1.1.................... moves to amend S.F. No. 230 as follows:
1.2Delete everything after the enacting clause and insert:

1.3    "Section 1. Minnesota Statutes 2008, section 256B.04, subdivision 14a, is amended to
1.4read:
1.5    Subd. 14a. Level of need determination. Nonemergency medical transportation
1.6level of need determinations must be performed by a physician, a registered nurse working
1.7under direct supervision of a physician, a physician's assistant, a nurse practitioner, a
1.8licensed practical nurse, or a discharge planner. Nonemergency medical transportation
1.9level of need determinations must not be performed more than semiannually on any
1.10individual, unless the individual's circumstances have sufficiently changed so as to require
1.11a new level of need determination. Nonemergency medical transportation level of need
1.12determinations must not be performed more than every seven years on an individual,
1.13if a physician certifies that the individual's medical condition that requires the use of
1.14nonemergency medical transportation is permanent and is not likely to improve, and this
1.15certification by the physician is confirmed by a level of need determination. Individuals
1.16residing in licensed nursing facilities are exempt from a level of need determination and
1.17are eligible for special transportation services until the individual no longer resides in a
1.18licensed nursing facility. If a person authorized by this subdivision to perform a level of
1.19need determination determines that an individual requires stretcher transportation, the
1.20individual is presumed to maintain that level of need until otherwise determined by a
1.21person authorized to perform a level of need determination, or for six months, whichever
1.22is sooner.

1.23    Sec. 2. Minnesota Statutes 2008, section 256B.0625, subdivision 17, is amended to
1.24read:
1.25    Subd. 17. Transportation costs. (a) For purposes of this subdivision, the following
1.26terms have the meanings given unless otherwise provided for in this subdivision:
2.1(1) "special transportation" means nonemergency medical transportation to or from a
2.2covered service that is provided to a recipient who has a physical or mental impairment
2.3that prohibits the recipient from independently and safely accessing and using a bus, taxi,
2.4other commercial transportation, or private automobile;
2.5(2) "access transportation service" means curb-to-curb nonemergency medical
2.6transportation to or from a covered service that is provided to a recipient without a
2.7physical or mental impairment, but who requires transportation services to be able to
2.8access a covered service, and who are unable to do so by bus or private automobile; and
2.9(3) "medical transportation" means the transport of a recipient to obtain a covered
2.10service or the transport of a recipient after the covered service is provided.
2.11(b) Medical assistance covers medical transportation costs incurred solely for
2.12obtaining emergency medical care or transportation costs incurred by eligible persons in
2.13obtaining emergency or nonemergency medical care when paid directly to an ambulance
2.14company, common carrier, or other recognized providers of transportation services.
2.15Medical transportation must be provided by:
2.16(1) an ambulance, as defined in section 144E.001, subdivision 2;
2.17(2) special transportation;
2.18(3) access transportation; or
2.19(4) other common carrier, including but not limited to, bus, taxi, other commercial
2.20carrier, or private automobile.
2.21(b) Medical assistance covers special transportation, as defined in Minnesota Rules,
2.22part 9505.0315, subpart 1, item F, if the recipient has a physical or mental impairment that
2.23would prohibit the recipient from safely accessing and using a bus, taxi, other commercial
2.24transportation, or private automobile.
2.25(c) "Rural urban commuting area" or "RUCA" means an area determined to be
2.26urban, rural, or super rural by the Centers for Medicare and Medicaid Services for
2.27purposes of Medicare reimbursement of ambulance services.
2.28The commissioner may use an order by the recipient's attending physician to certify that
2.29the recipient requires special transportation services. Special transportation includes
2.30providers shall perform driver-assisted service to services for eligible individuals.
2.31Driver-assisted service includes passenger pickup at and return to the individual's
2.32residence or place of business, assistance with admittance of the individual to the medical
2.33facility, and assistance in passenger securement or in securing of wheelchairs or stretchers
2.34in the vehicle. Special transportation providers must obtain written documentation from
2.35the health care service provider who is serving the recipient being transported, identifying
2.36the time that the recipient arrived. Special transportation and access transportation
3.1providers may not bill for separate base rates for the continuation of a trip beyond the
3.2original destination. Special transportation and access transportation providers must take
3.3recipients to the nearest appropriate health care provider, using the most direct route
3.4available as determined by a commercially available software program approved by the
3.5commissioner and designated by the provider as the program to be used to determine the
3.6route and mileage for all trips. The maximum minimum medical assistance reimbursement
3.7rates for special nonemergency medical transportation services are:
3.8(1) for areas defined under RUCA as urban:
3.9(1) (i) $17 for the base rate and $1.35 per mile for special transportation services to
3.10eligible persons who need a wheelchair-accessible van;
3.11(2) (ii) $11.50 for the base rate and $1.30 per mile for special transportation services
3.12to eligible persons who do not need a wheelchair-accessible van; and
3.13(iii) $10 for the base rate and $1.35 per mile for access transportation services to
3.14eligible persons who need a wheelchair-accessible van;
3.15(iv) $10 for the base rate and $1.30 per mile for access transportation services to
3.16eligible persons who do not need a wheelchair-accessible van;
3.17(3) (v) $60 for the base rate and $2.40 per mile, and an attendant rate of $9 per trip,
3.18for services to eligible persons who need a stretcher-accessible vehicle; and
3.19(vi) for all special transportation and access transportation services for a trip equal to
3.20or exceeding 51 miles, the provider shall received mileage reimbursement for each mile
3.21equal to or exceeding 51 miles at 125 percent of the respective mileage rates in this clause;
3.22(2) the base rates for special transportation services and access transportation in
3.23areas defined under RUCA as rural, shall be equal to the reimbursement rate established in
3.24clause (1) plus one percent;
3.25(3) the base rate for special transportation and access transportation services in areas
3.26defined under RUCA as super rural shall be equal to the reimbursement rate established in
3.27clause (1) plus 22.6 percent; and
3.28(4) for special transportation and access transportation services defined under RUCA
3.29as rural and super rural areas;
3.30(i) for a trip equal to 17 miles or less, mileage reimbursement shall be equal to 150
3.31percent of the respective mileage rate in clause (1);
3.32(ii) for a trip between 18 and 50 miles, mileage reimbursement shall be equal to 100
3.33percent of the respective mileage rate in clause (1); and
3.34(iii) for a trip equal to or exceeding 51 miles, mileage reimbursement shall be equal
3.35to 125 percent of the respective mileage rate in clause (1), items (i) to (v).
4.1(d) For purposes of reimbursement rates for special transportation and access
4.2transportation services under paragraph (c), the recipient's place of residence shall
4.3determine whether the urban, rural, or super rural reimbursement rate applies.
4.4(e) For all special transportation and access transportation services, the transportation
4.5provider must obtain delivery confirmation of the recipient by the medical provider to
4.6whom the recipient is delivered.

4.7    Sec. 3. Minnesota Statutes 2008, section 256B.0625, is amended by adding a
4.8subdivision to read:
4.9    Subd. 17b. Broker dispatching prohibition. The commissioner shall not use
4.10a broker or coordinator to manage or dispatch nonemergency medical transportation
4.11services.

4.12    Sec. 4. REIMBURSEMENT REFORM ACT.
4.13This act shall be referred to as the "Nonemergency Medical Transportation Reform
4.14Act of 2009.""
4.15Amend the title accordingly