1.1 .................... moves to amend H.F. No. 3222, the delete everything amendment
1.2(A08-1172), as follows:
1.3Page 26, after line 26 insert:
1.4 "Sec. 28. Minnesota Statutes 2006, section 256B.69, subdivision 28, is amended to
1.5read:
1.6 Subd. 28.
Medicare special needs plans; medical assistance basic health care.
1.7 (a) The commissioner may contract with qualified Medicare-approved special needs
1.8plans to provide medical assistance basic health care services to persons with disabilities,
1.9including those with developmental disabilities. Basic health care services include:
1.10 (1) those services covered by the medical assistance state plan except for ICF/MR
1.11services, home and community-based waiver services, case management for persons with
1.12developmental disabilities under section
256B.0625, subdivision 20a, and personal care
1.13and certain home care services defined by the commissioner in consultation with the
1.14stakeholder group established under paragraph (d); and
1.15 (2) basic health care services may also include risk for up to 100 days of nursing
1.16facility services for persons who reside in a noninstitutional setting and home health
1.17services related to rehabilitation as defined by the commissioner after consultation with
1.18the stakeholder group.
1.19 The commissioner may exclude other medical assistance services from the basic
1.20health care benefit set. Enrollees in these plans can access any excluded services on the
1.21same basis as other medical assistance recipients who have not enrolled.
1.22 Unless a person is otherwise required to enroll in managed care, enrollment in these
1.23plans for Medicaid services must be voluntary. For purposes of this subdivision, automatic
1.24enrollment with an option to opt out is not voluntary enrollment.
1.25 (b) Beginning January 1, 2007, the commissioner may contract with qualified
1.26Medicare special needs plans to provide basic health care services under medical
1.27assistance to persons who are dually eligible for both Medicare and Medicaid and those
2.1Social Security beneficiaries eligible for Medicaid but in the waiting period for Medicare.
2.2The commissioner shall consult with the stakeholder group under paragraph (d) in
2.3developing program specifications for these services. The commissioner shall report to
2.4the chairs of the house and senate committees with jurisdiction over health and human
2.5services policy and finance by February 1, 2007, on implementation of these programs and
2.6the need for increased funding for the ombudsman for managed care and other consumer
2.7assistance and protections needed due to enrollment in managed care of persons with
2.8disabilities. Payment for Medicaid services provided under this subdivision for the months
2.9of May and June will be made no earlier than July 1 of the same calendar year.
2.10 (c) Beginning January 1, 2008, the commissioner may expand contracting under this
2.11subdivision to all persons with disabilities not otherwise required to enroll in managed
2.12care.
2.13 (d) The commissioner shall establish a state-level stakeholder group to provide
2.14advice on managed care programs for persons with disabilities, including both MnDHO
2.15and contracts with special needs plans that provide basic health care services as described
2.16in paragraphs (a) and (b). The stakeholder group shall provide advice on program
2.17expansions under this subdivision and subdivision 23, including:
2.18 (1) implementation efforts;
2.19 (2) consumer protections; and
2.20 (3) program specifications such as quality assurance measures, data collection and
2.21reporting, and evaluation of costs, quality, and results.
2.22 (e) Each plan under contract to provide medical assistance basic health care services
2.23shall establish a local or regional stakeholder group, including representatives of the
2.24counties covered by the plan, members, consumer advocates, and providers, for advice on
2.25issues that arise in the local or regional area.
2.26 (f) Each plan under contract to provide medical assistance basic health care services
2.27shall ensure that any written material which targets and is disseminated to current or
2.28potential enrollees must be understandable to a person who reads at the third grade level,
2.29using the Flesch scale analysis readability score as determined under section 72C.09. The
2.30results of the Flesch score must be submitted to the commissioner."
2.31Renumber the sections in sequence and correct the internal references
2.32Amend the title accordingly