1.1.................... moves to amend H.F. No. 802 as follows:
1.2Delete everything after the enacting clause and insert:


1.5    Section 1. [245.4862] MENTAL HEALTH URGENT CARE AND PSYCHIATRIC
1.6CONSULTATION.
1.7    Subdivision 1. Mental health urgent care and psychiatric consultation. The
1.8commissioner shall include mental health urgent care and psychiatric consultation
1.9services as part of, but not limited to, the redesign of six community-based behavioral
1.10health hospitals and the Anoka-Metro Regional Treatment Center. These services must
1.11not duplicate existing services in the region, and must be implemented as specified in
1.12subdivisions 3 to 7.
1.13    Subd. 2. Definitions. For purposes of this section:
1.14(a) Mental health urgent care includes:
1.15(1) initial mental health screening;
1.16(2) mobile crisis assessment and intervention;
1.17(3) rapid access to psychiatry, including psychiatric evaluation, initial treatment,
1.18and short-term psychiatry;
1.19(4) nonhospital crisis stabilization residential beds; and
1.20(5) health care navigator services which include, but are not limited to, assisting
1.21uninsured individuals in obtaining health care coverage.
1.22(b) Psychiatric consultation services includes psychiatric consultation to primary
1.23care practitioners.
1.24    Subd. 3. Rapid access to psychiatry. The commissioner shall develop rapid access
1.25to psychiatric services based on the following criteria:
2.1(1) the individuals who receive the psychiatric services must be at risk of
2.2hospitalization and otherwise unable to receive timely services;
2.3(2) where clinically appropriate, the service may be provided via interactive video
2.4where the service is provided in conjunction with an emergency room, a local crisis
2.5service, or a primary care or behavioral care practitioner; and
2.6(3) the commissioner may integrate rapid access to psychiatry with the psychiatric
2.7consultation services in subdivision 4.
2.8    Subd. 4. Collaborative psychiatric consultation. (a) The commissioner shall
2.9establish a collaborative psychiatric consultation service based on the following criteria:
2.10(1) the service may be available via telephone, interactive video, e-mail, or other
2.11means of communication to emergency rooms, local crisis services, mental health
2.12professionals, and primary care practitioners, including pediatricians;
2.13(2) the service shall be provided by a multidisciplinary team including, at a
2.14minimum, a child and adolescent psychiatrist, an adult psychiatrist, and a licensed clinical
2.15social worker;
2.16(3) the service shall include a triage-level assessment to determine the most
2.17appropriate response to each request, including appropriate referrals to other mental health
2.18professionals, as well as provision of rapid psychiatric access when other appropriate
2.19services are not available;
2.20(4) the first priority for this service is to provide the consultations required under
2.21section 256B.0625, subdivision 13j; and
2.22(5) the service must encourage use of cognitive and behavioral therapies and other
2.23evidence-based treatments in addition to or in place of medication, where appropriate.
2.24(b) The commissioner shall appoint an interdisciplinary work group to establish
2.25appropriate medication and psychotherapy protocols to guide the consultative process,
2.26including consultation with the Drug Utilization Review Board, as provided in section
2.27256B.0625, subdivision 13j.
2.28    Subd. 5. Phased availability. (a) The commissioner may phase in the availability
2.29of mental health urgent care services based on the limits of appropriations and the
2.30commissioner's determination of level of need and cost-effectiveness.
2.31(b) For subdivisions 3 and 4, the first phase must focus on adults in Hennepin
2.32and Ramsey Counties and children statewide who are affected by section 256B.0625,
2.33subdivision 13j, and must include tracking of costs for the services provided and
2.34associated impacts on utilization of inpatient, emergency room, and other services.
2.35    Subd. 6. Limited appropriations. The commissioner shall maximize use
2.36of available health care coverage for the services provided under this section. The
3.1commissioner's responsibility to provide these services for individuals without health care
3.2coverage must not exceed the appropriations for this section.
3.3    Subd. 7. Flexible implementation. To implement this section, the commissioner
3.4shall select the structure and funding method that is the most cost-effective for each county
3.5or group of counties. This may include grants, contracts, direct provision by state-operated
3.6services, and public-private partnerships. Where feasible, the commissioner shall make
3.7any grants under this section a part of the integrated adult mental health initiative grants
3.8under section 245.4661.

3.9    Sec. 2. Minnesota Statutes 2009 Supplement, section 256.969, subdivision 3a, is
3.10amended to read:
3.11    Subd. 3a. Payments. (a) Acute care hospital billings under the medical
3.12assistance program must not be submitted until the recipient is discharged. However,
3.13the commissioner shall establish monthly interim payments for inpatient hospitals that
3.14have individual patient lengths of stay over 30 days regardless of diagnostic category.
3.15Except as provided in section 256.9693, medical assistance reimbursement for treatment
3.16of mental illness shall be reimbursed based on diagnostic classifications. Individual
3.17hospital payments established under this section and sections 256.9685, 256.9686, and
3.18256.9695 , in addition to third party and recipient liability, for discharges occurring during
3.19the rate year shall not exceed, in aggregate, the charges for the medical assistance covered
3.20inpatient services paid for the same period of time to the hospital. This payment limitation
3.21shall be calculated separately for medical assistance and general assistance medical
3.22care services. The limitation on general assistance medical care shall be effective for
3.23admissions occurring on or after July 1, 1991. Services that have rates established under
3.24subdivision 11 or 12, must be limited separately from other services. After consulting with
3.25the affected hospitals, the commissioner may consider related hospitals one entity and
3.26may merge the payment rates while maintaining separate provider numbers. The operating
3.27and property base rates per admission or per day shall be derived from the best Medicare
3.28and claims data available when rates are established. The commissioner shall determine
3.29the best Medicare and claims data, taking into consideration variables of recency of the
3.30data, audit disposition, settlement status, and the ability to set rates in a timely manner.
3.31The commissioner shall notify hospitals of payment rates by December 1 of the year
3.32preceding the rate year. The rate setting data must reflect the admissions data used to
3.33establish relative values. Base year changes from 1981 to the base year established for the
3.34rate year beginning January 1, 1991, and for subsequent rate years, shall not be limited
3.35to the limits ending June 30, 1987, on the maximum rate of increase under subdivision
4.11. The commissioner may adjust base year cost, relative value, and case mix index data
4.2to exclude the costs of services that have been discontinued by the October 1 of the year
4.3preceding the rate year or that are paid separately from inpatient services. Inpatient stays
4.4that encompass portions of two or more rate years shall have payments established based
4.5on payment rates in effect at the time of admission unless the date of admission preceded
4.6the rate year in effect by six months or more. In this case, operating payment rates for
4.7services rendered during the rate year in effect and established based on the date of
4.8admission shall be adjusted to the rate year in effect by the hospital cost index.
4.9    (b) For fee-for-service admissions occurring on or after July 1, 2002, the total
4.10payment, before third-party liability and spenddown, made to hospitals for inpatient
4.11services is reduced by .5 percent from the current statutory rates.
4.12    (c) In addition to the reduction in paragraph (b), the total payment for fee-for-service
4.13admissions occurring on or after July 1, 2003, made to hospitals for inpatient services
4.14before third-party liability and spenddown, is reduced five percent from the current
4.15statutory rates. Mental health services within diagnosis related groups 424 to 432, and
4.16facilities defined under subdivision 16 are excluded from this paragraph.
4.17    (d) In addition to the reduction in paragraphs (b) and (c), the total payment for
4.18fee-for-service admissions occurring on or after August 1, 2005, made to hospitals for
4.19inpatient services before third-party liability and spenddown, is reduced 6.0 percent
4.20from the current statutory rates. Mental health services within diagnosis related groups
4.21424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph.
4.22Notwithstanding section 256.9686, subdivision 7, for purposes of this paragraph, medical
4.23assistance does not include general assistance medical care. Payments made to managed
4.24care plans shall be reduced for services provided on or after January 1, 2006, to reflect
4.25this reduction.
4.26    (e) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for
4.27fee-for-service admissions occurring on or after July 1, 2008, through June 30, 2009, made
4.28to hospitals for inpatient services before third-party liability and spenddown, is reduced
4.293.46 percent from the current statutory rates. Mental health services with diagnosis related
4.30groups 424 to 432 and facilities defined under subdivision 16 are excluded from this
4.31paragraph. Payments made to managed care plans shall be reduced for services provided
4.32on or after January 1, 2009, through June 30, 2009, to reflect this reduction.
4.33    (f) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for
4.34fee-for-service admissions occurring on or after July 1, 2009, through June 30, 2010 2011,
4.35made to hospitals for inpatient services before third-party liability and spenddown, is
4.36reduced 1.9 percent from the current statutory rates. Mental health services with diagnosis
5.1related groups 424 to 432 and facilities defined under subdivision 16 are excluded from
5.2this paragraph. Payments made to managed care plans shall be reduced for services
5.3provided on or after July 1, 2009, through June 30, 2010 2011, to reflect this reduction.
5.4    (g) In addition to the reductions in paragraphs (b), (c), and (d), the total payment
5.5for fee-for-service admissions occurring on or after July 1, 2010 2011, made to hospitals
5.6for inpatient services before third-party liability and spenddown, is reduced 1.79 percent
5.7from the current statutory rates. Mental health services with diagnosis related groups
5.8424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph.
5.9Payments made to managed care plans shall be reduced for services provided on or after
5.10July 1, 2010 2011, to reflect this reduction.
5.11(h) In addition to the reductions in paragraphs (b), (c), (d), (f), and (g), the total
5.12payment for fee-for-service admissions occurring on or after July 1, 2009, made to
5.13hospitals for inpatient services before third-party liability and spenddown, is reduced
5.14one percent from the current statutory rates. Facilities defined under subdivision 16 are
5.15excluded from this paragraph. Payments made to managed care plans shall be reduced for
5.16services provided on or after October 1, 2009, to reflect this reduction.
5.17EFFECTIVE DATE.This section is effective April 1, 2010.

5.18    Sec. 3. Minnesota Statutes 2008, section 256.969, subdivision 27, is amended to read:
5.19    Subd. 27. Quarterly payment adjustment. (a) In addition to any other payment
5.20under this section, the commissioner shall make the following payments effective July
5.211, 2007:
5.22    (1) for a hospital located in Minnesota and not eligible for payments under
5.23subdivision 20, with a medical assistance inpatient utilization rate greater than 17.8
5.24percent of total patient days as of the base year in effect on July 1, 2005, a payment
5.25equal to 13 percent of the total of the operating and property payment rates, except that
5.26Hennepin County Medical Center and Regions Hospital shall not receive a payment
5.27under this subdivision;
5.28    (2) for a hospital located in Minnesota in a specified urban area outside of the
5.29seven-county metropolitan area and not eligible for payments under subdivision 20, with
5.30a medical assistance inpatient utilization rate less than or equal to 17.8 percent of total
5.31patient days as of the base year in effect on July 1, 2005, a payment equal to ten percent
5.32of the total of the operating and property payment rates. For purposes of this clause, the
5.33following cities are specified urban areas: Detroit Lakes, Rochester, Willmar, Alexandria,
5.34Austin, Cambridge, Brainerd, Hibbing, Mankato, Duluth, St. Cloud, Grand Rapids,
5.35Wyoming, Fergus Falls, Albert Lea, Winona, Virginia, Thief River Falls, and Wadena;
6.1    (3) for a hospital located in Minnesota but not located in a specified urban area
6.2under clause (2), with a medical assistance inpatient utilization rate less than or equal to
6.317.8 percent of total patient days as of the base year in effect on July 1, 2005, a payment
6.4equal to four percent of the total of the operating and property payment rates. A hospital
6.5located in Woodbury and not in existence during the base year shall be reimbursed under
6.6this clause; and
6.7    (4) in addition to any payments under clauses (1) to (3), for a hospital located in
6.8Minnesota and not eligible for payments under subdivision 20 with a medical assistance
6.9inpatient utilization rate of 17.9 percent of total patient days as of the base year in effect
6.10on July 1, 2005, a payment equal to eight percent of the total of the operating and property
6.11payment rates, and for a hospital located in Minnesota and not eligible for payments
6.12under subdivision 20 with a medical assistance inpatient utilization rate of 59.6 percent
6.13of total patient days as of the base year in effect on July 1, 2005, a payment equal to
6.14nine percent of the total of the operating and property payment rates. After making any
6.15ratable adjustments required under paragraph (b), the commissioner shall proportionately
6.16reduce payments under clauses (2) and (3) by an amount needed to make payments under
6.17this clause.
6.18    (b) The state share of payments under paragraph (a) shall be equal to federal
6.19reimbursements to the commissioner to reimburse expenditures reported under section
6.20256B.199, paragraphs (a) to (d) . The commissioner shall ratably reduce or increase
6.21payments under this subdivision in order to ensure that these payments equal the amount
6.22of reimbursement received by the commissioner under section 256B.199, paragraphs (a)
6.23to (d) , except that payments shall be ratably reduced by an amount equivalent to the state
6.24share of a four percent reduction in MinnesotaCare and medical assistance payments
6.25for inpatient hospital services. Effective July 1, 2009, the ratable reduction shall be
6.26equivalent to the state share of a three percent reduction in these payments. Effective for
6.27federal disproportionate share hospital funds earned on payments reported under section
6.28256B.199, paragraphs (a) to (d), for services rendered on or after April 1, 2010, payments
6.29shall not be made under this subdivision.
6.30    (c) The payments under paragraph (a) shall be paid quarterly based on each hospital's
6.31operating and property payments from the second previous quarter, beginning on July
6.3215, 2007, or upon federal approval of federal reimbursements under section 256B.199,
6.33paragraphs (a) to (d) , whichever occurs later.
6.34    (d) The commissioner shall not adjust rates paid to a prepaid health plan under
6.35contract with the commissioner to reflect payments provided in paragraph (a).
7.1    (e) The commissioner shall maximize the use of available federal money for
7.2disproportionate share hospital payments and shall maximize payments to qualifying
7.3hospitals. In order to accomplish these purposes, the commissioner may, in consultation
7.4with the nonstate entities identified in section 256B.199, paragraphs (a) to (d), adjust,
7.5on a pro rata basis if feasible, the amounts reported by nonstate entities under section
7.6256B.199, paragraphs (a) to (d), when application for reimbursement is made to the federal
7.7government, and otherwise adjust the provisions of this subdivision. The commissioner
7.8shall utilize a settlement process based on finalized data to maximize revenue under
7.9section 256B.199, paragraphs (a) to (d), and payments under this section.
7.10    (f) For purposes of this subdivision, medical assistance does not include general
7.11assistance medical care.
7.12EFFECTIVE DATE.This section is effective for services rendered on or after
7.13April 1, 2010.

7.14    Sec. 4. Minnesota Statutes 2008, section 256B.0625, subdivision 13f, is amended to
7.15read:
7.16    Subd. 13f. Prior authorization. (a) The Formulary Committee shall review and
7.17recommend drugs which require prior authorization. The Formulary Committee shall
7.18establish general criteria to be used for the prior authorization of brand-name drugs for
7.19which generically equivalent drugs are available, but the committee is not required to
7.20review each brand-name drug for which a generically equivalent drug is available.
7.21(b) Prior authorization may be required by the commissioner before certain
7.22formulary drugs are eligible for payment. The Formulary Committee may recommend
7.23drugs for prior authorization directly to the commissioner. The commissioner may also
7.24request that the Formulary Committee review a drug for prior authorization. Before the
7.25commissioner may require prior authorization for a drug:
7.26(1) the commissioner must provide information to the Formulary Committee on the
7.27impact that placing the drug on prior authorization may have on the quality of patient care
7.28and on program costs, information regarding whether the drug is subject to clinical abuse
7.29or misuse, and relevant data from the state Medicaid program if such data is available;
7.30(2) the Formulary Committee must review the drug, taking into account medical and
7.31clinical data and the information provided by the commissioner; and
7.32(3) the Formulary Committee must hold a public forum and receive public comment
7.33for an additional 15 days.
7.34The commissioner must provide a 15-day notice period before implementing the prior
7.35authorization.
8.1(c) Except as provided in subdivision 13j, prior authorization shall not be required or
8.2utilized for any atypical antipsychotic drug prescribed for the treatment of mental illness if:
8.3(1) there is no generically equivalent drug available; and
8.4(2) the drug was initially prescribed for the recipient prior to July 1, 2003; or
8.5(3) the drug is part of the recipient's current course of treatment.
8.6This paragraph applies to any multistate preferred drug list or supplemental drug rebate
8.7program established or administered by the commissioner. Prior authorization shall
8.8automatically be granted for 60 days for brand name drugs prescribed for treatment of
8.9mental illness within 60 days of when a generically equivalent drug becomes available,
8.10provided that the brand name drug was part of the recipient's course of treatment at the
8.11time the generically equivalent drug became available.
8.12(d) Prior authorization shall not be required or utilized for any antihemophilic factor
8.13drug prescribed for the treatment of hemophilia and blood disorders where there is no
8.14generically equivalent drug available if the prior authorization is used in conjunction with
8.15any supplemental drug rebate program or multistate preferred drug list established or
8.16administered by the commissioner.
8.17(e) The commissioner may require prior authorization for brand name drugs
8.18whenever a generically equivalent product is available, even if the prescriber specifically
8.19indicates "dispense as written-brand necessary" on the prescription as required by section
8.20151.21, subdivision 2 .
8.21(f) Notwithstanding this subdivision, the commissioner may automatically require
8.22prior authorization, for a period not to exceed 180 days, for any drug that is approved by
8.23the United States Food and Drug Administration on or after July 1, 2005. The 180-day
8.24period begins no later than the first day that a drug is available for shipment to pharmacies
8.25within the state. The Formulary Committee shall recommend to the commissioner general
8.26criteria to be used for the prior authorization of the drugs, but the committee is not
8.27required to review each individual drug. In order to continue prior authorizations for a
8.28drug after the 180-day period has expired, the commissioner must follow the provisions
8.29of this subdivision.
8.30EFFECTIVE DATE.This section is effective April 1, 2010.

8.31    Sec. 5. Minnesota Statutes 2008, section 256B.0625, is amended by adding a
8.32subdivision to read:
8.33    Subd. 13j. Antipsychotic and attention deficit disorder and attention deficit
8.34hyperactivity disorder medications. (a) The commissioner, in consultation with the
9.1Drug Utilization Review Board established in subdivision 13i and actively practicing
9.2pediatric mental health professionals, must:
9.3(1) identify recommended pediatric dose ranges for atypical antipsychotic drugs
9.4and drugs used for attention deficit disorder or attention deficit hyperactivity disorder
9.5based on available medical, clinical, and safety data and research. The commissioner
9.6shall periodically review the list of medications and pediatric dose ranges and update
9.7the medications and doses listed as needed after consultation with the Drug Utilization
9.8Review Board;
9.9(2) identify situations where a collaborative psychiatric consultation and prior
9.10authorization should be required before the initiation or continuation of drug therapy
9.11in pediatric patients including, but not limited to, high-dose regimens, off-label use of
9.12prescription medication, a patient's young age, and lack of coordination among multiple
9.13prescribing providers; and
9.14(3) track prescriptive practices and the use of psychotropic medications in children
9.15with the goal of reducing the use of medication, where appropriate.
9.16(b) Effective July 1, 2011, the commissioner shall require prior authorization and
9.17a collaborative psychiatric consultation before an atypical antipsychotic and attention
9.18deficit disorder and attention deficit hyperactivity disorder medication meeting the criteria
9.19identified in paragraph (a), clause (2), is eligible for payment. A collaborative psychiatric
9.20consultation must be completed before the identified medications are eligible for payment
9.21unless:
9.22(1) the patient has already been stabilized on the medication regimen; or
9.23(2) the prescriber indicates that the child is in crisis.
9.24If clause (1) or (2) applies, the collaborative psychiatric consultation must be completed
9.25within 90 days for payment to continue.
9.26(c) For purposes of this subdivision, a collaborative psychiatric consultation must
9.27meet the criteria described in section 245.4862, subdivision 5.

9.28    Sec. 6. Minnesota Statutes 2008, section 256B.0644, is amended to read:
9.29256B.0644 REIMBURSEMENT UNDER OTHER STATE HEALTH CARE
9.30PROGRAMS.
9.31    (a) A vendor of medical care, as defined in section 256B.02, subdivision 7, and a
9.32health maintenance organization, as defined in chapter 62D, must participate as a provider
9.33or contractor in the medical assistance program, general assistance medical care program,
9.34and MinnesotaCare as a condition of participating as a provider in health insurance plans
9.35and programs or contractor for state employees established under section 43A.18, the
10.1public employees insurance program under section 43A.316, for health insurance plans
10.2offered to local statutory or home rule charter city, county, and school district employees,
10.3the workers' compensation system under section 176.135, and insurance plans provided
10.4through the Minnesota Comprehensive Health Association under sections 62E.01 to
10.562E.19 . The limitations on insurance plans offered to local government employees shall
10.6not be applicable in geographic areas where provider participation is limited by managed
10.7care contracts with the Department of Human Services.
10.8    (b) For providers other than health maintenance organizations, participation in the
10.9medical assistance program means that:
10.10     (1) the provider accepts new medical assistance, general assistance medical care,
10.11and MinnesotaCare patients;
10.12    (2) for providers other than dental service providers, at least 20 percent of the
10.13provider's patients are covered by medical assistance, general assistance medical care,
10.14and MinnesotaCare as their primary source of coverage; or
10.15    (3) for dental service providers, at least ten percent of the provider's patients are
10.16covered by medical assistance, general assistance medical care, and MinnesotaCare as
10.17their primary source of coverage, or the provider accepts new medical assistance and
10.18MinnesotaCare patients who are children with special health care needs. For purposes
10.19of this section, "children with special health care needs" means children up to age 18
10.20who: (i) require health and related services beyond that required by children generally;
10.21and (ii) have or are at risk for a chronic physical, developmental, behavioral, or emotional
10.22condition, including: bleeding and coagulation disorders; immunodeficiency disorders;
10.23cancer; endocrinopathy; developmental disabilities; epilepsy, cerebral palsy, and other
10.24neurological diseases; visual impairment or deafness; Down syndrome and other genetic
10.25disorders; autism; fetal alcohol syndrome; and other conditions designated by the
10.26commissioner after consultation with representatives of pediatric dental providers and
10.27consumers.
10.28    (c) Patients seen on a volunteer basis by the provider at a location other than
10.29the provider's usual place of practice may be considered in meeting the participation
10.30requirement in this section. The commissioner shall establish participation requirements
10.31for health maintenance organizations. The commissioner shall provide lists of participating
10.32medical assistance providers on a quarterly basis to the commissioner of management and
10.33budget, the commissioner of labor and industry, and the commissioner of commerce. Each
10.34of the commissioners shall develop and implement procedures to exclude as participating
10.35providers in the program or programs under their jurisdiction those providers who do
10.36not participate in the medical assistance program. The commissioner of management
11.1and budget shall implement this section through contracts with participating health and
11.2dental carriers.
11.3(d) Any hospital or other provider that is participating in a coordinated care
11.4delivery system under section 256D.031, subdivision 6, or receives payments from the
11.5uncompensated care pool under section 256D.031, subdivision 8, shall not refuse to
11.6provide services to any patient enrolled in general assistance medical care regardless of
11.7the availability or the amount of payment.

11.8    Sec. 7. Minnesota Statutes 2009 Supplement, section 256B.0947, subdivision 1,
11.9is amended to read:
11.10    Subdivision 1. Scope. Effective November 1, 2010 2011, and subject to federal
11.11approval, medical assistance covers medically necessary, intensive nonresidential
11.12rehabilitative mental health services as defined in subdivision 2, for recipients as defined
11.13in subdivision 3, when the services are provided by an entity meeting the standards
11.14in this section.

11.15    Sec. 8. Minnesota Statutes 2009 Supplement, section 256B.196, subdivision 2, is
11.16amended to read:
11.17    Subd. 2. Commissioner's duties. (a) For the purposes of this subdivision and
11.18subdivision 3, the commissioner shall determine the fee-for-service outpatient hospital
11.19services upper payment limit for nonstate government hospitals. The commissioner shall
11.20then determine the amount of a supplemental payment to Hennepin County Medical
11.21Center and Regions Hospital for these services that would increase medical assistance
11.22spending in this category to the aggregate upper payment limit for all nonstate government
11.23hospitals in Minnesota. In making this determination, the commissioner shall allot the
11.24available increases between Hennepin County Medical Center and Regions Hospital
11.25based on the ratio of medical assistance fee-for-service outpatient hospital payments to
11.26the two facilities. The commissioner shall adjust this allotment as necessary based on
11.27federal approvals, the amount of intergovernmental transfers received from Hennepin and
11.28Ramsey Counties, and other factors, in order to maximize the additional total payments.
11.29The commissioner shall inform Hennepin County and Ramsey County of the periodic
11.30intergovernmental transfers necessary to match federal Medicaid payments available
11.31under this subdivision in order to make supplementary medical assistance payments to
11.32Hennepin County Medical Center and Regions Hospital equal to an amount that when
11.33combined with existing medical assistance payments to nonstate governmental hospitals
11.34would increase total payments to hospitals in this category for outpatient services to
12.1the aggregate upper payment limit for all hospitals in this category in Minnesota. Upon
12.2receipt of these periodic transfers, the commissioner shall make supplementary payments
12.3to Hennepin County Medical Center and Regions Hospital.
12.4    (b) For the purposes of this subdivision and subdivision 3, the commissioner shall
12.5determine an upper payment limit for physicians affiliated with Hennepin County Medical
12.6Center and with Regions Hospital. The upper payment limit shall be based on the average
12.7commercial rate or be determined using another method acceptable to the Centers for
12.8Medicare and Medicaid Services. The commissioner shall inform Hennepin County and
12.9Ramsey County of the periodic intergovernmental transfers necessary to match the federal
12.10Medicaid payments available under this subdivision in order to make supplementary
12.11payments to physicians affiliated with Hennepin County Medical Center and Regions
12.12Hospital equal to the difference between the established medical assistance payment for
12.13physician services and the upper payment limit. Upon receipt of these periodic transfers,
12.14the commissioner shall make supplementary payments to physicians of Hennepin Faculty
12.15Associates and HealthPartners.
12.16    (c) Beginning January 1, 2010, Hennepin County and Ramsey County shall may
12.17make monthly voluntary intergovernmental transfers to the commissioner in the following
12.18amounts: $133,333 by not to exceed $12,000,000 per year from Hennepin County
12.19and $100,000 by $6,000,000 per year from Ramsey County. The commissioner shall
12.20increase the medical assistance capitation payments to Metropolitan Health Plan and
12.21HealthPartners by any licensed health plan under contract with the medical assistance
12.22program that agrees to make enhanced payments to Hennepin County Medical Center or
12.23Regions Hospital. The increase shall be in an amount equal to the annual value of the
12.24monthly transfers plus federal financial participation., with each health plan receiving its
12.25pro rata share of the increase based on the pro rata share of medical assistance admissions
12.26to Hennepin County Medical Center and Regions Hospital by those plans. Upon the
12.27request of the commissioner, health plans shall submit individual-level cost data for
12.28verification purposes. The commissioner may ratably reduce these payments on a pro rata
12.29basis in order to satisfy federal requirements for actuarial soundness. If payments are
12.30reduced, transfers shall be reduced accordingly. Any licensed health plan that receives
12.31increased medical assistance capitation payments under the intergovernmental transfer
12.32described in this paragraph shall increase its medical assistance payments to Hennepin
12.33County Medical Center and Regions Hospital by the same amount as the increased
12.34payments received in the capitation payment described in this paragraph.
12.35    (d) The commissioner shall inform Hennepin County and Ramsey County on an
12.36ongoing basis of the need for any changes needed in the intergovernmental transfers
13.1in order to continue the payments under paragraphs (a) to (c), at their maximum level,
13.2including increases in upper payment limits, changes in the federal Medicaid match, and
13.3other factors.
13.4    (e) The payments in paragraphs (a) to (c) shall be implemented independently of
13.5each other, subject to federal approval and to the receipt of transfers under subdivision 3.
13.6EFFECTIVE DATE.This section is effective the day following final enactment.

13.7    Sec. 9. [256B.197] INTERGOVERNMENTAL TRANSFERS; INPATIENT
13.8HOSPITAL PAYMENTS.
13.9    Subdivision 1. Federal approval required. This section is effective for federal
13.10fiscal year 2010 and future years contingent on federal approval of the intergovernmental
13.11transfers and payments authorized under this section and contingent on payment of the
13.12intergovernmental transfers under this section.
13.13    Subd. 2. Eligible nonstate government hospitals. (a) Hennepin County Medical
13.14Center and Regions Hospital are eligible nonstate government hospitals.
13.15(b) If the commissioner obtains federal approval to include other hospitals, including
13.16Fairview University Medical Center, the commissioner may expand the definition of
13.17eligible nonstate government hospitals to include other hospitals.
13.18    Subd. 3. Commissioner's duties. (a) For the purposes of this subdivision, the
13.19commissioner shall determine the fee-for-service inpatient hospital services upper
13.20payment limit for nonstate government hospitals. The commissioner shall determine,
13.21for each eligible nonstate government hospital, the amount of a supplemental payment
13.22for inpatient hospital services that would increase medical assistance spending for each
13.23eligible nonstate government hospital up to the amount that Medicare would pay for
13.24the Medicaid fee-for-service inpatient hospital services provided by that hospital. If
13.25the combined amount of such supplemental payment amounts and existing medical
13.26assistance payments for inpatient hospital services to all nonstate government hospitals
13.27is less than the upper payment limit, the commissioner shall increase the supplemental
13.28payment amount for each eligible nonstate government hospital in proportion to the initial
13.29supplemental payments in order to maximize the additional total payments.
13.30(b) The commissioner shall inform each eligible nonstate government hospital and
13.31associated governmental entities of intergovernmental transfers necessary to provide
13.32the nonfederal share for the supplemental payment amount attributable to each eligible
13.33nonstate government hospital, as calculated under paragraph (a).
13.34(c) Upon receipt of an intergovernmental transfer from a governmental entity
13.35associated with an eligible nonstate government hospital or from the eligible nonstate
14.1government hospital, the commissioner shall make a supplemental payment, using the
14.2amounts calculated under paragraph (a), to the associated eligible nonstate government
14.3hospital.
14.4(d) The commissioner may implement the payments in this section through use of
14.5periodic payments and intergovernmental transfers.
14.6(e) The commissioner shall inform eligible nonstate government hospitals and
14.7associated governmental entities on an ongoing basis of the need for any changes needed
14.8in the payment amounts or intergovernmental transfers in order to continue the payments
14.9under paragraph (c) at their maximum level, including increases in upper payment limits,
14.10changes in the federal Medicaid match, and other factors.
14.11EFFECTIVE DATE.This section is effective April 1, 2010.

14.12    Sec. 10. Minnesota Statutes 2009 Supplement, section 256D.03, subdivision 3, is
14.13amended to read:
14.14    Subd. 3. General assistance medical care; eligibility. (a) General assistance
14.15medical care may be paid for any person who is not eligible for medical assistance
14.16under chapter 256B, including eligibility for medical assistance based on a spenddown
14.17of excess income according to section 256B.056, subdivision 5, or MinnesotaCare for
14.18applicants and recipients defined in paragraph (c), except as provided in paragraph (d),
14.19and: Beginning April 1, 2010, the general assistance medical care program shall be
14.20administered according to section 256D.031, unless otherwise stated, except for outpatient
14.21prescription drug coverage which will continue to be administered under this section.
14.22(b) Drug coverage under general assistance medical care is limited to prescription
14.23drugs that:
14.24(1) are covered under the medical assistance program as described in section
14.25256B.0625, subdivisions 13 and 13d; and
14.26(2) are provided by manufacturers that have fully executed general assistance
14.27medical care rebate agreements with the commissioner and comply with the agreements.
14.28Prescription drug coverage under general assistance medical care must conform to
14.29coverage under the medical assistance program according to section 256B.0625,
14.30subdivisions 13 to 13g.
14.31    (1) who is receiving assistance under section 256D.05, except for families with
14.32children who are eligible under Minnesota family investment program (MFIP), or who is
14.33having a payment made on the person's behalf under sections 256I.01 to 256I.06; or
14.34    (2) who is a resident of Minnesota; and
15.1    (i) who has gross countable income not in excess of 75 percent of the federal poverty
15.2guidelines for the family size, using a six-month budget period and whose equity in assets
15.3is not in excess of $1,000 per assistance unit. General assistance medical care is not
15.4available for applicants or enrollees who are otherwise eligible for medical assistance but
15.5fail to verify their assets. Enrollees who become eligible for medical assistance shall be
15.6terminated and transferred to medical assistance. Exempt assets, the reduction of excess
15.7assets, and the waiver of excess assets must conform to the medical assistance program in
15.8section 256B.056, subdivisions 3 and 3d, with the following exception: the maximum
15.9amount of undistributed funds in a trust that could be distributed to or on behalf of the
15.10beneficiary by the trustee, assuming the full exercise of the trustee's discretion under the
15.11terms of the trust, must be applied toward the asset maximum; or
15.12    (ii) who has gross countable income above 75 percent of the federal poverty
15.13guidelines but not in excess of 175 percent of the federal poverty guidelines for the family
15.14size, using a six-month budget period, whose equity in assets is not in excess of the limits
15.15in section 256B.056, subdivision 3c, and who applies during an inpatient hospitalization.
15.16    (b) The commissioner shall adjust the income standards under this section each July
15.171 by the annual update of the federal poverty guidelines following publication by the
15.18United States Department of Health and Human Services.
15.19    (c) Effective for applications and renewals processed on or after September 1, 2006,
15.20general assistance medical care may not be paid for applicants or recipients who are adults
15.21with dependent children under 21 whose gross family income is equal to or less than 275
15.22percent of the federal poverty guidelines who are not described in paragraph (f).
15.23    (d) Effective for applications and renewals processed on or after September 1, 2006,
15.24general assistance medical care may be paid for applicants and recipients who meet all
15.25eligibility requirements of paragraph (a), clause (2), item (i), for a temporary period
15.26beginning the date of application. Immediately following approval of general assistance
15.27medical care, enrollees shall be enrolled in MinnesotaCare under section 256L.04,
15.28subdivision 7 , with covered services as provided in section 256L.03 for the rest of the
15.29six-month general assistance medical care eligibility period, until their six-month renewal.
15.30    (e) To be eligible for general assistance medical care following enrollment in
15.31MinnesotaCare as required by paragraph (d), an individual must complete a new
15.32application.
15.33    (f) Applicants and recipients eligible under paragraph (a), clause (2), item (i), are
15.34exempt from the MinnesotaCare enrollment requirements in this subdivision if they:
16.1    (1) have applied for and are awaiting a determination of blindness or disability by
16.2the state medical review team or a determination of eligibility for Supplemental Security
16.3Income or Social Security Disability Insurance by the Social Security Administration;
16.4    (2) fail to meet the requirements of section 256L.09, subdivision 2;
16.5    (3) are homeless as defined by United States Code, title 42, section 11301, et seq.;
16.6    (4) are classified as end-stage renal disease beneficiaries in the Medicare program;
16.7    (5) are enrolled in private health care coverage as defined in section 256B.02,
16.8subdivision 9;
16.9    (6) are eligible under paragraph (k);
16.10    (7) receive treatment funded pursuant to section 254B.02; or
16.11    (8) reside in the Minnesota sex offender program defined in chapter 246B.
16.12    (g) For applications received on or after October 1, 2003, eligibility may begin no
16.13earlier than the date of application. For individuals eligible under paragraph (a), clause
16.14(2), item (i), a redetermination of eligibility must occur every 12 months. Individuals are
16.15eligible under paragraph (a), clause (2), item (ii), only during inpatient hospitalization but
16.16may reapply if there is a subsequent period of inpatient hospitalization.
16.17    (h) Beginning September 1, 2006, Minnesota health care program applications and
16.18renewals completed by recipients and applicants who are persons described in paragraph
16.19(d) and submitted to the county agency shall be determined for MinnesotaCare eligibility
16.20by the county agency. If all other eligibility requirements of this subdivision are met,
16.21eligibility for general assistance medical care shall be available in any month during which
16.22MinnesotaCare enrollment is pending. Upon notification of eligibility for MinnesotaCare,
16.23notice of termination for eligibility for general assistance medical care shall be sent to
16.24an applicant or recipient. If all other eligibility requirements of this subdivision are
16.25met, eligibility for general assistance medical care shall be available until enrollment in
16.26MinnesotaCare subject to the provisions of paragraphs (d), (f), and (g).
16.27    (i) The date of an initial Minnesota health care program application necessary to
16.28begin a determination of eligibility shall be the date the applicant has provided a name,
16.29address, and Social Security number, signed and dated, to the county agency or the
16.30Department of Human Services. If the applicant is unable to provide a name, address,
16.31Social Security number, and signature when health care is delivered due to a medical
16.32condition or disability, a health care provider may act on an applicant's behalf to establish
16.33the date of an initial Minnesota health care program application by providing the county
16.34agency or Department of Human Services with provider identification and a temporary
16.35unique identifier for the applicant. The applicant must complete the remainder of the
16.36application and provide necessary verification before eligibility can be determined. The
17.1applicant must complete the application within the time periods required under the
17.2medical assistance program as specified in Minnesota Rules, parts 9505.0015, subpart
17.35, and 9505.0090, subpart 2. The county agency must assist the applicant in obtaining
17.4verification if necessary.
17.5    (j) County agencies are authorized to use all automated databases containing
17.6information regarding recipients' or applicants' income in order to determine eligibility for
17.7general assistance medical care or MinnesotaCare. Such use shall be considered sufficient
17.8in order to determine eligibility and premium payments by the county agency.
17.9    (k) General assistance medical care is not available for a person in a correctional
17.10facility unless the person is detained by law for less than one year in a county correctional
17.11or detention facility as a person accused or convicted of a crime, or admitted as an
17.12inpatient to a hospital on a criminal hold order, and the person is a recipient of general
17.13assistance medical care at the time the person is detained by law or admitted on a criminal
17.14hold order and as long as the person continues to meet other eligibility requirements
17.15of this subdivision.
17.16    (l) General assistance medical care is not available for applicants or recipients who
17.17do not cooperate with the county agency to meet the requirements of medical assistance.
17.18    (m) In determining the amount of assets of an individual eligible under paragraph
17.19(a), clause (2), item (i), there shall be included any asset or interest in an asset, including
17.20an asset excluded under paragraph (a), that was given away, sold, or disposed of for
17.21less than fair market value within the 60 months preceding application for general
17.22assistance medical care or during the period of eligibility. Any transfer described in this
17.23paragraph shall be presumed to have been for the purpose of establishing eligibility for
17.24general assistance medical care, unless the individual furnishes convincing evidence to
17.25establish that the transaction was exclusively for another purpose. For purposes of this
17.26paragraph, the value of the asset or interest shall be the fair market value at the time it
17.27was given away, sold, or disposed of, less the amount of compensation received. For any
17.28uncompensated transfer, the number of months of ineligibility, including partial months,
17.29shall be calculated by dividing the uncompensated transfer amount by the average monthly
17.30per person payment made by the medical assistance program to skilled nursing facilities
17.31for the previous calendar year. The individual shall remain ineligible until this fixed period
17.32has expired. The period of ineligibility may exceed 30 months, and a reapplication for
17.33benefits after 30 months from the date of the transfer shall not result in eligibility unless
17.34and until the period of ineligibility has expired. The period of ineligibility begins in the
17.35month the transfer was reported to the county agency, or if the transfer was not reported,
18.1the month in which the county agency discovered the transfer, whichever comes first. For
18.2applicants, the period of ineligibility begins on the date of the first approved application.
18.3    (n) When determining eligibility for any state benefits under this subdivision,
18.4the income and resources of all noncitizens shall be deemed to include their sponsor's
18.5income and resources as defined in the Personal Responsibility and Work Opportunity
18.6Reconciliation Act of 1996, title IV, Public Law 104-193, sections 421 and 422, and
18.7subsequently set out in federal rules.
18.8    (o) Undocumented noncitizens and nonimmigrants are ineligible for general
18.9assistance medical care. For purposes of this subdivision, a nonimmigrant is an individual
18.10in one or more of the classes listed in United States Code, title 8, section 1101, subsection
18.11(a), paragraph (15), and an undocumented noncitizen is an individual who resides in
18.12the United States without the approval or acquiescence of the United States Citizenship
18.13and Immigration Services.
18.14    (p) Notwithstanding any other provision of law, a noncitizen who is ineligible for
18.15medical assistance due to the deeming of a sponsor's income and resources, is ineligible
18.16for general assistance medical care.
18.17    (q) Effective July 1, 2003, general assistance medical care emergency services end.
18.18EFFECTIVE DATE.This section is effective April 1, 2010.

18.19    Sec. 11. [256D.031] GENERAL ASSISTANCE MEDICAL CARE.
18.20    Subdivision 1. Eligibility. (a) Except as provided under subdivision 2, general
18.21assistance medical care may be paid for any individual who is not eligible for medical
18.22assistance under chapter 256B, including eligibility for medical assistance based on a
18.23spenddown of excess income according to section 256B.056, subdivision 5, and who:
18.24(1) is receiving assistance under section 256D.05, except for families with children
18.25who are eligible under the Minnesota family investment program (MFIP), or who is
18.26having a payment made on the person's behalf under sections 256I.01 to 256I.06; or
18.27(2) is a resident of Minnesota and has gross countable income not in excess of 75
18.28percent of federal poverty guidelines for the family size, using a six-month budget period,
18.29and whose equity in assets is not in excess of $1,000 per assistance unit.
18.30Exempt assets, the reduction of excess assets, and the waiver of excess assets must
18.31conform to the medical assistance program in section 256B.056, subdivisions 3 and 3d,
18.32except that the maximum amount of undistributed funds in a trust that could be distributed
18.33to or on behalf of the beneficiary by the trustee, assuming the full exercise of the trustee's
18.34discretion under the terms of the trust, must be applied toward the asset maximum.
19.1(b) The commissioner shall adjust the income standards under this section each July
19.21 by the annual update of the federal poverty guidelines following publication by the
19.3United States Department of Health and Human Services.
19.4    Subd. 2. Ineligible groups. (a) General assistance medical care may not be paid for
19.5an applicant or a recipient who:
19.6(1) is otherwise eligible for medical assistance but fails to verify their assets;
19.7(2) is an adult in a family with children as defined in section 256L.01, subdivision 3a;
19.8(3) is enrolled in private health coverage as defined in section 256B.02, subdivision
19.99;
19.10(4) is in a correctional facility, including an individual in a county correctional or
19.11detention facility as an individual accused or convicted of a crime, or admitted as an
19.12inpatient to a hospital on a criminal hold order;
19.13(5) resides in the Minnesota sex offender program defined in chapter 246B;
19.14(6) does not cooperate with the county agency to meet the requirements of medical
19.15assistance; or
19.16(7) does not cooperate with a county or state agency or the state medical review team
19.17in determining a disability or for determining eligibility for Supplemental Security Income
19.18or Social Security Disability Insurance by the Social Security Administration.
19.19(b) Undocumented noncitizens and nonimmigrants are ineligible for general
19.20assistance medical care. For purposes of this subdivision, a nonimmigrant is an individual
19.21in one or more of the classes listed in United States Code, title 8, section 1101, subsection
19.22(a), paragraph (15), and an undocumented noncitizen is an individual who resides in the
19.23United States without approval or acquiescence of the United States Citizenship and
19.24Immigration Services.
19.25(c) Notwithstanding any other provision of law, a noncitizen who is ineligible for
19.26medical assistance due to the deeming of a sponsor's income and resources is ineligible for
19.27general assistance medical care.
19.28(d) General assistance medical care recipients who become eligible for medical
19.29assistance shall be terminated from general assistance medical care and transferred to
19.30medical assistance.
19.31    Subd. 2a. Transitional MinnesotaCare. (a) Except as provided in paragraph (c),
19.32effective for applications received on or after April 1, 2010, and before June 1, 2010, all
19.33applicants who meet the eligibility requirements in subdivision 1, paragraph (a), clause
19.34(2), and who are not described in subdivision 2 shall be enrolled in MinnesotaCare under
19.35section 256L.04, subdivision 7, immediately following approval for general assistance
19.36medical care.
20.1(b) If all other eligibility requirements of this subdivision are met, general assistance
20.2medical care may be paid for individuals identified in paragraph (a) for a temporary period
20.3beginning the date of application in accordance with subdivision 4. Notwithstanding
20.4subdivision 7, paragraph (c), eligibility for general assistance medical care shall continue
20.5until enrollment in MinnesotaCare is completed. Upon notification of eligibility for
20.6MinnesotaCare, notice of termination for eligibility for general assistance medical care
20.7shall be sent to the applicant. Once enrolled in MinnesotaCare, the MinnesotaCare-covered
20.8services as described in section 256L.03 shall apply for the remainder of the six-month
20.9general assistance medical care eligibility period until their six-month renewal.
20.10(c) This subdivision does not apply if the applicant:
20.11(1) has applied for and is awaiting a determination of blindness or disability by the
20.12state medical review team or a determination of eligibility for Supplemental Security
20.13Income or Social Security Disability Insurance by the Social Security Administration;
20.14(2) is homeless as defined by United States Code, title 42, section 11301, et seq.;
20.15(3) is classified as an end-stage renal disease beneficiary in the Medicare program;
20.16(4) receives treatment funded in section 254B.02; or
20.17(5) fails to meet the requirements of section 256L.09, subdivision 2.
20.18Applicants and recipients who meet any one of these criteria shall remain eligible for
20.19general assistance medical care and are not eligible to enroll in MinnesotaCare until
20.20the next renewal period.
20.21(d) To be eligible for general assistance medical care following enrollment
20.22in MinnesotaCare as required in paragraph (a), an individual must complete a new
20.23application.
20.24(e) This subdivision expires June 1, 2010. For any applicant or recipient who meets
20.25the requirements of this subdivision before June 1, 2010, the commissioner shall continue
20.26the process of enrolling the individual in MinnesotaCare and, upon the completion of
20.27enrollment, the individual shall receive services under MinnesotaCare in accordance
20.28with paragraph (b).
20.29    Subd. 3. Eligibility and enrollment procedures. (a) Eligibility for general
20.30assistance medical care shall begin no earlier than the date of application. The date of
20.31application shall be the date the applicant has provided a name, address, and Social
20.32Security number, signed and dated, to the county agency or the Department of Human
20.33Services. If the applicant is unable to provide a name, address, Social Security number,
20.34and signature when health care is delivered due to a medical condition or disability, a
20.35health care provider may act on an applicant's behalf to establish the date of an application
20.36by providing the county agency or Department of Human Services with provider
21.1identification and a temporary unique identifier for the applicant. The applicant must
21.2complete the remainder of the application and provide necessary verification before
21.3eligibility can be determined. The applicant must complete the application within the time
21.4periods required under the medical assistance program as specified in Minnesota Rules,
21.5parts 9505.0015, subpart 5; and 9505.0090, subpart 2. The county agency must assist the
21.6applicant in obtaining verification if necessary.
21.7    (b) County agencies are authorized to use all automated databases containing
21.8information regarding recipients' or applicants' income in order to determine eligibility for
21.9general assistance medical care or MinnesotaCare. Such use shall be considered sufficient
21.10in order to determine eligibility and premium payments by the county agency.
21.11    (c) In determining the amount of assets of an individual eligible under subdivision 1,
21.12paragraph (a), clause (2), there shall be included any asset or interest in an asset, including
21.13an asset excluded under subdivision 1, paragraph (a), that was given away, sold, or
21.14disposed of for less than fair market value within the 60 months preceding application for
21.15general assistance medical care or during the period of eligibility. Any transfer described
21.16in this paragraph shall be presumed to have been for the purpose of establishing eligibility
21.17for general assistance medical care, unless the individual furnishes convincing evidence to
21.18establish that the transaction was exclusively for another purpose. For purposes of this
21.19paragraph, the value of the asset or interest shall be the fair market value at the time it
21.20was given away, sold, or disposed of, less the amount of compensation received. For any
21.21uncompensated transfer, the number of months of ineligibility, including partial months,
21.22shall be calculated by dividing the uncompensated transfer amount by the average monthly
21.23per person payment made by the medical assistance program to skilled nursing facilities
21.24for the previous calendar year. The individual shall remain ineligible until this fixed period
21.25has expired. The period of ineligibility may exceed 30 months, and a reapplication for
21.26benefits after 30 months from the date of the transfer shall not result in eligibility unless
21.27and until the period of ineligibility has expired. The period of ineligibility begins in the
21.28month the transfer was reported to the county agency, or if the transfer was not reported,
21.29the month in which the county agency discovered the transfer, whichever comes first. For
21.30applicants, the period of ineligibility begins on the date of the first approved application.
21.31    (d) When determining eligibility for any state benefits under this subdivision,
21.32the income and resources of all noncitizens shall be deemed to include their sponsor's
21.33income and resources as defined in the Personal Responsibility and Work Opportunity
21.34Reconciliation Act of 1996, title IV, Public Law 104-193, sections 421 and 422, and
21.35subsequently set out in federal rules.
22.1(e) Applicants and recipients are eligible for general assistance medical care for a
22.2six-month eligibility period. Eligibility may be renewed for additional six-month periods.
22.3During each six-month eligibility period, individuals are not eligible for MinnesotaCare.
22.4    Subd. 4. General assistance medical care; services. (a) Within the limitations
22.5described in this section, general assistance medical care covers medically necessary
22.6services that include:
22.7(1) inpatient hospital services;
22.8    (2) outpatient hospital services;
22.9    (3) services provided by Medicare-certified rehabilitation agencies;
22.10    (4) prescription drugs;
22.11    (5) equipment necessary to administer insulin and diagnostic supplies and equipment
22.12for diabetics to monitor blood sugar level;
22.13    (6) eyeglasses and eye examinations;
22.14    (7) hearing aids;
22.15    (8) prosthetic devices, if not covered by veteran's benefits;
22.16    (9) laboratory and x-ray services;
22.17    (10) physicians' services;
22.18    (11) medical transportation except special transportation;
22.19    (12) dental services;
22.20    (13) mental health services covered under chapter 256B;
22.21    (14) services performed by a certified pediatric nurse practitioner, a certified family
22.22nurse practitioner, a certified adult nurse practitioner, a certified obstetric/gynecological
22.23nurse practitioner, a certified neonatal nurse practitioner, or a certified geriatric nurse
22.24practitioner in independent practice, if (1) the service is otherwise covered under this
22.25chapter as a physician service, (2) the service provided on an inpatient basis is not included
22.26as part of the cost for inpatient services included in the operating payment rate, and (3) the
22.27service is within the scope of practice of the nurse practitioner's license as a registered
22.28nurse, as defined in section 148.171;
22.29    (15) services of a certified public health nurse or a registered nurse practicing in
22.30a public health nursing clinic that is a department of, or that operates under the direct
22.31authority of, a unit of government, if the service is within the scope of practice of the
22.32public health nurse's license as a registered nurse, as defined in section 148.171;
22.33    (16) telemedicine consultations, to the extent they are covered under section
22.34256B.0625, subdivision 3b;
22.35    (17) care coordination and patient education services provided by a community
22.36health worker according to section 256B.0625, subdivision 49; and
23.1(18) regardless of the number of employees that an enrolled health care provider
23.2may have, sign language interpreter services when provided by an enrolled health care
23.3provider during the course of providing a direct, person-to-person-covered health care
23.4service to an enrolled recipient who has a hearing loss and uses interpreting services.
23.5(b) Sex reassignment surgery is not covered under this section.
23.6(c) Drug coverage is covered in accordance with section 256D.03, subdivision 3,
23.7paragraph (b).
23.8(d) The following co-payments shall apply for services provided:
23.9(1) $25 for nonemergency visits to a hospital-based emergency room; and
23.10(2) $3 per brand-name drug prescription, subject to a $7 per month maximum for
23.11prescription drug co-payments. No co-payments shall apply to antipsychotic drugs when
23.12used for the treatment of mental illness.
23.13(e) Co-payments shall be limited to one per day per provider for nonemergency
23.14visits to a hospital-based emergency room. Recipients of general assistance medical care
23.15are responsible for all co-payments in this subdivision. Reimbursement for prescription
23.16drugs shall be reduced by the amount of the co-payment until the recipient has reached the
23.17$7 per month maximum for prescription drug co-payments. The provider shall collect
23.18the co-payment from the recipient. Providers may not deny services to recipients who
23.19are unable to pay the co-payment.
23.20(f) Chemical dependency services that are reimbursed under chapter 254B shall not
23.21be reimbursed under general assistance medical care.
23.22(g) Inpatient hospital services that are provided in community behavioral health
23.23hospitals operated by state-operated services shall not be reimbursed under general
23.24assistance medical care.
23.25    Subd. 5. Payment rates and contract modification; April 1, 2010, to May 31,
23.262010. (a) For the period April 1, 2010, to May 31, 2010, general assistance medical
23.27care shall be paid on a fee-for-service basis. Fee-for-service payment rates for services
23.28other than outpatient prescription drugs shall be set at 37 percent of the payment rate in
23.29effect on March 31, 2010.
23.30(b) Outpatient prescription drug coverage provided during the period April 1, 2010,
23.31to May 31, 2010, shall be paid on a fee-for-service basis according to section 256B.0625,
23.32subdivision 13e.
23.33    Subd. 6. Coordinated care delivery systems. (a) Effective June 1, 2010, the
23.34commissioner shall contract with hospitals or groups of hospitals that qualify under
23.35paragraph (b) and agree to deliver services according to this subdivision. Contracting
23.36hospitals shall develop and implement a coordinated care delivery system to provide
24.1health care services to individuals who are eligible for general assistance medical care
24.2under this section and who either choose to receive services through the coordinated
24.3care delivery system or who are enrolled by the commissioner under paragraph (c). The
24.4health care services provided by the system must include: (1) the services described in
24.5subdivision 4 with the exception of outpatient prescription drug coverage but shall include
24.6drugs administered in an outpatient setting; or (2) a set of comprehensive and medically
24.7necessary health services that the recipients might reasonably require to be maintained in
24.8good health and that has been approved by the commissioner, including as a minimum,
24.9but not limited to, emergency care, emergency ground ambulance transportation services,
24.10inpatient hospital and physician care, outpatient health services, preventive health services,
24.11mental health services, and prescription drugs. A hospital establishing a coordinated
24.12care delivery system under this subdivision must ensure that the requirements of this
24.13subdivision are met.
24.14(b) A hospital or group of hospitals may contract with the commissioner to develop
24.15and implement a coordinated care delivery system as follows:
24.16(1) effective June 1, 2010, a hospital qualifies under this subdivision if: (i) during
24.17calendar year 2007, it received fee-for-service payments for services to general assistance
24.18medical care recipients (A) equal to or greater than $1,500,000, or (B) equal to or greater
24.19than 1.3 percent of net patient revenue; or (ii) a contract with the hospital is necessary to
24.20provide geographic access or to ensure that at least 80 percent of enrollees have access to
24.21a coordinated care delivery system; and
24.22(2) effective December 1, 2010, a Minnesota hospital not qualified under clause
24.23(1) may contract with the commissioner under this subdivision if it agrees to satisfy the
24.24requirements of this subdivision.
24.25Participation by hospitals shall become effective quarterly on June 1, September 1,
24.26December 1, or March 1. Hospital participation is effective for a period of 12 months and
24.27may be renewed for successive 12-month periods.
24.28(c) Applicants and recipients may enroll in any available coordinated care delivery
24.29system. If more than one coordinated care delivery system is available, the applicant or
24.30recipient shall be allowed to choose among the systems. The commissioner may assign
24.31an applicant or recipient to a coordinated care delivery system if no choice is made by
24.32the applicant or recipient. Upon enrollment into a coordinated care delivery system, the
24.33enrollee must agree to receive all nonemergency services through the coordinated care
24.34delivery system. Enrollment in a coordinated care delivery system is for six months
24.35and may be renewed for additional six-month periods, except that initial enrollment is
24.36for six months or until the end of a recipient's period of general assistance medical care
25.1eligibility, whichever occurs first. An individual is not eligible to enroll in MinnesotaCare
25.2during a period of enrollment in a coordinated care delivery system. From June 1, 2010, to
25.3November 30, 2010, applicants and enrollees not enrolled in a coordinated care delivery
25.4system may seek services from a hospital eligible for reimbursement under the temporary
25.5uncompensated care pool established under subdivision 8. After November 30, 2010,
25.6services are available only through a coordinated care delivery system.
25.7(d) The hospital may contract and coordinate with providers and clinics for the
25.8delivery of services and shall contract with essential community providers as defined
25.9under section 62Q.19, subdivision 1, paragraph (a), clauses (1) and (2), to the extent
25.10practicable. If a provider or clinic contracts with a hospital to provide services through the
25.11coordinated care delivery system, the provider may not refuse to provide services to any
25.12of the system's enrollees, and payment for services shall be negotiated with the hospital
25.13and paid by the hospital from the system's allocation under subdivision 7.
25.14(e) A coordinated care delivery system must:
25.15(1) provide the covered services required under paragraph (a) to recipients enrolled
25.16in the coordinated care delivery system, and comply with the requirements of subdivision
25.174, paragraphs (b) to (g);
25.18(2) establish a process to monitor enrollment and ensure the quality of care provided;
25.19and
25.20(3) in cooperation with counties, coordinate the delivery of health care services with
25.21existing homeless prevention, supportive housing, and rent subsidy programs and funding
25.22administered by the Minnesota Housing Finance Agency under chapter 462A; and
25.23(4) adopt innovative and cost-effective methods of care delivery and coordination,
25.24which may include the use of allied health professionals, telemedicine, patient educators,
25.25care coordinators, and community health workers.
25.26(f) The hospital may require an enrollee to designate a primary care provider or a
25.27primary care clinic that is certified as a health care home under section 256B.0751. The
25.28hospital may limit the delivery of services to a network of providers who have contracted
25.29with the hospital to deliver services in accordance with this subdivision, and require
25.30an enrollee to seek services only within this network. The hospital may also require
25.31a referral to a provider before the service is eligible for payment. A coordinated care
25.32delivery system is not required to provide payment to a provider who is not employed
25.33by or under contract with the system for services provided to an enrollee of the system,
25.34except in cases of an emergency.
25.35(g) An enrollee of a coordinated care delivery system has the right to appeal to the
25.36commissioner according to section 256.045.
26.1(h) The state shall not be liable for the payment of any cost or obligation incurred
26.2by the coordinated care delivery system.
26.3(i) The hospital must provide the commissioner with data necessary for assessing
26.4enrollment, quality of care, cost, and utilization of services. Each hospital must provide,
26.5on a quarterly basis on a form prescribed by the commissioner for each enrollee served
26.6through the coordinated care delivery system, the services provided, the cost of services
26.7provided, and the actual payment amount for the services provided and any other
26.8information the commissioner deems necessary to claim federal Medicaid match.
26.9    Subd. 7. Payments; rate setting for the hospital coordinated care delivery
26.10system. (a) Effective for general assistance medical care services, with the exception
26.11of outpatient prescription drug coverage, provided on or after June 1, 2010, through a
26.12coordinated care delivery system, the commissioner shall allocate the annual appropriation
26.13for the coordinated care delivery system to hospitals participating under subdivision 6
26.14twice every three months, starting June 1, 2010. The payment shall be allocated among all
26.15hospitals qualified to participate on the allocation date. Each hospital or group of hospitals
26.16shall receive a pro rata share of the allocation based on the hospital's or group of hospitals'
26.17calendar year 2007 payments for general assistance medical care services, provided that,
26.18for the purposes of this allocation, payments to Hennepin County Medical Center, Regions
26.19Hospital, and Fairview University Medical Center shall be weighted at 110 percent of the
26.20actual amount. The commissioner shall conduct a settle-up after the conclusion of each
26.21quarter to ensure that final allocations reflect actual hospital utilization and shall reallocate
26.22funds as necessary among participating hospitals. The 2007 base year shall be updated by
26.23one calendar year each June 1, beginning June 1, 2011.
26.24(b) In order to be reimbursed under this section, nonhospital providers of health
26.25care services shall contract with one or more hospitals described in paragraph (a) to
26.26provide services to general assistance medical care recipients through the coordinated care
26.27delivery system established by the hospital. The hospital shall reimburse bills submitted
26.28by nonhospital providers participating under this paragraph at a rate negotiated between
26.29the hospital and the nonhospital provider.
26.30(c) The commissioner shall apply for federal matching funds under section
26.31256B.199, paragraphs (a) to (d), for expenditures under this subdivision.
26.32(d) Outpatient prescription drug coverage provided on or after June 1, 2010, shall
26.33be paid on a fee-for-service basis according to section 256B.0625, subdivision 13e, and
26.34subdivision 9.
26.35    Subd. 8. Temporary uncompensated care pool. (a) The commissioner shall
26.36establish a temporary uncompensated care pool, effective June 1, 2010. Payments from
27.1the pool must be distributed, within the limits of the available appropriation, to hospitals
27.2that are not part of a coordinated care delivery system established under subdivision 6.
27.3(b) Hospitals seeking reimbursement from this pool must submit an invoice to
27.4the commissioner in a form prescribed by the commissioner for payment for services
27.5provided to an applicant or enrollee not enrolled in a coordinated care delivery system. A
27.6payment amount, as calculated under current law, must be determined, but not paid, for
27.7each admission of or service provided to a general assistance medical care recipient on or
27.8after June 1, 2010, to November 30, 2010.
27.9(c) The aggregated payment amounts for each hospital must be calculated as a
27.10percentage of the total calculated amount for all hospitals.
27.11(d) Distributions from the uncompensated care pool for each hospital must be
27.12determined by multiplying the factor in paragraph (c) by the amount of money in the
27.13uncompensated care pool that is available for the six-month period.
27.14(e) The commissioner shall apply for federal matching funds under section
27.15256B.199, paragraphs (a) to (d), for expenditures under this subdivision.
27.16(f) Outpatient prescription drugs are not eligible for payment under this subdivision.
27.17    Subd. 9. Prescription drug pool. (a) The commissioner shall establish a
27.18prescription drug pool, effective June 1, 2010. Money in the pool must be used to
27.19reimburse pharmacies and other providers for prescription drugs dispensed to enrollees,
27.20on a fee-for-service basis according to section 256B.0625, subdivision 13e. If the
27.21commissioner forecasts that expenditures under this subdivision will exceed the
27.22appropriation for this purpose, the commissioner may bring recommendations to the
27.23Legislative Advisory Commission on methods to resolve the shortfall.
27.24(b) Effective June 1, 2010, coordinated care delivery systems established under
27.25subdivision 6 shall pay to the commissioner, on a quarterly basis, an assessment that in the
27.26aggregate equals 20 percent of the state appropriation for the prescription drug pool. Each
27.27coordinated care delivery system's assessment must be in proportion to the system's share
27.28of total funding provided by the state for coordinated care delivery systems, as calculated
27.29by the commissioner based on the most recent available data.
27.30    Subd. 10. Assistance for veterans. Hospitals participating in the coordinated care
27.31delivery system under subdivision 6 shall consult with counties, county veterans service
27.32officers, and the Veterans Administration to identify other programs for which general
27.33assistance medical care recipients enrolled in their system are qualified.
27.34EFFECTIVE DATE.This section is effective for services rendered on or after
27.35April 1, 2010.

28.1    Sec. 12. Minnesota Statutes 2008, section 256L.05, subdivision 3, is amended to read:
28.2    Subd. 3. Effective date of coverage. (a) The effective date of coverage is the
28.3first day of the month following the month in which eligibility is approved and the first
28.4premium payment has been received. As provided in section 256B.057, coverage for
28.5newborns is automatic from the date of birth and must be coordinated with other health
28.6coverage. The effective date of coverage for eligible newly adoptive children added to a
28.7family receiving covered health services is the month of placement. The effective date
28.8of coverage for other new members added to the family is the first day of the month
28.9following the month in which the change is reported. All eligibility criteria must be met
28.10by the family at the time the new family member is added. The income of the new family
28.11member is included with the family's gross income and the adjusted premium begins in
28.12the month the new family member is added.
28.13(b) The initial premium must be received by the last working day of the month for
28.14coverage to begin the first day of the following month.
28.15(c) Benefits are not available until the day following discharge if an enrollee is
28.16hospitalized on the first day of coverage.
28.17(d) Notwithstanding any other law to the contrary, benefits under sections 256L.01 to
28.18256L.18 are secondary to a plan of insurance or benefit program under which an eligible
28.19person may have coverage and the commissioner shall use cost avoidance techniques to
28.20ensure coordination of any other health coverage for eligible persons. The commissioner
28.21shall identify eligible persons who may have coverage or benefits under other plans of
28.22insurance or who become eligible for medical assistance.
28.23(e) The effective date of coverage for single adults and households with no children
28.24formerly enrolled in general assistance medical care and enrolled in MinnesotaCare
28.25according to section 256D.03, subdivision 3 256D.031, subdivision 2a, is the first day of
28.26the month following the last day of general assistance medical care coverage.
28.27EFFECTIVE DATE.This section is effective April 1, 2010.

28.28    Sec. 13. Minnesota Statutes 2008, section 256L.05, subdivision 3a, is amended to read:
28.29    Subd. 3a. Renewal of eligibility. (a) Beginning July 1, 2007, an enrollee's eligibility
28.30must be renewed every 12 months. The 12-month period begins in the month after the
28.31month the application is approved.
28.32    (b) Each new period of eligibility must take into account any changes in
28.33circumstances that impact eligibility and premium amount. An enrollee must provide all
28.34the information needed to redetermine eligibility by the first day of the month that ends
28.35the eligibility period. If there is no change in circumstances, the enrollee may renew
29.1eligibility at designated locations that include community clinics and health care providers'
29.2offices. The designated sites shall forward the renewal forms to the commissioner. The
29.3commissioner may establish criteria and timelines for sites to forward applications to the
29.4commissioner or county agencies. The premium for the new period of eligibility must be
29.5received as provided in section 256L.06 in order for eligibility to continue.
29.6    (c) For single adults and households with no children formerly enrolled in general
29.7assistance medical care and enrolled in MinnesotaCare according to section 256D.03,
29.8subdivision 3 256D.031, subdivision 2a, the first period of eligibility begins the month the
29.9enrollee submitted the application or renewal for general assistance medical care.
29.10    (d) An enrollee who fails to submit renewal forms and related documentation
29.11necessary for verification of continued eligibility in a timely manner shall remain eligible
29.12for one additional month beyond the end of the current eligibility period before being
29.13disenrolled. The enrollee remains responsible for MinnesotaCare premiums for the
29.14additional month.
29.15EFFECTIVE DATE.This section is effective April 1, 2010.

29.16    Sec. 14. Minnesota Statutes 2008, section 256L.07, subdivision 6, is amended to read:
29.17    Subd. 6. Exception for certain adults. Single adults and households with
29.18no children formerly enrolled in general assistance medical care and enrolled in
29.19MinnesotaCare according to section 256D.03, subdivision 3 256D.031, subdivision 2a, are
29.20eligible without meeting the requirements of this section until renewal.
29.21EFFECTIVE DATE.This section is effective April 1, 2010.

29.22    Sec. 15. Minnesota Statutes 2008, section 256L.15, subdivision 4, is amended to read:
29.23    Subd. 4. Exception for transitioned adults. County agencies shall pay premiums
29.24for single adults and households with no children formerly enrolled in general assistance
29.25medical care and enrolled in MinnesotaCare according to section 256D.03, subdivision 3
29.26256D.031, subdivision 2a, until six-month renewal. The county agency has the option of
29.27continuing to pay premiums for these enrollees.
29.28EFFECTIVE DATE.This section is effective April 1, 2010.

29.29    Sec. 16. Minnesota Statutes 2008, section 256L.17, subdivision 7, is amended to read:
29.30    Subd. 7. Exception for certain adults. Single adults and households with
29.31no children formerly enrolled in general assistance medical care and enrolled in
30.1MinnesotaCare according to section 256D.03, subdivision 3 256D.031, subdivision 2a, are
30.2exempt from the requirements of this section until renewal.
30.3EFFECTIVE DATE.This section is effective April 1, 2010.

30.4    Sec. 17. Minnesota Statutes 2008, section 517.08, subdivision 1c, is amended to read:
30.5    Subd. 1c. Disposition of license fee. (a) Of the marriage license fee collected
30.6pursuant to subdivision 1b, paragraph (a), $25 must be retained by the county. The local
30.7registrar must pay $85 to the commissioner of management and budget to be deposited
30.8as follows:
30.9    (1) $50 $55 in the general fund;
30.10    (2) $3 in the state government special revenue fund to be appropriated to the
30.11commissioner of public safety for parenting time centers under section 119A.37;
30.12    (3) $2 in the special revenue fund to be appropriated to the commissioner of health
30.13for developing and implementing the MN ENABL program under section 145.9255; and
30.14    (4) $25 in the special revenue fund is appropriated to the commissioner of
30.15employment and economic development for the displaced homemaker program under
30.16section 116L.96; and
30.17    (5) $5 in the special revenue fund is appropriated to the commissioner of human
30.18services for the Minnesota Healthy Marriage and Responsible Fatherhood Initiative under
30.19section 256.742.
30.20    (b) Of the $40 fee under subdivision 1b, paragraph (b), $25 must be retained by the
30.21county. The local registrar must pay $15 to the commissioner of management and budget
30.22to be deposited as follows:
30.23    (1) $5 as provided in paragraph (a), clauses (2) and (3); and
30.24    (2) $10 in the special revenue fund is appropriated to the commissioner of
30.25employment and economic development for the displaced homemaker program under
30.26section 116L.96.
30.27    (c) The increase in the marriage license fee under paragraph (a) provided for in Laws
30.282004, chapter 273, and disbursement of the increase in that fee to the special fund for the
30.29Minnesota Healthy Marriage and Responsible Fatherhood Initiative under paragraph (a),
30.30clause (5), is contingent upon the receipt of federal funding under United States Code, title
30.3142, section 1315, for purposes of the initiative.
30.32EFFECTIVE DATE.This section is effective July 1, 2010.

30.33    Sec. 18. DRUG REBATE PROGRAM.
31.1The commissioner of human services shall continue to administer a drug rebate
31.2program for drugs purchased for persons eligible for the general assistance medical care
31.3program in accordance with Minnesota Statutes, sections 256.01, subdivision 2, paragraph
31.4(cc), and 256D.03.
31.5EFFECTIVE DATE.This section is effective April 1, 2010.

31.6    Sec. 19. REVISOR'S INSTRUCTION.
31.7The revisor of statutes shall edit Minnesota Statutes, sections 256B.69 and 256B.692,
31.8to remove references to the general assistance medical care program.
31.9EFFECTIVE DATE.This section is effective June 1, 2010.

31.10    Sec. 20. REPEALER.
31.11(a) Minnesota Statutes 2008, sections 256.742; 256.979, subdivision 8; 256B.195,
31.12subdivisions 4 and 5; and 256D.03, subdivision 9, are repealed.
31.13(b) Minnesota Statutes 2009 Supplement, sections 256B.195, subdivisions 1, 2, and
31.143; and 256D.03, subdivision 4, are repealed.
31.15(c) Minnesota Statutes 2008, sections 256L.05, subdivision 1b; 256L.07, subdivision
31.166; 256L.15, subdivision 4; and 256L.17, subdivision 7, are repealed effective January 1,
31.172011.
31.18EFFECTIVE DATE.This section is effective April 1, 2010.

31.21

Section 1. HUMAN SERVICES APPROPRIATION.

31.22The sums shown in the columns marked "Appropriations" are added to or, if shown
31.23in parentheses, subtracted from the appropriations in Laws 2009, chapter 79, as amended
31.24by Laws 2009, chapter 173, or other law to the agencies and for the purposes specified in
31.25this article. The appropriations are from the general fund, or another named fund, and are
31.26available for the fiscal years indicated for each purpose. The figures "2010" and "2011"
31.27used in this article mean that the addition to or subtraction from appropriations listed under
31.28them are available for the fiscal year ending June 30, 2010, or June 30, 2011, respectively.
31.29"The first year" is fiscal year 2010. "The second year" is fiscal year 2011. "The biennium"
31.30is fiscal years 2010 and 2011. Supplemental appropriations and reductions for the fiscal
31.31year ending June 30, 2010, are effective the day following final enactment.

32.1				APPROPRIATIONS
32.2				Available for the Year
32.3				Ending June 30
32.4					2010		2011

32.5

Sec. 2. HUMAN SERVICES

32.6

Subdivision 1.Total Appropriation

$

(7,155,000)

$

(7,446,000)

32.7	Appropriations by Fund
32.8		2010	2011
32.9	General	34,807,000	118,493,000
32.10	Health Care Access	(41,962,000)	(125,939,000)

32.11The amounts that may be spent for each
32.12purpose are specified in the following
32.13subdivisions.

32.14 32.15

Subd. 2.Children Support Enforcement Grants

-0-

(300,000)

32.16Minnesota Healthy Marriage and
32.17Responsible Fatherhood Initiative Fee.
32.18 Notwithstanding Minnesota Statutes, section
32.19517.08, the balance and the fee revenue
32.20available to the commissioner of human
32.21services for the healthy marriage and
32.22responsible fatherhood initiative in the state
32.23government special revenue fund must be
32.24transferred to and deposited into the general
32.25fund by June 30, 2011.

32.26 32.27

Subd. 3.Children and Economic Assistance Operations

(1,408,000)

(1,560,000)

32.28

Subd. 4.Basic Health Care Grants

32.29The amounts that may be spent from this
32.30appropriation for each purpose are as follows:

32.31

(a) MinnesotaCare Grants

32.32	Appropriations by Fund
32.33	Health Care Access	(41,962,000)	(125,939,000)

33.1 33.2

(b) Medical Assistance Basic Health Care Grants - Families and Children

-0-

(49,000)

33.3 33.4

(c) Medical Assistance Basic Health Care Grants - Elderly and Disabled

-0-

(1,275,000)

33.5

(d) General Assistance Medical Care

39,413,000

135,837,000

33.6For general assistance medical care payments
33.7under Minnesota Statutes, section 256D.031.
33.8$5,500,000 in fiscal year 2010 and
33.9$65,500,000 in fiscal year 2011 is for
33.10payments to coordinated care delivery
33.11systems under Minnesota Statutes, section
33.12256D.031, subdivision 7.
33.13$4,375,000 in fiscal year 2010 and
33.14$51,875,000 in fiscal year 2011 is for
33.15payments for prescription drugs under
33.16Minnesota Statutes, section 256D.031,
33.17subdivision 9.
33.18$28,000,000 in fiscal year 2010 is for
33.19provider and prescription drug payments
33.20under Minnesota Statutes, section 256D.031,
33.21subdivision 5.
33.22$1,538,000 in fiscal year 2010 and
33.23$18,462,000 in fiscal year 2011 is for
33.24payments from the temporary uncompensated
33.25care pool under Minnesota Statutes, section
33.26256D.031, subdivision 8.
33.27Any amount under paragraph (d) that is not
33.28spent in the first year does not cancel and is
33.29available for payments in the second year.
33.30The commissioner may transfer any
33.31unexpended amount under Minnesota
33.32Statutes, section 256D.031, subdivision 9,
33.33after the final allocation in fiscal year 2011 to
34.1make payments under Minnesota Statutes,
34.2section 256D.031, subdivision 7.
34.3Any unexpended amount not used for
34.4general assistance medical care expenditures
34.5incurred before April 1, 2010, under
34.6Minnesota Statutes, section 256D.03, shall be
34.7used to make payments under paragraph (d).

34.8

Subd. 5.Health Care Management

34.9The amounts that may be spent from the
34.10appropriation for each purpose are as follows:

34.11

Health Care Administration

(2,998,000)

(5,270,000)

34.12Base Adjustment. The general fund base
34.13for health care administration is reduced by
34.14$182,000 in fiscal year 2012 and $182,000 in
34.15fiscal year 2013.

34.16

Subd. 6.Continuing Care Grants

34.17

(a) Mental Health Grants

(200,000)

(7,904,000)

34.18The general fund appropriation to the
34.19commissioner of human services for adult
34.20mental health grants in Laws 2009, chapter
34.2179, article 13, section 3, subdivision 8, as
34.22amended by Laws 2009, chapter 173, article
34.232, section 1, subdivision 8, is reduced by
34.24$7,704,000 in fiscal year 2011. This is a
34.25onetime reduction.
34.26$200,000 of the reduction in each year is
34.27to eliminate specialty care grants for the
34.282007 mental health initiative infrastructure
34.29investments.

34.30

(b) Other Continuing Care Grants

-0-

(2,037,000)

34.31HIV Grants. The general fund appropriation
34.32for the HIV drug and insurance grant
34.33program shall be reduced by $2,037,000 in
35.1fiscal year 2011 and increased by $2,037,000
35.2in fiscal year 2013. These adjustments are
35.3onetime and must not be applied to the base.
35.4Notwithstanding any contrary provision, this
35.5provision expires June 30, 2013.

35.6

Subd. 7.Continuing Care Management

-0-

1,051,000

35.7

Subd. 8.Transfers

35.8The commissioner must transfer $29,538,000
35.9in fiscal year 2010 and $18,462,000 in fiscal
35.10year 2011 from the health care access fund to
35.11the general fund. This is a onetime transfer.
35.12 The commissioner must transfer $4,800,000
35.13from the consolidated chemical dependency
35.14treatment fund to the general fund by June
35.1530, 2010.
35.16EFFECTIVE DATE.This article is effective April 1, 2010."
35.17Amend the title accordingly