the issuer's responsibilities as provided in paragraph (c).
4.20    (c) An issuer of an annuity or similar financial instrument who receives notice
4.21on a disclosure form of the state's right to be named a preferred remainder beneficiary
4.22as described in paragraph (b) shall provide confirmation to the requesting agency that
4.23a remainder beneficiary designating the state has been made and a preferred remainder
4.24beneficiary. The issuer shall also notify the county agency when there is a change in the
4.25amount of income or principal being withdrawn from the annuity or other similar financial
4.26instrument or a change in the state's preferred remainder beneficiary designation under
4.27the annuity or other similar financial instrument occurs. The county agency shall provide
4.28the issuer with the name, address, and telephone number of a unit within the department
4.29that the issuer can contact to comply with this paragraph.
4.30    (d) "Preferred remainder beneficiary" for purposes of this subdivision and sections
4.31256B.0594 and 256B.0595 means the state is a remainder beneficiary in the first position in
4.32an amount equal to the amount of medical assistance paid on behalf of the institutionalized
4.33person, or is a remainder beneficiary in the second position if the institutionalized person
4.34designates and is survived by a remainder beneficiary who is (1) a spouse who does not
4.35reside in a medical institution, (2) a minor child, or (3) a child of any age who is blind or
4.36permanently and totally disabled as defined in the Supplemental Security Income program.
5.1Notwithstanding this paragraph, the state is the remainder beneficiary in the first position
5.2if the spouse or child disposes of the remainder for less than fair market value.
5.3    (e) For purposes of this subdivision, "institutionalized person" and "long-term care
5.4services" have the meanings given in section 256B.0595, subdivision 1, paragraph (h).
5.5    (f) For purposes of this subdivision, "medical institution" means a skilled
5.6nursing facility, intermediate care facility, intermediate care facility for persons with
5.7developmental disabilities, nursing facility, or inpatient hospital.

5.8    Sec. 6. Minnesota Statutes 2006, section 256B.057, subdivision 1, is amended to read:
5.9    Subdivision 1. Infants and pregnant women. (a)(1) An infant less than one year of
5.10age or a pregnant woman who has written verification of a positive pregnancy test from a
5.11physician or licensed registered nurse is eligible for medical assistance if countable family
5.12income is equal to or less than 275 percent of the federal poverty guideline for the same
5.13family size. A pregnant woman who has written verification of a positive pregnancy test
5.14from a physician or licensed registered nurse is eligible for medical assistance if countable
5.15family income is equal to or less than 200 percent of the federal poverty guideline for the
5.16same family size. For purposes of this subdivision, "countable family income" means the
5.17amount of income considered available using the methodology of the AFDC program
5.18under the state's AFDC plan as of July 16, 1996, as required by the Personal Responsibility
5.19and Work Opportunity Reconciliation Act of 1996 (PRWORA), Public Law 104-193,
5.20except for the earned income disregard and employment deductions.
5.21    (2) For applications processed within one calendar month prior to the effective date,
5.22eligibility shall be determined by applying the income standards and methodologies in
5.23effect prior to the effective date for any months in the six-month budget period before
5.24that date and the income standards and methodologies in effect on the effective date for
5.25any months in the six-month budget period on or after that date. The income standards
5.26for each month shall be added together and compared to the applicant's total countable
5.27income for the six-month budget period to determine eligibility.
5.28    (b)(1) [Expired, 1Sp2003 c 14 art 12 s 19]
5.29    (2) For applications processed within one calendar month prior to July 1, 2003,
5.30eligibility shall be determined by applying the income standards and methodologies in
5.31effect prior to July 1, 2003, for any months in the six-month budget period before July 1,
5.322003, and the income standards and methodologies in effect on the expiration date for any
5.33months in the six-month budget period on or after July 1, 2003. The income standards
5.34for each month shall be added together and compared to the applicant's total countable
5.35income for the six-month budget period to determine eligibility.
6.1    (3) An amount equal to the amount of earned income exceeding 275 percent of
6.2the federal poverty guideline, up to a maximum of the amount by which the combined
6.3total of 185 percent of the federal poverty guideline plus the earned income disregards
6.4and deductions allowed under the state's AFDC plan as of July 16, 1996, as required
6.5by the Personal Responsibility and Work Opportunity Act of 1996 (PRWORA), Public
6.6Law 104-193, exceeds 275 percent of the federal poverty guideline will be deducted for
6.7pregnant women and infants less than one year of age.
6.8    (c) Dependent care and child support paid under court order shall be deducted from
6.9the countable income of pregnant women.
6.10    (d) An infant born on or after January 1, 1991, to a woman who was eligible for and
6.11receiving medical assistance on the date of the child's birth shall continue to be eligible for
6.12medical assistance without redetermination until the child's first birthday, as long as the
6.13child remains in the woman's household.

6.14    Sec. 7. Minnesota Statutes 2006, section 256B.0571, subdivision 6, is amended to read:
6.15    Subd. 6. Partnership policy. "Partnership policy" means a long-term care insurance
6.16policy that meets the requirements under subdivision 10 and was issued on or after the
6.17effective date of the state plan amendment implementing the partnership program in
6.18Minnesota. Policies that are exchanged or that have riders or endorsements added on or
6.19after the effective date of the state plan amendment as authorized by the commissioner of
6.20commerce qualify as a partnership policy.

6.21    Sec. 8. Minnesota Statutes 2006, section 256B.0571, subdivision 8, is amended to read:
6.22    Subd. 8. Program established. (a) The commissioner, in cooperation with the
6.23commissioner of commerce, shall establish the Minnesota partnership for long-term care
6.24program to provide for the financing of long-term care through a combination of private
6.25insurance and medical assistance.
6.26    (b) An individual who meets the requirements in this paragraph is eligible to
6.27participate in the partnership program. The individual must:
6.28    (1) be a Minnesota resident at the time coverage first became effective under the
6.29partnership policy;
6.30    (2) be a beneficiary of a partnership policy that (i) is issued on or after the effective
6.31date of the state plan amendment implementing the partnership program in Minnesota,
6.32or (ii) qualifies as a partnership policy under the provisions of subdivision 8a, or (iii) if
6.33permitted under subdivision 17, qualifies for a partnership program established by another
6.34state under United States Code, title 42, section 1396p(b)(1)(C), and is either issued on
6.35or after the effective date of the state plan amendment implementing the partnership
7.1program in the state of issuance or qualifies for an exchange under the requirements of
7.2the partnership program in that state; and
7.3    (3) have exhausted all of the benefits under the partnership policy as described in this
7.4section. Benefits received under a long-term care insurance policy before July 1, 2006, do
7.5not count toward the exhaustion of benefits required in this subdivision.

7.6    Sec. 9. Minnesota Statutes 2006, section 256B.0571, subdivision 9, is amended to read:
7.7    Subd. 9. Medical assistance eligibility. (a) Upon application request for medical
7.8assistance program payment of long-term care services by an individual who meets the
7.9requirements described in subdivision 8, the commissioner shall determine the individual's
7.10eligibility for medical assistance according to paragraphs (b) to (i).
7.11    (b) After determining assets subject to the asset limit under section 256B.056,
7.12subdivision 3 or 3c, or 256B.057, subdivision 9 or 10, the commissioner shall allow
7.13the individual to designate assets to be protected from recovery under subdivisions 13
7.14and 15 up to the dollar amount of the benefits utilized under the partnership policy.
7.15Designated assets shall be disregarded for purposes of determining eligibility for payment
7.16of long-term care services.
7.17    (c) The individual shall identify the designated assets and the full fair market value
7.18of those assets and designate them as assets to be protected at the time of initial application
7.19for medical assistance. The full fair market value of real property or interests in real
7.20property shall be based on the most recent full assessed value for property tax purposes
7.21for the real property, unless the individual provides a complete professional appraisal by
7.22a licensed appraiser to establish the full fair market value. The extent of a life estate in
7.23real property shall be determined using the life estate table in the health care program's
7.24manual. Ownership of any asset in joint tenancy shall be treated as ownership as tenants
7.25in common for purposes of its designation as a disregarded asset. The unprotected value
7.26of any protected asset is subject to estate recovery according to subdivisions 13 and 15.
7.27    (d) The right to designate assets to be protected is personal to the individual and
7.28ends when the individual dies, except as otherwise provided in subdivisions 13 and
7.2915. It does not include the increase in the value of the protected asset and the income,
7.30dividends, or profits from the asset. It may be exercised by the individual or by anyone
7.31with the legal authority to do so on the individual's behalf. It shall not be sold, assigned,
7.32transferred, or given away.
7.33    (e) If the dollar amount of the benefits utilized under a partnership policy is greater
7.34than the full fair market value of all assets protected at the time of the application for
7.35medical assistance long-term care services, the individual may designate additional assets
8.1that become available during the individual's lifetime for protection under this section.
8.2The individual must make the designation in writing to the county agency no later than
8.3the last date on which the individual must report a change in circumstances to the county
8.4agency, as provided for under the medical assistance program ten days from the date the
8.5designation is requested by the county agency. Any excess used for this purpose shall not
8.6be available to the individual's estate to protect assets in the estate from recovery under
8.7section 256B.15 or 524.3-1202, or otherwise.
8.8    (f) This section applies only to estate recovery under United States Code, title 42,
8.9section 1396p, subsections (a) and (b), and does not apply to recovery authorized by other
8.10provisions of federal law, including, but not limited to, recovery from trusts under United
8.11States Code, title 42, section 1396p, subsection (d)(4)(A) and (C), or to recovery from
8.12annuities, or similar legal instruments, subject to section 6012, subsections (a) and (b), of
8.13the Deficit Reduction Act of 2005, Public Law 109-171.
8.14    (g) An individual's protected assets owned by the individual's spouse who applies
8.15for payment of medical assistance long-term care services shall not be protected assets or
8.16disregarded for purposes of eligibility of the individual's spouse solely because they were
8.17protected assets of the individual.
8.18    (h) Assets designated under this subdivision shall not be subject to penalty under
8.19section 256B.0595.
8.20    (i) The commissioner shall otherwise determine the individual's eligibility
8.21for payment of long-term care services according to medical assistance eligibility
8.22requirements.

8.23    Sec. 10. Minnesota Statutes 2006, section 256B.0571, subdivision 15, is amended to
8.24read:
8.25    Subd. 15. Limitation on liens. (a) An individual's interest in real property shall not
8.26be subject to a medical assistance lien under sections 514.980 to 514.985 or a notice of
8.27potential claim lien arising under section 256B.15 while and to the extent it is protected
8.28under subdivision 9. An individual's interest in real property that exceeds the value
8.29protected under subdivision 9 is subject to a lien for recovery.
8.30    (b) Medical assistance liens under sections 514.980 to 514.985 or liens arising
8.31under notices of potential claims section 256B.15 against an individual's interests in real
8.32property in the individual's estate that are designated as protected under subdivision 13,
8.33paragraph (b), shall be released to the extent of the dollar value of the protection applied
8.34to the interest.
9.1    (c) If an interest in real property is protected from a lien for recovery of medical
9.2assistance paid on behalf of the individual under paragraph (a) or (b), no lien for recovery
9.3of medical assistance paid on behalf of that individual shall be filed against the protected
9.4interest in real property after it is distributed to the individual's heirs or devisees.

9.5    Sec. 11. Minnesota Statutes 2006, section 256B.0571, is amended by adding a
9.6subdivision to read:
9.7    Subd. 17. Reciprocal agreements. The commissioner may enter into an agreement
9.8with any other state with a partnership program under United States Code, title 42,
9.9section 1396p(b)(1)(C), for reciprocal recognition of qualified long-term care insurance
9.10policies purchased under each state's partnership program. The commissioner shall notify
9.11the secretary of the United States Department of Health and Human Services if the
9.12commissioner declines to enter into a national reciprocal agreement.

9.13    Sec. 12. Minnesota Statutes 2006, section 256B.058, is amended to read:
9.14256B.058 TREATMENT OF INCOME OF INSTITUTIONALIZED SPOUSE.
9.15    Subdivision 1. Income not available. The income described in subdivisions 2 and 3
9.16shall be deducted from an institutionalized spouse's monthly income and is not considered
9.17available for payment of the monthly costs of an institutionalized person spouse in the
9.18institution after the person has been determined eligible for medical assistance.
9.19    Subd. 2. Monthly income allowance for community spouse. (a) For an
9.20institutionalized spouse with a spouse residing in the community, monthly income may be
9.21allocated to the community spouse as a monthly income allowance for the community
9.22spouse. Beginning with the first full calendar month the institutionalized spouse is
9.23in the institution, the monthly income allowance is not considered available to the
9.24institutionalized spouse for monthly payment of costs of care in the institution as long as
9.25the income is made available to the community spouse.
9.26    (b) The monthly income allowance is the amount by which the community spouse's
9.27monthly maintenance needs allowance under paragraphs (c) and (d) exceeds the amount
9.28of monthly income otherwise available to the community spouse.
9.29    (c) The community spouse's monthly maintenance needs allowance is the lesser of
9.30$1,500 or 122 percent of the monthly federal poverty guideline for a family of two plus
9.31an excess shelter allowance. The excess shelter allowance is for the amount of shelter
9.32expenses that exceed 30 percent of 122 percent of the federal poverty guideline line for a
9.33family of two. Shelter expenses are the community spouse's expenses for rent, mortgage
9.34payments including principal and interest, taxes, insurance, required maintenance charges
10.1for a cooperative or condominium that is the community spouse's principal residence,
10.2and the standard utility allowance under section 5(e) of the federal Food Stamp Act of
10.31977. If the community spouse has a required maintenance charge for a cooperative or
10.4condominium, the standard utility allowance must be reduced by the amount of utility
10.5expenses included in the required maintenance charge.
10.6    If the community or institutionalized spouse establishes that the community spouse
10.7needs income greater than the monthly maintenance needs allowance determined in this
10.8paragraph due to exceptional circumstances resulting in significant financial duress, the
10.9monthly maintenance needs allowance may be increased to an amount that provides
10.10needed additional income.
10.11    (d) The percentage of the federal poverty guideline used to determine the monthly
10.12maintenance needs allowance in paragraph (c) is increased to 133 percent on July 1,
10.131991, and to 150 percent on July 1, 1992. Adjustments in the income limits due to annual
10.14changes in the federal poverty guidelines shall be implemented the first day of July
10.15following publication of the annual changes. The $1,500 maximum must be adjusted
10.16January 1, 1990, and every January 1 after that by the same percentage increase in the
10.17Consumer Price Index for all urban consumers (all items; United States city average)
10.18between the two previous Septembers.
10.19    (e) If a court has entered an order against an institutionalized spouse for monthly
10.20income for support of the community spouse, the community spouse's monthly income
10.21allowance under this subdivision shall not be less than the amount of the monthly income
10.22ordered.
10.23    Subd. 3. Family allowance. (a) A family allowance determined under paragraph
10.24(b) is not considered available to the institutionalized spouse for monthly payment of costs
10.25of care in the institution.
10.26    (b) The family allowance is equal to one-third of the amount by which 122 percent
10.27of the monthly federal poverty guideline for a family of two exceeds the monthly income
10.28for that family member.
10.29    (c) For purposes of this subdivision, the term family member only includes a
10.30minor or dependent child as defined in the Internal Revenue Code, dependent parent, or
10.31dependent sibling of the institutionalized or community spouse if the sibling resides with
10.32the community spouse.
10.33    (d) The percentage of the federal poverty guideline used to determine the family
10.34allowance in paragraph (b) is increased to 133 percent on July 1, 1991, and to 150 percent
10.35on July 1, 1992. Adjustments in the income limits due to annual changes in the federal
11.1poverty guidelines shall be implemented the first day of July following publication of
11.2the annual changes.
11.3    Subd. 4. Treatment of income. (a) No income of the community spouse will
11.4be considered available to an eligible institutionalized spouse, beginning the first full
11.5calendar month of institutionalization, except as provided in this subdivision.
11.6    (b) In determining the income of an institutionalized spouse or community spouse,
11.7after the institutionalized spouse has been determined eligible for medical assistance,
11.8the following rules apply.
11.9    (1) For income that is not from a trust, availability is determined according to items
11.10(i) to (v), unless the instrument providing the income otherwise specifically provides:
11.11    (i) if payment is made solely in the name of one spouse, the income is considered
11.12available only to that spouse;
11.13    (ii) if payment is made in the names of both spouses, one-half of the income is
11.14considered available to each;
11.15    (iii) if payment is made in the names of one or both spouses together with one or
11.16more other persons, the income is considered available to each spouse according to the
11.17spouse's interest, or one-half of the joint interest is considered available to each spouse
11.18if each spouse's interest is not specified;
11.19    (iv) if there is no instrument that establishes ownership, one-half of the income is
11.20considered available to each spouse; and
11.21    (v) either spouse may rebut the determination of availability of income by showing
11.22by a preponderance of the evidence that ownership interests are different than provided
11.23above.
11.24    (2) For income from a trust, income is considered available to each spouse as
11.25provided in the trust. If the trust does not specify an amount available to either or both
11.26spouses, availability will be determined according to items (i) to (iii):
11.27    (i) if payment of income is made only to one spouse, the income is considered
11.28available only to that spouse;
11.29    (ii) if payment of income is made to both spouses, one-half is considered available to
11.30each; and
11.31    (iii) if payment is made to either or both spouses and one or more other persons,
11.32the income is considered available to each spouse in proportion to each spouse's interest,
11.33or if no such interest is specified, one-half of the joint interest is considered available
11.34to each spouse.

11.35    Sec. 13. Minnesota Statutes 2006, section 256B.059, subdivision 1, is amended to read:
12.1    Subdivision 1. Definitions. (a) For purposes of this section and section sections
12.2256B.058 and 256B.0595, the terms defined in this subdivision have the meanings given
12.3them.
12.4    (b) "Community spouse" means the spouse of an institutionalized spouse.
12.5    (c) "Spousal share" means one-half of the total value of all assets, to the extent that
12.6either the institutionalized spouse or the community spouse had an ownership interest at
12.7the time of the first continuous period of institutionalization.
12.8    (d) "Assets otherwise available to the community spouse" means assets individually
12.9or jointly owned by the community spouse, other than assets excluded by subdivision 5,
12.10paragraph (c).
12.11    (e) "Community spouse asset allowance" is the value of assets that can be transferred
12.12under subdivision 3.
12.13    (f) "Institutionalized spouse" means a person who is:
12.14    (1) in a hospital, nursing facility, or intermediate care facility for persons with
12.15developmental disabilities, or receiving home and community-based services under
12.16section 256B.0915 or 256B.49, and is expected to remain in the facility or institution or
12.17receive the home and community-based services for at least 30 consecutive days; and
12.18    (2) married to a person who is not in a hospital, nursing facility, or intermediate
12.19care facility for persons with developmental disabilities, and is not receiving home and
12.20community-based services under section 256B.0915 or 256B.49.
12.21    (g) "For the sole benefit of" means no other individual or entity can benefit in any
12.22way from the assets or income at the time of a transfer or at any time in the future.
12.23    (h) "Continuous period of institutionalization" means a 30-consecutive-day period
12.24of time in which a person is expected to stay in a medical or long-term care facility,
12.25or receive home and community-based services that would qualify for coverage under
12.26the elderly waiver (EW) or alternative care (AC) programs. For a stay in a facility, the
12.2730-consecutive-day period begins on the date of entry into a medical or long-term care
12.28facility. For receipt of home and community-based services, the 30-consecutive-day
12.29period begins on the date that the following conditions are met:
12.30    (1) the person is receiving services that meet the nursing facility level of care
12.31determined by a long-term care consultation;
12.32    (2) the person has received the long-term care consultation within the past 60 days;
12.33    (3) the services are paid by the EW program under section 256B.0915 or the AC
12.34program under section 256B.0913 or would qualify for payment under the EW or AC
12.35programs if the person were otherwise eligible for either program, and but for the receipt
12.36of such services the person would have resided in a nursing facility; and
13.1    (4) the services are provided by a licensed provider qualified to provide home and
13.2community-based services.

13.3    Sec. 14. Minnesota Statutes 2006, section 256B.059, subdivision 1a, is amended to
13.4read:
13.5    Subd. 1a. Institutionalized spouse. The provisions of this section apply only
13.6when a spouse is institutionalized for a begins the first continuous period beginning of
13.7institutionalization on or after October 1, 1989.

13.8    Sec. 15. Minnesota Statutes 2006, section 256B.0594, is amended to read:
13.9256B.0594 PAYMENT OF BENEFITS FROM AN ANNUITY.
13.10    When payment becomes due under an annuity that names the department a
13.11remainder beneficiary as described in section 256B.056, subdivision 11, the issuer shall
13.12request and the department shall, within 45 days after receipt of the request, provide
13.13a written statement of the total amount of the medical assistance paid or confirmation
13.14that any family member designated as a remainder beneficiary meets requirements for
13.15qualification as a beneficiary in the first position. Upon timely receipt of the written
13.16statement of the amount of medical assistance paid, the issuer shall pay the department an
13.17amount equal to the lesser of the amount due the department under the annuity or the total
13.18amount of medical assistance paid on behalf of the individual or the individual's spouse.
13.19Any amounts remaining after the issuer's payment to the department shall be payable
13.20according to the terms of the annuity or similar financial instrument. The county agency
13.21or the department shall provide the issuer with the name, address, and telephone number
13.22of a unit within the department the issuer can contact to comply with this section. The
13.23requirements of section 72A.201, subdivision 4, clause (3), shall not apply to payments
13.24made under this section until the issuer has received final payment information from the
13.25department, if the issuer has notified the beneficiary of the requirements of this section at
13.26the time it initially requests payment information from the department.

13.27    Sec. 16. Minnesota Statutes 2006, section 256B.0595, subdivision 1, is amended to
13.28read:
13.29    Subdivision 1. Prohibited transfers. (a) For transfers of assets made on or before
13.30August 10, 1993, if a an institutionalized person or the institutionalized person's spouse
13.31has given away, sold, or disposed of, for less than fair market value, any asset or interest
13.32therein, except assets other than the homestead that are excluded under the supplemental
13.33security program, within 30 months before or any time after the date of institutionalization
13.34if the person has been determined eligible for medical assistance, or within 30 months
14.1before or any time after the date of the first approved application for medical assistance
14.2if the person has not yet been determined eligible for medical assistance, the person is
14.3ineligible for long-term care services for the period of time determined under subdivision
14.42.
14.5    (b) Effective for transfers made after August 10, 1993, a an institutionalized person,
14.6a an institutionalized person's spouse, or any person, court, or administrative body with
14.7legal authority to act in place of, on behalf of, at the direction of, or upon the request of the
14.8institutionalized person or institutionalized person's spouse, may not give away, sell, or
14.9dispose of, for less than fair market value, any asset or interest therein, except assets other
14.10than the homestead that are excluded under the supplemental security income program,
14.11for the purpose of establishing or maintaining medical assistance eligibility. This applies
14.12to all transfers, including those made by a community spouse after the month in which
14.13the institutionalized spouse is determined eligible for medical assistance. For purposes of
14.14determining eligibility for long-term care services, any transfer of such assets within 36
14.15months before or any time after an institutionalized person applies for requests medical
14.16assistance payment of long-term care services, or 36 months before or any time after a
14.17medical assistance recipient becomes an institutionalized person, for less than fair market
14.18value may be considered. Any such transfer is presumed to have been made for the purpose
14.19of establishing or maintaining medical assistance eligibility and the institutionalized
14.20person is ineligible for long-term care services for the period of time determined under
14.21subdivision 2, unless the institutionalized person furnishes convincing evidence to
14.22establish that the transaction was exclusively for another purpose, or unless the transfer is
14.23permitted under subdivision 3 or 4. In the case of payments from a trust or portions of a
14.24trust that are considered transfers of assets under federal law, or in the case of any other
14.25disposal of assets made on or after February 8, 2006, any transfers made within 60 months
14.26before or any time after an institutionalized person applies for requests medical assistance
14.27payment of long-term care services and within 60 months before or any time after a
14.28medical assistance recipient becomes an institutionalized person, may be considered.
14.29    (c) This section applies to transfers, for less than fair market value, of income
14.30or assets, including assets that are considered income in the month received, such as
14.31inheritances, court settlements, and retroactive benefit payments or income to which the
14.32institutionalized person or the institutionalized person's spouse is entitled but does not
14.33receive due to action by the institutionalized person, the institutionalized person's spouse,
14.34or any person, court, or administrative body with legal authority to act in place of, on
14.35behalf of, at the direction of, or upon the request of the institutionalized person or the
14.36institutionalized person's spouse.
15.1    (d) This section applies to payments for care or personal services provided by a
15.2relative, unless the compensation was stipulated in a notarized, written agreement which
15.3was in existence when the service was performed, the care or services directly benefited
15.4the person, and the payments made represented reasonable compensation for the care
15.5or services provided. A notarized written agreement is not required if payment for the
15.6services was made within 60 days after the service was provided.
15.7    (e) This section applies to the portion of any asset or interest that a an institutionalized
15.8person, a an institutionalized person's spouse, or any person, court, or administrative body
15.9with legal authority to act in place of, on behalf of, at the direction of, or upon the request
15.10of the institutionalized person or the institutionalized person's spouse, transfers to any
15.11annuity that exceeds the value of the benefit likely to be returned to the institutionalized
15.12person or institutionalized person's spouse while alive, based on estimated life expectancy
15.13using the life expectancy tables employed by the supplemental security income program
15.14to determine the value of an agreement for services for life as determined according to the
15.15current actuarial tables published by the Office of the Chief Actuary of the Social Security
15.16Administration. The commissioner may adopt rules reducing life expectancies based on
15.17the need for long-term care. This section applies to an annuity described in this paragraph
15.18purchased on or after March 1, 2002, that:
15.19    (1) is not purchased from an insurance company or financial institution that is
15.20subject to licensing or regulation by the Minnesota Department of Commerce or a similar
15.21regulatory agency of another state;
15.22    (2) does not pay out principal and interest in equal monthly installments; or
15.23    (3) does not begin payment at the earliest possible date after annuitization.
15.24    (f) Effective for transactions, including the purchase of an annuity, occurring on
15.25or after February 8, 2006, the purchase of an annuity by or on behalf of an individual
15.26institutionalized person who has applied for or is receiving long-term care services or the
15.27individual's institutionalized person's spouse shall be treated as the disposal of an asset for
15.28less than fair market value unless the department is named as the a preferred remainder
15.29beneficiary in first position for an amount equal to at least the total amount of medical
15.30assistance paid on behalf of the individual or the individual's spouse; or the department
15.31is named as the remainder beneficiary in second position for an amount equal to at least
15.32the total amount of medical assistance paid on behalf of the individual or the individual's
15.33spouse after the individual's community spouse or minor or disabled child and is named as
15.34the remainder beneficiary in the first position if the community spouse or a representative
15.35of the minor or disabled child disposes of the remainder for less than fair market value as
15.36described in section 256B.056, subdivision 11. Any subsequent change to the designation
16.1of the department as a preferred remainder beneficiary shall result in the annuity being
16.2treated as a disposal of assets for less than fair market value. The amount of such transfer
16.3shall be the maximum amount the individual institutionalized person or the individual's
16.4institutionalized person's spouse could receive from the annuity or similar financial
16.5instrument. Any change in the amount of the income or principal being withdrawn
16.6from the annuity or other similar financial instrument at the time of the most recent
16.7disclosure shall be deemed to be a transfer of assets for less than fair market value unless
16.8the individual institutionalized person or the individual's institutionalized person's spouse
16.9demonstrates that the transaction was for fair market value. In the event a distribution
16.10of income or principal has been improperly distributed or disbursed from an annuity or
16.11other retirement planning instrument of an institutionalized person or the institutionalized
16.12person's spouse, a cause of action exists against the individual receiving the improper
16.13distribution for the cost of medical assistance services provided or the amount of the
16.14improper distribution, whichever is less. The action may be brought by the state or the
16.15local agency responsible for providing medical assistance under chapter 256B.
16.16    (g) Effective for transactions, including the purchase of an annuity, occurring on
16.17or after February 8, 2006, the purchase of an annuity by or on behalf of an individual
16.18institutionalized person applying for or receiving long-term care services shall be treated
16.19as a disposal of assets for less than fair market value unless it is:
16.20    (i) an annuity described in subsection (b) or (q) of section 408 of the Internal
16.21Revenue Code of 1986; or
16.22    (ii) purchased with proceeds from:
16.23    (A) an account or trust described in subsection (a), (c), or (p) of section 408 of the
16.24Internal Revenue Code;
16.25    (B) a simplified employee pension within the meaning of section 408(k) of the
16.26Internal Revenue Code; or
16.27    (C) a Roth IRA described in section 408A of the Internal Revenue Code; or
16.28    (iii) an annuity that is irrevocable and nonassignable; is actuarially sound as
16.29determined in accordance with actuarial publications of the Office of the Chief Actuary of
16.30the Social Security Administration; and provides for payments in equal amounts during
16.31the term of the annuity, with no deferral and no balloon payments made.
16.32     (h) For purposes of this section, long-term care services include services in a nursing
16.33facility, services that are eligible for payment according to section 256B.0625, subdivision
16.342 , because they are provided in a swing bed, intermediate care facility for persons with
16.35developmental disabilities, and home and community-based services provided pursuant
16.36to sections 256B.0915, 256B.092, and 256B.49. For purposes of this subdivision and
17.1subdivisions 2, 3, and 4, "institutionalized person" includes a person who is an inpatient
17.2in a nursing facility or in a swing bed, or intermediate care facility for persons with
17.3developmental disabilities or who is receiving home and community-based services under
17.4sections 256B.0915, 256B.092, and 256B.49.
17.5    (i) This section applies to funds used to purchase a promissory note, loan, or
17.6mortgage unless the note, loan, or mortgage:
17.7    (1) has a repayment term that is actuarially sound;
17.8    (2) provides for payments to be made in equal amounts during the term of the loan,
17.9with no deferral and no balloon payments made; and
17.10    (3) prohibits the cancellation of the balance upon the death of the lender.
17.11    In the case of a promissory note, loan, or mortgage that does not meet an exception
17.12in clauses (1) to (3), the value of such note, loan, or mortgage shall be the outstanding
17.13balance due as of the date of the individual's application institutionalized person's request
17.14for medical assistance payment of long-term care services.
17.15    (j) This section applies to the purchase of a life estate interest in another individual's
17.16person's home unless the purchaser resides in the home for a period of at least one year
17.17after the date of purchase.

17.18    Sec. 17. Minnesota Statutes 2006, section 256B.0595, subdivision 2, is amended to
17.19read:
17.20    Subd. 2. Period of ineligibility. (a) For any uncompensated transfer occurring on or
17.21before August 10, 1993, the number of months of ineligibility for long-term care services
17.22shall be the lesser of 30 months, or the uncompensated transfer amount divided by the
17.23average medical assistance rate for nursing facility services in the state in effect on the
17.24date of application. The amount used to calculate the average medical assistance payment
17.25rate shall be adjusted each July 1 to reflect payment rates for the previous calendar year.
17.26The period of ineligibility begins with the month in which the assets were transferred.
17.27If the transfer was not reported to the local agency at the time of application, and the
17.28applicant received long-term care services during what would have been the period of
17.29ineligibility if the transfer had been reported, a cause of action exists against the transferee
17.30for the cost of long-term care services provided during the period of ineligibility, or for the
17.31uncompensated amount of the transfer, whichever is less. The action may be brought by
17.32the state or the local agency responsible for providing medical assistance under chapter
17.33256G. The uncompensated transfer amount is the fair market value of the asset at the time
17.34it was given away, sold, or disposed of, less the amount of compensation received.
18.1    (b) For uncompensated transfers made after August 10, 1993, the number of months
18.2of ineligibility for long-term care services shall be the total uncompensated value of the
18.3resources transferred divided by the average medical assistance rate for nursing facility
18.4services in the state in effect on the date of application. The amount used to calculate the
18.5average medical assistance payment rate shall be adjusted each July 1 to reflect payment
18.6rates for the previous calendar year. The period of ineligibility begins with the first day
18.7of the month after the month in which the assets were transferred except that if one or
18.8more uncompensated transfers are made during a period of ineligibility, the total assets
18.9transferred during the ineligibility period shall be combined and a penalty period calculated
18.10to begin on the first day of the month after the month in which the first uncompensated
18.11transfer was made. If the transfer was reported to the local agency after the date that
18.12advance notice of a period of ineligibility that affects the next month could be provided to
18.13the recipient and the recipient received medical assistance services or the transfer was not
18.14reported to the local agency, and the applicant or recipient received medical assistance
18.15services during what would have been the period of ineligibility if the transfer had been
18.16reported, a cause of action exists against the transferee for the cost of medical assistance
18.17services provided during the period of ineligibility, or for the uncompensated amount of
18.18the transfer, whichever is less. The action may be brought by the state or the local agency
18.19responsible for providing medical assistance under chapter 256G. The uncompensated
18.20transfer amount is the fair market value of the asset at the time it was given away, sold, or
18.21disposed of, less the amount of compensation received. Effective for transfers made on or
18.22after March 1, 1996, involving persons who apply for medical assistance on or after April
18.2313, 1996, no cause of action exists for a transfer unless:
18.24    (1) the transferee knew or should have known that the transfer was being made by a
18.25person who was a resident of a long-term care facility or was receiving that level of care in
18.26the community at the time of the transfer;
18.27    (2) the transferee knew or should have known that the transfer was being made to
18.28assist the person to qualify for or retain medical assistance eligibility; or
18.29    (3) the transferee actively solicited the transfer with intent to assist the person to
18.30qualify for or retain eligibility for medical assistance.
18.31    (c) For uncompensated transfers made on or after February 8, 2006, the period
18.32of ineligibility:
18.33    (1) for uncompensated transfers by or on behalf of individuals receiving medical
18.34assistance payment of long-term care services, begins on the first day of the month
18.35in which following advance notice can be given following of the penalty period, but no
18.36later than the first day of the month in which assets have been transferred for less than
19.1fair market value, that follows three full calendar months from the date of the report
19.2or discovery of the transfer; or
19.3    (2) for uncompensated transfers by individuals requesting medical assistance
19.4payment of long-term care services, begins the date on which the individual is eligible
19.5for medical assistance under the Medicaid state plan and would otherwise be receiving
19.6long-term care services based on an approved application for such care but for the
19.7application of the penalty period, whichever is later,; and which does not occur
19.8    (3) cannot begin during any other period of ineligibility.
19.9    (d) If a calculation of a penalty period results in a partial month, payments for
19.10long-term care services shall be reduced in an amount equal to the fraction.
19.11    (e) In the case of multiple fractional transfers of assets in more than one month for
19.12less than fair market value on or after February 8, 2006, the period of ineligibility is
19.13calculated by treating the total, cumulative, uncompensated value of all assets transferred
19.14during all months on or after February 8, 2006, as one transfer.

19.15    Sec. 18. Minnesota Statutes 2006, section 256B.0595, subdivision 3, is amended to
19.16read:
19.17    Subd. 3. Homestead exception to transfer prohibition. (a) An institutionalized
19.18person is not ineligible for long-term care services due to a transfer of assets for less than
19.19fair market value if the asset transferred was a homestead and:
19.20    (1) title to the homestead was transferred to the individual's:
19.21    (i) spouse;
19.22    (ii) child who is under age 21;
19.23    (iii) blind or permanently and totally disabled child as defined in the supplemental
19.24security income program;
19.25    (iv) sibling who has equity interest in the home and who was residing in the home
19.26for a period of at least one year immediately before the date of the individual's admission
19.27to the facility; or
19.28    (v) son or daughter who was residing in the individual's home for a period of at least
19.29two years immediately before the date of the individual's admission to the facility the
19.30individual became an institutionalized person, and who provided care to the individual
19.31that, as certified by the individual's attending physician, permitted the individual to reside
19.32at home rather than receive care in an institution or facility;
19.33    (2) a satisfactory showing is made that the individual intended to dispose of the
19.34homestead at fair market value or for other valuable consideration; or
20.1    (3) the local agency grants a waiver of a penalty resulting from a transfer for less
20.2than fair market value because denial of eligibility would cause undue hardship for the
20.3individual, based on imminent threat to the individual's health and well-being. Whenever
20.4an applicant or recipient is denied eligibility because of a transfer for less than fair market
20.5value, the local agency shall notify the applicant or recipient that the applicant or recipient
20.6may request a waiver of the penalty if the denial of eligibility will cause undue hardship.
20.7With the written consent of the individual or the personal representative of the individual,
20.8a long-term care facility in which an individual is residing may file an undue hardship
20.9waiver request, on behalf of the individual who is denied eligibility for long-term care
20.10services on or after July 1, 2006, due to a period of ineligibility resulting from a transfer on
20.11or after February 8, 2006. In evaluating a waiver, the local agency shall take into account
20.12whether the individual was the victim of financial exploitation, whether the individual has
20.13made reasonable efforts to recover the transferred property or resource, and other factors
20.14relevant to a determination of hardship. If the local agency does not approve a hardship
20.15waiver, the local agency shall issue a written notice to the individual stating the reasons
20.16for the denial and the process for appealing the local agency's decision.
20.17    (b) When a waiver is granted under paragraph (a), clause (3), a cause of action exists
20.18against the person to whom the homestead was transferred for that portion of long-term
20.19care services granted within:
20.20    (1) 30 months of a transfer made on or before August 10, 1993;
20.21    (2) 60 months if the homestead was transferred after August 10, 1993, to a trust or
20.22portion of a trust that is considered a transfer of assets under federal law;
20.23    (3) 36 months if transferred in any other manner after August 10, 1993, but prior
20.24to February 8, 2006; or
20.25    (4) 60 months if the homestead was transferred on or after February 8, 2006,
20.26or the amount of the uncompensated transfer, whichever is less, together with the
20.27costs incurred due to the action. The action shall be brought by the state unless the
20.28state delegates this responsibility to the local agency responsible for providing medical
20.29assistance under chapter 256G.

20.30    Sec. 19. Minnesota Statutes 2006, section 256B.0595, subdivision 4, is amended to
20.31read:
20.32    Subd. 4. Other exceptions to transfer prohibition. An institutionalized person
20.33who has made, or whose spouse has made a transfer prohibited by subdivision 1, is not
20.34ineligible for long-term care services if one of the following conditions applies:
21.1    (1) the assets were transferred to the individual's spouse or to another for the sole
21.2benefit of the spouse; or
21.3    (2) the institutionalized spouse, prior to being institutionalized, transferred assets
21.4to a spouse, provided that the spouse to whom the assets were transferred does not then
21.5transfer those assets to another person for less than fair market value. (At the time when
21.6one spouse is institutionalized, assets must be allocated between the spouses as provided
21.7under section 256B.059); or
21.8    (3) the assets were transferred to the individual's child who is blind or permanently
21.9and totally disabled as determined in the supplemental security income program; or
21.10    (4) a satisfactory showing is made that the individual intended to dispose of the
21.11assets either at fair market value or for other valuable consideration; or
21.12    (5) the local agency determines that denial of eligibility for long-term care services
21.13would work an undue hardship and grants a waiver of a penalty resulting from a transfer
21.14for less than fair market value based on an imminent threat to the individual's health
21.15and well-being. Whenever an applicant or recipient is denied eligibility because of a
21.16transfer for less than fair market value, the local agency shall notify the applicant or
21.17recipient that the applicant or recipient may request a waiver of the penalty if the denial of
21.18eligibility will cause undue hardship. With the written consent of the individual or the
21.19personal representative of the individual, a long-term care facility in which an individual
21.20is residing may file an undue hardship waiver request, on behalf of the individual who
21.21is denied eligibility for long-term care services on or after July 1, 2006, due to a period
21.22of ineligibility resulting from a transfer on or after February 8, 2006. In evaluating a
21.23waiver, the local agency shall take into account whether the individual was the victim of
21.24financial exploitation, whether the individual has made reasonable efforts to recover the
21.25transferred property or resource, whether the individual has taken any action to prevent
21.26the designation of the department as a remainder beneficiary on an annuity as described
21.27in section 256B.056, subdivision 11, and other factors relevant to a determination of
21.28hardship. The local agency shall make a determination within 30 days of the receipt of all
21.29necessary information needed to make such a determination. If the local agency does not
21.30approve a hardship waiver, the local agency shall issue a written notice to the individual
21.31stating the reasons for the denial and the process for appealing the local agency's decision.
21.32When a waiver is granted, a cause of action exists against the person to whom the assets
21.33were transferred for that portion of long-term care services granted within:
21.34    (i) 30 months of a transfer made on or before August 10, 1993;
21.35    (ii) 60 months of a transfer if the assets were transferred after August 30, 1993, to a
21.36trust or portion of a trust that is considered a transfer of assets under federal law;
22.1    (iii) 36 months of a transfer if transferred in any other manner after August 10, 1993,
22.2but prior to February 8, 2006; or
22.3    (iv) 60 months of any transfer made on or after February 8, 2006,
22.4or the amount of the uncompensated transfer, whichever is less, together with the
22.5costs incurred due to the action. The action shall be brought by the state unless the
22.6state delegates this responsibility to the local agency responsible for providing medical
22.7assistance under this chapter; or
22.8    (6) for transfers occurring after August 10, 1993, the assets were transferred by
22.9the person or person's spouse: (i) into a trust established for the sole benefit of a son or
22.10daughter of any age who is blind or disabled as defined by the Supplemental Security
22.11Income program; or (ii) into a trust established for the sole benefit of an individual who is
22.12under 65 years of age who is disabled as defined by the Supplemental Security Income
22.13program.
22.14    "For the sole benefit of" has the meaning found in section 256B.059, subdivision 1.

22.15    Sec. 20. Minnesota Statutes 2006, section 256B.0595, is amended by adding a
22.16subdivision to read:
22.17    Subd. 8. Cause of action; transfer prior to death. (a) A cause of action exists
22.18against a transferee who receives assets for less than fair market value, either:
22.19    (1) from a person who was a recipient of medical assistance and who made an
22.20uncompensated transfer that was known to the county agency but a penalty period could
22.21not be implemented under this section due to the death of the person; or
22.22    (2) from a person who was a recipient of medical assistance who made an
22.23uncompensated transfer that was not known to the county agency and the transfer was
22.24made with the intent to hinder, delay, or defraud the state or local agency from recovering
22.25as allowed under section 256B.15. In determining intent under this clause consideration
22.26may be given, among other factors, to whether:
22.27    (i) the transfer was to a family member;
22.28    (ii) the transferor retained possession or control of the property after the transfer;
22.29    (iii) the transfer was concealed;
22.30    (iv) the transfer included the majority of the transferor's assets;
22.31    (v) the value of the consideration received was not reasonably equivalent to the fair
22.32market value of the property; and
22.33    (vi) the transfer occurred shortly before the death of the transferor.
22.34    (b) No cause of action exists under this subdivision unless:
23.1    (1) the transferee knew or should have known that the transfer was being made by a
23.2person who was receiving medical assistance as described in section 256B.15, subdivision
23.31, paragraph (b); and
23.4    (2) the transferee received the asset without providing a reasonable equivalent fair
23.5market value in exchange for the transfer.
23.6    (c) The cause of action is for the uncompensated amount of the transfer or the
23.7amount of medical assistance paid on behalf of the person, whichever is less. The
23.8uncompensated transfer amount is the fair market value of the asset at the time it was
23.9given away, sold, or disposed of, less the amount of the compensation received.

23.10    Sec. 21. Minnesota Statutes 2006, section 256B.0595, is amended by adding a
23.11subdivision to read:
23.12    Subd. 9. Filing cause of action; limitation. (a) The county of financial
23.13responsibility under chapter 256G may bring a cause of action under any or all of the
23.14following:
23.15    (1) subdivision 2, paragraphs (a) and (b);
23.16    (2) subdivision 3, paragraph (b);
23.17    (3) subdivision 4, clause (5); and
23.18    (4) subdivision 8
23.19on behalf of the claimant who must be the commissioner.
23.20    (b) Notwithstanding any other law to the contrary, a cause of action under
23.21subdivision 2, paragraph (a) or (b) or subdivision 8, must be commenced within six years
23.22of the date the local agency determines that a transfer was made for less than fair market
23.23value. Notwithstanding any other law to the contrary, a cause of action under subdivision
23.243, paragraph (b), or subdivision 4, clause (5), must be commenced within six years of the
23.25date of approval of a waiver of the penalty period for a transfer for less than fair market
23.26value based on undue hardship.

23.27    Sec. 22. Minnesota Statutes 2006, section 256B.0625, subdivision 13g, is amended to
23.28read:
23.29    Subd. 13g. Preferred drug list. (a) The commissioner shall adopt and implement a
23.30preferred drug list by January 1, 2004. The commissioner may enter into a contract with
23.31a vendor or one or more states for the purpose of participating in a multistate preferred
23.32drug list and supplemental rebate program. The commissioner shall ensure that any
23.33contract meets all federal requirements and maximizes federal financial participation. The
23.34commissioner shall publish the preferred drug list annually in the State Register and shall
23.35maintain an accurate and up-to-date list on the agency Web site.
24.1    (b) The commissioner may add to, delete from, and otherwise modify the preferred
24.2drug list, after consulting with the Formulary Committee and appropriate medical
24.3specialists and providing public notice and the opportunity for public comment.
24.4    (c) The commissioner shall adopt and administer the preferred drug list as part of the
24.5administration of the supplemental drug rebate program. Reimbursement for prescription
24.6drugs not on the preferred drug list may be subject to prior authorization, unless the drug
24.7manufacturer signs a supplemental rebate contract.
24.8    (d) For purposes of this subdivision, "preferred drug list" means a list of prescription
24.9drugs within designated therapeutic classes selected by the commissioner, for which prior
24.10authorization based on the identity of the drug or class is not required.
24.11    (e) The commissioner shall seek any federal waivers or approvals necessary to
24.12implement this subdivision.

24.13    Sec. 23. Minnesota Statutes 2006, section 256B.075, subdivision 2, is amended to read:
24.14    Subd. 2. Fee-for-service. (a) The commissioner shall develop and implement
24.15a disease management program for medical assistance and general assistance medical
24.16care recipients who are not enrolled in the prepaid medical assistance or prepaid general
24.17assistance medical care programs and who are receiving services on a fee-for-service basis.
24.18The commissioner may contract with an outside organization to provide these services.
24.19    (b) The commissioner shall seek any federal approval necessary to implement this
24.20section and to obtain federal matching funds.
24.21    (c) The commissioner shall develop and implement a pilot intensive care
24.22management program for medical assistance children with complex and chronic medical
24.23issues who are not able to participate in the metro-based U Special Kids program due
24.24to geographic distance.

24.25    Sec. 24. [256B.0948] STATEWIDE HEALTH INFORMATION EXCHANGE.
24.26    Subdivision 1. Commissioner's authority to join and participate. The
24.27commissioner of human services has the authority to join and participate in a statewide
24.28health information exchange that must meet the following criteria:
24.29    (1) the health information exchange must be organized as a nonprofit legal entity so
24.30that none of the entity's property or assets inure to any private organizations or individuals;
24.31    (2) seats must be reserved on the board of directors or managers for the
24.32commissioner, or the commissioner's designated representative, from which the
24.33commissioner or the commissioner's designee may monitor, supervise, and participate in
24.34the governance of the health information exchange; and
25.1    (3) the health information exchange must be designed to advance state interests and
25.2lessen the burdens of government by offering a variety of electronic health information
25.3exchange capabilities and services.
25.4    Subd. 2. Development expenses. Notwithstanding chapter 16C, the commissioner
25.5may pay the state's prorated share of development related expenses retroactively from
25.6October 29, 2007, regardless of the date the participation agreement was signed.

25.7    Sec. 25. Minnesota Statutes 2006, section 256B.15, subdivision 4, is amended to read:
25.8    Subd. 4. Other survivors. (a) If the decedent who was single or the surviving
25.9spouse of a married couple is survived by one of the following persons, a claim exists
25.10against the estate payable first from the value of the nonhomestead property included in
25.11the estate and the personal representative shall make, execute, and deliver to the county
25.12agency a lien against the homestead property in the estate for any unpaid balance of the
25.13claim to the claimant as provided under this section:
25.14    (a) (1) a sibling who resided in the decedent medical assistance recipient's home at
25.15least one year before the decedent's institutionalization and continuously since the date
25.16of institutionalization; or
25.17    (b) (2) a son or daughter or a grandchild who resided in the decedent medical
25.18assistance recipient's home for at least two years immediately before the parent's or
25.19grandparent's institutionalization and continuously since the date of institutionalization,
25.20and who establishes by a preponderance of the evidence having provided care to the
25.21parent or grandparent who received medical assistance, that the care was provided before
25.22institutionalization, and that the care permitted the parent or grandparent to reside at
25.23home rather than in an institution.
25.24    (b) For purposes of this subdivision, "institutionalization" means receiving care:
25.25(1) in a nursing facility or swing bed, or intermediate care facility for persons with
25.26developmental disabilities; or (2) through home and community-based services under
25.27section 256B.0915, 256B.092, or 256B.49.

25.28    Sec. 26. Minnesota Statutes 2006, section 256B.69, subdivision 6, is amended to read:
25.29    Subd. 6. Service delivery. (a) Each demonstration provider shall be responsible for
25.30the health care coordination for eligible individuals. Demonstration providers:
25.31    (1) shall authorize and arrange for the provision of all needed health services
25.32including but not limited to the full range of services listed in sections 256B.02,
25.33subdivision 8 , and 256B.0625 in order to ensure appropriate health care is delivered
25.34to enrollees, notwithstanding section 256B.0621, demonstration providers that provide
26.1nursing home and community-based services under this section shall provide relocation
26.2service coordination to enrolled persons age 65 and over;
26.3    (2) shall accept the prospective, per capita payment from the commissioner in return
26.4for the provision of comprehensive and coordinated health care services for eligible
26.5individuals enrolled in the program;
26.6    (3) may contract with other health care and social service practitioners to provide
26.7services to enrollees; and
26.8    (4) shall institute recipient grievance procedures according to the method established
26.9by the project, utilizing applicable requirements of chapter 62D. Disputes not resolved
26.10through this process shall be appealable to the commissioner as provided in subdivision 11.
26.11    (b) Demonstration providers must comply with the standards for claims settlement
26.12under section 72A.201, subdivisions 4, 5, 7, and 8, when contracting with other health
26.13care and social service practitioners to provide services to enrollees. A demonstration
26.14provider must pay a clean claim, as defined in Code of Federal Regulations, title 42,
26.15section 447.45(b), within 30 business days of the date of acceptance of the claim.

26.16    Sec. 27. Minnesota Statutes 2006, section 256B.69, subdivision 27, is amended to read:
26.17    Subd. 27. Information for persons with limited English-language proficiency.
26.18    Managed care contracts entered into under this section and sections 256D.03, subdivision
26.194 , paragraph (c), and 256L.12 must require demonstration providers to inform enrollees
26.20that upon request the enrollee can obtain a certificate of coverage in the following
26.21languages: Spanish, Hmong, Laotian, Russian, Somali, Vietnamese, or Cambodian.
26.22Upon request, the demonstration provider must provide the enrollee with a certificate of
26.23coverage in the specified language of preference provide language assistance to enrollees
26.24that ensures meaningful access to its programs and services according to Title VI of the
26.25Civil Rights Act and federal regulations adopted under that law or any guidance from the
26.26United States Department of Health and Human Services.

26.27    Sec. 28. Minnesota Statutes 2007 Supplement, section 256D.03, subdivision 3, is
26.28amended to read:
26.29    Subd. 3. General assistance medical care; eligibility. (a) General assistance
26.30medical care may be paid for any person who is not eligible for medical assistance under
26.31chapter 256B, including eligibility for medical assistance based on a spenddown of excess
26.32income according to section 256B.056, subdivision 5, or MinnesotaCare as defined in
26.33paragraph (b), except as provided in paragraph (c), and:
27.1    (1) who is receiving assistance under section 256D.05, except for families with
27.2children who are eligible under Minnesota family investment program (MFIP), or who is
27.3having a payment made on the person's behalf under sections 256I.01 to 256I.06; or
27.4    (2) who is a resident of Minnesota; and
27.5    (i) who has gross countable income not in excess of 75 percent of the federal poverty
27.6guidelines for the family size, using a six-month budget period and whose equity in assets
27.7is not in excess of $1,000 per assistance unit. General assistance medical care is not
27.8available for applicants or enrollees who are otherwise eligible for medical assistance but
27.9fail to verify their assets. Enrollees who become eligible for medical assistance shall be
27.10terminated and transferred to medical assistance. Exempt assets, the reduction of excess
27.11assets, and the waiver of excess assets must conform to the medical assistance program in
27.12section 256B.056, subdivision 3, with the following exception: the maximum amount of
27.13undistributed funds in a trust that could be distributed to or on behalf of the beneficiary by
27.14the trustee, assuming the full exercise of the trustee's discretion under the terms of the
27.15trust, must be applied toward the asset maximum;
27.16    (ii) who has gross countable income above 75 percent of the federal poverty
27.17guidelines but not in excess of 175 percent of the federal poverty guidelines for the
27.18family size, using a six-month budget period, whose equity in assets is not in excess
27.19of the limits in section 256B.056, subdivision 3c, and who applies during an inpatient
27.20hospitalization; or
27.21    (iii) the commissioner shall adjust the income standards under this section each July
27.221 by the annual update of the federal poverty guidelines following publication by the
27.23United States Department of Health and Human Services.
27.24    (b) Effective for applications and renewals processed on or after September 1, 2006,
27.25general assistance medical care may not be paid for applicants or recipients who are adults
27.26with dependent children under 21 whose gross family income is equal to or less than 275
27.27percent of the federal poverty guidelines who are not described in paragraph (e).
27.28    (c) Effective for applications and renewals processed on or after September 1, 2006,
27.29general assistance medical care may be paid for applicants and recipients who meet all
27.30eligibility requirements of paragraph (a), clause (2), item (i), for a temporary period
27.31beginning the date of application. Immediately following approval of general assistance
27.32medical care, enrollees shall be enrolled in MinnesotaCare under section 256L.04,
27.33subdivision 7 , with covered services as provided in section 256L.03 for the rest of the
27.34six-month general assistance medical care eligibility period, until their six-month renewal.
28.1    (d) To be eligible for general assistance medical care following enrollment in
28.2MinnesotaCare as required by paragraph (c), an individual must complete a new
28.3application.
28.4    (e) Applicants and recipients eligible under paragraph (a), clause (1); who are
28.5exempt from the MinnesotaCare enrollment requirements in this subdivision if they:
28.6    (1) have applied for and are awaiting a determination of blindness or disability by
28.7the state medical review team or a determination of eligibility for Supplemental Security
28.8Income or Social Security Disability Insurance by the Social Security Administration; who
28.9    (2) fail to meet the requirements of section 256L.09, subdivision 2; who
28.10    (3) are homeless as defined by United States Code, title 42, section 11301, et seq.;
28.11who
28.12    (4) are classified as end-stage renal disease beneficiaries in the Medicare program;
28.13who
28.14    (5) are enrolled in private health care coverage as defined in section 256B.02,
28.15subdivision 9; who
28.16    (6) are eligible under paragraph (j); or who
28.17    (7) receive treatment funded pursuant to section 254B.02 are exempt from the
28.18MinnesotaCare enrollment requirements of this subdivision; or
28.19    (8) reside in the Minnesota sex offender program defined in chapter 246B.
28.20    (f) For applications received on or after October 1, 2003, eligibility may begin no
28.21earlier than the date of application. For individuals eligible under paragraph (a), clause
28.22(2), item (i), a redetermination of eligibility must occur every 12 months. Individuals are
28.23eligible under paragraph (a), clause (2), item (ii), only during inpatient hospitalization but
28.24may reapply if there is a subsequent period of inpatient hospitalization.
28.25    (g) Beginning September 1, 2006, Minnesota health care program applications and
28.26renewals completed by recipients and applicants who are persons described in paragraph
28.27(c) and submitted to the county agency shall be determined for MinnesotaCare eligibility
28.28by the county agency. If all other eligibility requirements of this subdivision are met,
28.29eligibility for general assistance medical care shall be available in any month during which
28.30MinnesotaCare enrollment is pending. Upon notification of eligibility for MinnesotaCare,
28.31notice of termination for eligibility for general assistance medical care shall be sent to
28.32an applicant or recipient. If all other eligibility requirements of this subdivision are
28.33met, eligibility for general assistance medical care shall be available until enrollment in
28.34MinnesotaCare subject to the provisions of paragraphs (c), (e), and (f).
28.35    (h) The date of an initial Minnesota health care program application necessary to
28.36begin a determination of eligibility shall be the date the applicant has provided a name,
29.1address, and Social Security number, signed and dated, to the county agency or the
29.2Department of Human Services. If the applicant is unable to provide a name, address,
29.3Social Security number, and signature when health care is delivered due to a medical
29.4condition or disability, a health care provider may act on an applicant's behalf to establish
29.5the date of an initial Minnesota health care program application by providing the county
29.6agency or Department of Human Services with provider identification and a temporary
29.7unique identifier for the applicant. The applicant must complete the remainder of the
29.8application and provide necessary verification before eligibility can be determined. The
29.9county agency must assist the applicant in obtaining verification if necessary.
29.10    (i) County agencies are authorized to use all automated databases containing
29.11information regarding recipients' or applicants' income in order to determine eligibility for
29.12general assistance medical care or MinnesotaCare. Such use shall be considered sufficient
29.13in order to determine eligibility and premium payments by the county agency.
29.14    (j) General assistance medical care is not available for a person in a correctional
29.15facility unless the person is detained by law for less than one year in a county correctional
29.16or detention facility as a person accused or convicted of a crime, or admitted as an
29.17inpatient to a hospital on a criminal hold order, and the person is a recipient of general
29.18assistance medical care at the time the person is detained by law or admitted on a criminal
29.19hold order and as long as the person continues to meet other eligibility requirements
29.20of this subdivision.
29.21    (k) General assistance medical care is not available for applicants or recipients who
29.22do not cooperate with the county agency to meet the requirements of medical assistance.
29.23    (l) In determining the amount of assets of an individual eligible under paragraph
29.24(a), clause (2), item (i), there shall be included any asset or interest in an asset, including
29.25an asset excluded under paragraph (a), that was given away, sold, or disposed of for
29.26less than fair market value within the 60 months preceding application for general
29.27assistance medical care or during the period of eligibility. Any transfer described in this
29.28paragraph shall be presumed to have been for the purpose of establishing eligibility for
29.29general assistance medical care, unless the individual furnishes convincing evidence to
29.30establish that the transaction was exclusively for another purpose. For purposes of this
29.31paragraph, the value of the asset or interest shall be the fair market value at the time it
29.32was given away, sold, or disposed of, less the amount of compensation received. For any
29.33uncompensated transfer, the number of months of ineligibility, including partial months,
29.34shall be calculated by dividing the uncompensated transfer amount by the average monthly
29.35per person payment made by the medical assistance program to skilled nursing facilities
29.36for the previous calendar year. The individual shall remain ineligible until this fixed period
30.1has expired. The period of ineligibility may exceed 30 months, and a reapplication for
30.2benefits after 30 months from the date of the transfer shall not result in eligibility unless
30.3and until the period of ineligibility has expired. The period of ineligibility begins in the
30.4month the transfer was reported to the county agency, or if the transfer was not reported,
30.5the month in which the county agency discovered the transfer, whichever comes first. For
30.6applicants, the period of ineligibility begins on the date of the first approved application.
30.7    (m) When determining eligibility for any state benefits under this subdivision,
30.8the income and resources of all noncitizens shall be deemed to include their sponsor's
30.9income and resources as defined in the Personal Responsibility and Work Opportunity
30.10Reconciliation Act of 1996, title IV, Public Law 104-193, sections 421 and 422, and
30.11subsequently set out in federal rules.
30.12    (n) Undocumented noncitizens and nonimmigrants are ineligible for general
30.13assistance medical care. For purposes of this subdivision, a nonimmigrant is an individual
30.14in one or more of the classes listed in United States Code, title 8, section 1101(a)(15), and
30.15an undocumented noncitizen is an individual who resides in the United States without the
30.16approval or acquiescence of the United States Citizenship and Immigration Services.
30.17    (o) Notwithstanding any other provision of law, a noncitizen who is ineligible for
30.18medical assistance due to the deeming of a sponsor's income and resources, is ineligible
30.19for general assistance medical care.
30.20    (p) Effective July 1, 2003, general assistance medical care emergency services end.
30.21EFFECTIVE DATE.This section is effective the day following final enactment.

30.22    Sec. 29. Minnesota Statutes 2006, section 524.3-803, is amended to read:
30.23524.3-803 LIMITATIONS ON PRESENTATION OF CLAIMS.
30.24    (a) All claims as defined in section 524.1-201(6), against a decedent's estate which
30.25arose before the death of the decedent, including claims of the state and any subdivision
30.26thereof, whether due or to become due, absolute or contingent, liquidated or unliquidated,
30.27if not barred earlier by other statute of limitations, are barred against the estate, the personal
30.28representative, and the heirs and devisees of the decedent, unless presented as follows:
30.29    (1) in the case of a creditor who is only entitled, under the United States Constitution
30.30and under the Minnesota Constitution, to notice by publication under section 524.3-801,
30.31within four months after the date of the court administrator's notice to creditors which
30.32is subsequently published pursuant to section 524.3-801;
30.33    (2) in the case of a creditor who was served with notice under section 524.3-801(c),
30.34within the later to expire of four months after the date of the first publication of notice to
30.35creditors or one month after the service;
31.1    (3) within the later to expire of one year after the decedent's death, or one year after
31.2June 16, 1989, whether or not notice to creditors has been published or served under
31.3section 524.3-801, provided, however, that in the case of a decedent who died before June
31.416, 1989, no claim which was then barred by any provision of law may be deemed to have
31.5been revived by the amendment of this section. Claims authorized by section 246.53,
31.6256B.15, or 256D.16 must not be barred after one year as provided in this clause.
31.7    (b) All claims against a decedent's estate which arise at or after the death of the
31.8decedent, including claims of the state and any subdivision thereof, whether due or to
31.9become due, absolute or contingent, liquidated or unliquidated, are barred against the
31.10estate, the personal representative, and the heirs and devisees of the decedent, unless
31.11presented as follows:
31.12    (1) a claim based on a contract with the personal representative, within four months
31.13after performance by the personal representative is due;
31.14    (2) any other claim, within four months after it arises.
31.15    (c) Nothing in this section affects or prevents:
31.16    (1) any proceeding to enforce any mortgage, pledge, or other lien upon property
31.17of the estate;
31.18    (2) any proceeding to establish liability of the decedent or the personal representative
31.19for which there is protection by liability insurance, to the limits of the insurance protection
31.20only;
31.21    (3) the presentment and payment at any time within one year after the decedent's
31.22death of any claim arising before the death of the decedent that is referred to in section
31.23524.3-715 , clause (18), although the same may be otherwise barred under this section; or
31.24    (4) the presentment and payment at any time before a petition is filed in compliance
31.25with section 524.3-1001 or 524.3-1002 or a closing statement is filed under section
31.26524.3-1003 , of:
31.27    (i) any claim arising after the death of the decedent that is referred to in section
31.28524.3-715 , clause (18), although the same may be otherwise barred hereunder;
31.29    (ii) any other claim, including claims subject to clause (3), which would otherwise be
31.30barred hereunder, upon allowance by the court upon petition of the personal representative
31.31or the claimant for cause shown on notice and hearing as the court may direct.

31.32    Sec. 30. REPEALER.
31.33Minnesota Statutes 2006, section 256B.0571, subdivision 8a, is repealed."
31.34Delete the title and insert:
32.1relating to human services; amending health care services provisions;
32.2making changes to general assistance medical care, medical assistance, and
32.3MinnesotaCare; modifying claims, liens, and treatment of assets; establishing a
32.4statewide information exchange;amending Minnesota Statutes 2006, sections
32.5256B.056, subdivisions 2, 4a, 11, by adding a subdivision; 256B.057, subdivision
32.61; 256B.0571, subdivisions 6, 8, 9, 15, by adding a subdivision; 256B.058;
32.7256B.059, subdivisions 1, 1a; 256B.0594; 256B.0595, subdivisions 1, 2, 3, 4,
32.8by adding subdivisions; 256B.0625, subdivision 13g; 256B.075, subdivision 2;
32.9256B.15, subdivision 4; 256B.69, subdivisions 6, 27; 524.3-803; Minnesota
32.10Statutes 2007 Supplement, sections 256B.055, subdivision 14; 256D.03,
32.11subdivision 3; proposing coding for new law in Minnesota Statutes, chapter
32.12256B; repealing Minnesota Statutes 2006, section 256B.0571, subdivision 8a."