1.1    .................... moves to amend H.F. No. 3380, the first engrossment, as follows:
1.2Delete everything after the enacting clause and insert:

1.3    "Section 1. Minnesota Statutes 2007 Supplement, section 256B.69, subdivision 4,
1.4is amended to read:
1.5    Subd. 4. Limitation of choice. (a) The commissioner shall develop criteria to
1.6determine when limitation of choice may be implemented in the experimental counties.
1.7The criteria shall ensure that all eligible individuals in the county have continuing access
1.8to the full range of medical assistance services as specified in subdivision 6.
1.9    (b) The commissioner shall exempt the following persons from participation in the
1.10project, in addition to those who do not meet the criteria for limitation of choice:
1.11    (1) persons eligible for medical assistance according to section 256B.055,
1.12subdivision 1 ;
1.13    (2) persons eligible for medical assistance due to blindness or disability as
1.14determined by the Social Security Administration or the state medical review team, unless:
1.15    (i) they are 65 years of age or older; or
1.16    (ii) they reside in Itasca County or they reside in a county in which the commissioner
1.17conducts a pilot project under a waiver granted pursuant to section 1115 of the Social
1.18Security Act;
1.19    (3) recipients who currently have private coverage through a health maintenance
1.20organization;
1.21    (4) recipients who are eligible for medical assistance by spending down excess
1.22income for medical expenses other than the nursing facility per diem expense;
1.23    (5) recipients who receive benefits under the Refugee Assistance Program,
1.24established under United States Code, title 8, section 1522(e);
1.25    (6) children who are both determined to be severely emotionally disturbed and
1.26receiving case management services according to section 256B.0625, subdivision 20,
2.1except children who are eligible for and who decline enrollment in an approved preferred
2.2integrated network under section 245.4682;
2.3    (7) adults who are both determined to be seriously and persistently mentally ill and
2.4received case management services according to section 256B.0625, subdivision 20;
2.5    (8) persons eligible for medical assistance according to section 256B.057,
2.6subdivision 10 ; and
2.7    (9) persons with access to cost-effective employer-sponsored private health
2.8insurance or persons enrolled in a non-Medicare individual health plan determined to be
2.9cost-effective according to section 256B.0625, subdivision 15.
2.10Children under age 21 who are in foster placement may enroll in the project on an elective
2.11basis. Individuals excluded under clauses (1), (6), and (7) may choose to enroll on an
2.12elective basis. The commissioner may enroll recipients in the prepaid medical assistance
2.13program for seniors who are (1) age 65 and over, and (2) eligible for medical assistance by
2.14spending down excess income.
2.15    (c) The commissioner may allow persons with a one-month spenddown who are
2.16otherwise eligible to enroll to voluntarily enroll or remain enrolled, if they elect to prepay
2.17their monthly spenddown to the state.
2.18    (d) The commissioner may require those individuals to enroll in the prepaid medical
2.19assistance program who otherwise would have been excluded under paragraph (b), clauses
2.20(1), (3), and (8), and under Minnesota Rules, part 9500.1452, subpart 2, items H, K, and L.
2.21    (e) Before limitation of choice is implemented, eligible individuals shall be notified
2.22and after notification, shall be allowed to choose only among demonstration providers.
2.23The commissioner may assign an individual with private coverage through a health
2.24maintenance organization, to the same health maintenance organization for medical
2.25assistance coverage, if the health maintenance organization is under contract for medical
2.26assistance in the individual's county of residence. After initially choosing a provider,
2.27the recipient is allowed to change that choice only at specified times as allowed by the
2.28commissioner. If a demonstration provider ends participation in the project for any reason,
2.29a recipient enrolled with that provider must select a new provider but may change providers
2.30without cause once more within the first 60 days after enrollment with the second provider.
2.31    (f) An infant born to a woman who is eligible for and receiving medical assistance
2.32and who is enrolled in the prepaid medical assistance program shall be retroactively
2.33enrolled to the month of birth in the same managed care plan as the mother once the
2.34child is enrolled in medical assistance unless the child is determined to be excluded from
2.35enrollment in a prepaid plan under this section.
3.1    (g) The commissioner shall assign an eligible individual, in the absence of a specific
3.2managed care plan choice by the individual, to the county-based purchasing health plan in
3.3counties having an approved county-based purchasing health plan.

3.4    Sec. 2. Laws 2005, First Special Session chapter 4, article 8, section 84, as amended by
3.5Laws 2006, chapter 264, section 15, is amended to read:
3.6    Sec. 84. SOLE-SOURCE OR SINGLE-PLAN MANAGED CARE
3.7CONTRACT.
3.8    (a) Notwithstanding Minnesota Statutes, section 256B.692, subdivision 6, clause
3.9(1), paragraph (c), the commissioner of human services shall approve a county-based
3.10purchasing health plan proposal, submitted on behalf of Cass, Crow Wing, Morrison,
3.11Todd, and Wadena Counties, that requires county-based purchasing on a single-plan basis
3.12contract if the implementation of the single-plan purchasing proposal does not limit an
3.13enrollee's provider choice or access to services and all other requirements applicable to
3.14health plan purchasing are satisfied. The commissioner shall continue, until January 1,
3.152010, single health plan purchasing arrangements with county-based purchasing entities
3.16in the service areas in existence on May 1, 2006, including arrangements for which a
3.17proposal was submitted by May 1, 2006, on behalf of Cass, Crow Wing, Morrison, Todd,
3.18and Wadena Counties, in response to a request for proposals issued by the commissioner.
3.19    (b) Notwithstanding Minnesota Statutes, section 256B.692, subdivision 6, clause
3.20(1), paragraph (c), the commissioner of human services shall approve a county-based
3.21purchasing health plan proposal submitted on behalf of Winona, Houston, Fillmore, and
3.22Mower Counties for medical assistance, MinnesotaCare, general assistance medical care,
3.23and other prepaid health care programs administered by the commissioner of human
3.24services that requires county-based purchasing in a single-plan basis contract if the
3.25implementation of the single-plan purchasing proposal does not limit an enrollee's
3.26provider choice or access to services, and all other requirements applicable to health plan
3.27purchasing are satisfied.
3.28    (c) The commissioner shall reopen all counties for competitive reprocurement every
3.29five years, beginning 2011.
3.30    (d) The commissioner shall consider, and may approve, contracting on a
3.31single-health plan basis with county-based purchasing plans, or with other qualified health
3.32plans that have coordination arrangements with counties, to serve persons with a disability
3.33who voluntarily enroll, in order to promote better coordination or integration of health
3.34care services, social services and other community-based services, provided that all
3.35requirements applicable to health plan purchasing, including those in Minnesota Statutes,
3.36section 256B.69, subdivision 23, are satisfied. By January 15, 2007, the commissioner
4.1shall report to the chairs of the appropriate legislative committees in the house and senate
4.2an analysis of the advantages and disadvantages of using single-health plan purchasing
4.3to serve persons with a disability who are eligible for health care programs. The report
4.4shall include consideration of the impact of federal health care programs and policies for
4.5persons who are eligible for both federal and state health care programs and shall consider
4.6strategies to improve coordination between federal and state health care programs for
4.7those persons."
4.8Amend the title accordingly