1.1.................... moves to amend H.F. No. 374 as follows:
1.2Delete everything after the enacting clause and insert:

1.3    "Section 1. Minnesota Statutes 2008, section 256.045, is amended by adding a
1.4subdivision to read:
1.5    Subd. 3d. Special requirements regarding medical assistance nonemergency
1.6transportation services. Notwithstanding the provisions of Minnesota Rules, parts
1.79505.0125, subpart 1, and 9505.0130, subpart 2, a recipient of nonemergency medical
1.8transportation services under section 256B.0625, subdivisions 17a to 17f, shall be given a
1.9written notice of a denial, reduction, termination, or suspension of those services no later
1.10than 30 days before the effective date of the action, and a local agency shall not reduce,
1.11suspend, or terminate eligibility for those services when a recipient appeals within 30 days
1.12of the agency's mailing of the notice, unless the recipient requests in writing not to receive
1.13continued nonemergency medical transportation services while the appeal is pending.

1.14    Sec. 2. Minnesota Statutes 2008, section 256B.04, subdivision 14a, is amended to read:
1.15    Subd. 14a. Level of need determination. (a) Nonemergency medical transportation
1.16level of need determinations must be performed by a physician, a registered nurse working
1.17under direct supervision of a physician, a physician's assistant, a nurse practitioner,
1.18a licensed practical nurse, a county social worker, or a discharge planner, on a form
1.19prescribed by the commissioner of human services that is designed to determine the
1.20recipient's appropriate level of need for nonemergency medical transportation services.
1.21(b) The prescribed form, when completed by any of the individuals specified in
1.22paragraph (a), shall be submitted to commissioner. The completed form shall serve as
1.23sufficient evidence of the recipient's LON for nonemergency medical transportation
1.24services, and the recipient shall be eligible to receive transportation services at the LON
1.25determined appropriate by the form. Upon receipt of this form, the commissioner may
2.1not reimburse any other person or entity for performing a LON determination for that
2.2recipient at any time sooner than described in this subdivision.
2.3(c) Nonemergency medical transportation level of need determinations must
2.4not be performed more than semiannually on any individual, unless the individual's
2.5circumstances have sufficiently changed so as to require a new level of need determination.
2.6Nonemergency medical transportation level of need determinations must not be performed
2.7more frequently than every seven years on an individual, if a physician certifies that
2.8the individual's medical condition that requires the use of nonemergency medical
2.9transportation is permanent and is not likely to improve, and this certification by the
2.10physician is confirmed by a LON determination. Individuals residing in licensed nursing
2.11facilities are exempt from a level of need determination and are eligible for special
2.12transportation services until the individual no longer resides in a licensed nursing facility.
2.13If a person authorized by this subdivision to perform a level of need determination
2.14determines that an individual requires stretcher transportation, the individual is presumed
2.15to maintain that level of need until otherwise determined by a person authorized to
2.16perform a level of need determination, or for six months, whichever is sooner.
2.17(d) The form used to determine recipients' level of need under this subdivision shall
2.18be developed by a legislative task force comprised of an equal number of representatives
2.19appointed by each of the following:
2.20(1) the Minnesota Department of Human Services;
2.21(2) metro special transportation service providers;
2.22(3) nonmetro special transportation service providers, and
2.23(4) individuals appointed to the task force by the speaker of the house of
2.24representatives and by the senate through the Subcommittee on Committees of the
2.25Committee on Rules and Administration. The form to be used must be agreed to by
2.26consensus of at least 60 percent of the task force members. This form must be developed
2.27by October 1, 2009.
2.28EFFECTIVE DATE.This section is effective October 1, 2009.

2.29    Sec. 3. Minnesota Statutes 2008, section 256B.0625, is amended by adding a
2.30subdivision to read:
2.31    Subd. 17b. Medical Transportation. (a) For purposes of this subdivision and
2.32subdivisions 17a to 17f, the following definitions apply:
2.33(1) "access transportation service" means curb-to-curb or door-through-door
2.34nonemergency medical transportation to or from a covered service that is provided to
2.35a recipient without a physical or mental impairment, but who requires transportation
3.1services to be able to access a covered service, and who is unable to do so by bus or
3.2private automobile;
3.3(2) "curb-to-curb" means access transportation service for recipients who do not
3.4require driver-assisted services;
3.5(3) "door-through-door" means access transportation service for recipients who
3.6require driver-assisted services to be able to safely move from inside of the main portion of
3.7the building at their pickup, and into the main portion of the building at their destination;
3.8the driver shall assist with opening the first door of the building or, if the building has a
3.9vestibule, shall also open the door of the vestibule;
3.10(4) "driver-assisted services" means any assistance that a recipient may need beyond
3.11their initial point of exit from the vehicle;
3.12(5) "medical transportation" means the transport of a recipient to obtain a covered
3.13service or the transport of a recipient after the covered service is provided;
3.14(6) "rural urban commuting area" or "RUCA" means an area determined to be urban,
3.15rural, or super rural by the Centers for Medicare and Medicaid Services for purposes of
3.16Medicare reimbursement of ambulance services;
3.17(7) "special transportation" means station-to-station nonemergency medical
3.18transportation to or from a covered service for a recipient who has a physical or mental
3.19impairment that prohibits the recipient from independently and safely accessing and using
3.20a bus, taxi, other commercial transportation, or private automobile; and
3.21(8) "station-to station" means transportation for recipients who require driver-assisted
3.22services to and within the building at which they are being picked up from or transported
3.23to, beyond the first door or vestibule, which may include assistance to or from a nursing
3.24station or medical practitioner's reception station, or assistance with admittance to the
3.25medical facility.

3.26    Sec. 4. Minnesota Statutes 2008, section 256B.0625, is amended by adding a
3.27subdivision to read:
3.28    Subd. 17c. Transportation costs. (a) Medical assistance covers medical
3.29transportation costs incurred solely for obtaining emergency medical care or transportation
3.30costs incurred by eligible persons in obtaining emergency or nonemergency medical
3.31care when paid directly to an ambulance company, common carrier, or other recognized
3.32providers of transportation services. Medical transportation must be provided by:
3.33(l) ambulance, as defined in section 144E.001, subdivision 2;
3.34(2) special transportation;
3.35(3) access transportation service; or
4.1(4) other common carrier, including, but not limited to, bus, taxicab, other
4.2commercial carrier, or private automobile.
4.3(b) The commissioner shall certify that the recipient requires special transportation
4.4services by use of a level of need determination, as described in section 256B.04,
4.5subdivision l4a. Drivers providing nonemergency medical transportation in a vehicle
4.6equipped to transport a recipient in a wheelchair or stretcher shall be responsible for
4.7assistance in passenger securement and in securing of wheelchairs or stretchers in the
4.8vehicle. Special transportation providers must obtain written documentation from the
4.9health care service provider who is serving the recipient being transported, identifying
4.10the time that the recipient arrived. Special transportation and access transportation
4.11providers may not bill for separate base rates for the continuation of a trip beyond the
4.12original destination. Special transportation and access transportation providers must
4.13take recipients to the nearest appropriate health care provider, using the quickest route
4.14available as determined by a commercially available software program approved by the
4.15commissioner and designated by the provider as the program to be used to determine
4.16the route and mileage for all trips.

4.17    Sec. 5. Minnesota Statutes 2008, section 256B.0625, is amended by adding a
4.18subdivision to read:
4.19    Subd. 17d. Payment for nonemergency medical transportation. The minimum
4.20medical assistance reimbursement rates for nonemergency medical transportation services
4.21are:
4.22(1) for areas defined under RUCA as urban:
4.23(i) $17 for the base rate and $1.50 per mile for services to eligible persons who need
4.24a wheelchair-accessible van for special transportation services;
4.25(ii) $11.00 for the base rate and $1.45 per mile for services to eligible persons who
4.26do not need a wheelchair-accessible van for special transportation services;
4.27(iii) $8 for the base rate and $1.45 per mile for services to eligible persons who need
4.28a wheelchair-accessible van for curb-to-curb access transportation service;
4.29(iv) $11 for the base rate and $1.45 per mile for services to eligible persons who
4.30need a wheelchair-accessible van for door-through-door access transportation service;
4.31(v) $5 for the base rate and $1.45 per mile for services to eligible persons who do not
4.32need a wheelchair-accessible van for curb-to-curb access transportation service;
4.33(vi) $7 for the base rate and $1.45 per mile for services to eligible persons who do
4.34not need a wheelchair-accessible van for door-through-door access transportation service.
5.1(vii) $60 for the base rate and $2.40 per mile, and an attendant rate of $9 per trip, for
5.2services to eligible persons who need a stretcher-accessible vehicle;
5.3(2) for areas defined under RUCA as rural: the same base rate as for areas defined
5.4under RUCA as urban and 110 percent of the urban mileage rate;
5.5(3) for areas defined under RUCA as super rural: the same base rate as for areas
5.6defined under RUCA as urban and 115 percent of the urban mileage rate;
5.7(4) for all special transportation and access transportation services, for a trip equal to
5.8or exceeding 51 miles, the provider shall receive mileage reimbursement for each mile
5.9equal to or exceeding 51 miles at 125 percent or the urban mileage rate; this rate shall
5.10supersede that specified in clauses (2) and (3) for areas defined as rural and super rural; and
5.11(5) For purposes of reimbursement rates for special transportation and access
5.12transportation services, the recipient's place of residence shall determine whether the
5.13RUCA urban, rural, or super rural reimbursement rate applies.

5.14    Sec. 6. Minnesota Statutes 2008, section 256B.0625, is amended by adding a
5.15subdivision to read:
5.16    Subd. 17e. Access transportation services in metropolitan area. Access
5.17transportation services in the 11-county metropolitan area shall be coordinated by the
5.18"Minnesota Non-Emergency Transportation" (MNET) program. MNET shall ensure that
5.19the most appropriate, and cost-effective, form of transportation is utilized for any eligible
5.20person in obtaining nonemergency medical care. The contractor, or broker, administering
5.21this program shall be paid as follows:
5.22(1) for the actual cost of service that is reimbursed to access transportation service
5.23providers or actual cost incurred for each bus pass or mileage reimbursement provided to
5.24recipients, plus a "trip administration fee" in the amount of $5.00 for each completed trip;
5.25(2) for "standing orders," defined as a trip by a recipient with the same origin and
5.26destination for which the recipient is transported two or more times per week, the trip
5.27administration fee for that trip shall be $7.50 per calendar week, regardless of the number
5.28of times the recipient travels from that same origin to that same destination during that
5.29week;
5.30(3) the trip administration fee shall only be paid for trips for which the recipient
5.31received transportation, and shall not be paid for any "no-shows" or "cancellations"; and
5.32(4) level of need determinations shall be paid at a rate of $25 each for recipients
5.33who are ambulatory, who use wheelchairs, or who require nonemergency stretcher
5.34transportation; there shall not be any payment for level of need determinations in excess of
5.35the number that is authorized for a recipient in section 256B.04, subdivision 14a.

6.1    Sec. 7. Minnesota Statutes 2008, section 256B.0625, is amended by adding a
6.2subdivision to read:
6.3    Subd. 17f. Broker dispatching prohibition. The commissioner shall not use a
6.4broker to manage, coordinate, or dispatch special transportation services. The only role
6.5that the broker may have with regard to special transportation is the performance of
6.6level of need determinations in accordance with section 256B.04, subdivision 14a. For
6.7purposes of this subdivision, "broker" means any person, organization, or other entity
6.8that receives any payment or reimbursement, from the state of Minnesota or any of its
6.9departments, to provide, coordinate, dispatch, procure, or contract for the provision of
6.10nonemergency medical transportation.

6.11    Sec. 8. REPEALER.
6.12Minnesota Statutes 2008, section 256B.0625, subdivision 17, is repealed."
6.13Renumber the sections in sequence and correct the internal references
6.14Amend the title accordingly