1.1.................... moves to amend H.F. No. .... (revisor document 10-4968), as follows:
1.2Page 32, after line 23, insert:
1.3 "Sec. 18. Minnesota Statutes 2009 Supplement, section 256L.03, subdivision 5,
1.4is amended to read:
1.5 Subd. 5.
Co-payments and coinsurance. (a) Except as provided in paragraphs (b)
1.6and (c), the MinnesotaCare benefit plan shall include the following co-payments and
1.7coinsurance requirements for all enrollees:
1.8 (1) ten percent of the paid charges for inpatient hospital services for adult enrollees,
1.9subject to an annual inpatient out-of-pocket maximum of $1,000 per individual;
1.10 (2) $3 per prescription for adult enrollees;
1.11 (3) $25 for eyeglasses for adult enrollees;
1.12 (4) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an
1.13episode of service which is required because of a recipient's symptoms, diagnosis, or
1.14established illness, and which is delivered in an ambulatory setting by a physician or
1.15physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse,
1.16audiologist, optician, or optometrist; and
1.17 (5) $6 for nonemergency visits to a hospital-based emergency room.
1.18 (b) Paragraph (a), clause (1), does not apply to parents and relative caretakers of
1.19children under the age of 21.
1.20 (c) Paragraph (a) does not apply to pregnant women and children under the age of 21.
1.21 (d) Paragraph (a), clause (4), does not apply to mental health services.
1.22 (e) Adult enrollees with family gross income that exceeds 200 percent of the federal
1.23poverty guidelines or 215 percent of the federal poverty guidelines on or after July 1, 2009,
1.24and who are not pregnant shall be financially responsible for the coinsurance amount, if
1.25applicable, and amounts which exceed the $10,000 inpatient hospital benefit limit.
1.26 (f) When a MinnesotaCare enrollee becomes a member of a prepaid health plan,
1.27or changes from one prepaid health plan to another during a calendar year, any charges
2.1submitted towards the $10,000 annual inpatient benefit limit, and any out-of-pocket
2.2expenses incurred by the enrollee for inpatient services, that were submitted or incurred
2.3prior to enrollment, or prior to the change in health plans, shall be disregarded.
2.4(g) Paragraph (a), clause (4) does not apply to single adults and households
2.5with no children formerly enrolled in general assistance medical care and enrolled in
2.6MinnesotaCare according to section 256D.03, subdivision 3, if the enrollee obtains
2.7services from, or on a referral basis through, a health care provider certified as a health
2.8care home under section 256B.0751 at least quarterly. A health care provider certified as
2.9a health care home may provide an exemption from this requirement and authorize less
2.10frequent visits, if this is consistent with standards for quality care, but must report this
2.11exemption to the commissioner."
2.12Page 34, after line 26, insert:
2.13 "Sec. 23. Minnesota Statutes 2008, section 256L.15, is amended by adding a
2.14subdivision to read:
2.15 Subd. 4a. Exception for transitioned adults obtaining services from a health
2.16care home. Single adults and households with no children formerly enrolled in general
2.17assistance medical care and enrolled in MinnesotaCare according to section 256D.03,
2.18subdivision 3, are exempt from premiums at the time of six-month renewal and subsequent
2.19renewals, if the enrollee obtains services from, or on a referral basis through, a health
2.20care provider certified as a health care home under section 256B.0751 at least quarterly.
2.21A health care provider certified as a health care home may provide an exemption from
2.22this requirement and authorize less frequent visits, if this is consistent with standards for
2.23quality care, but must report this exemption to the commissioner."
2.24Renumber the sections in sequence and correct the internal references
2.25Amend the title accordingly