1.1.................... moves to amend H.F. No. 535 as follows:
1.2Delete everything after the enacting clause and insert:

1.3    "Section 1. Minnesota Statutes 2010, section 125A.21, subdivision 2, is amended to
1.4read:
1.5    Subd. 2. Third-party reimbursement. (a) Beginning July 1, 2000, districts
1.6shall seek reimbursement from insurers and similar third parties for the cost of services
1.7provided by the district whenever the services provided by the district are otherwise
1.8covered by the child's health coverage. Districts shall request, but may not require, the
1.9child's family to provide information about the child's health coverage when a child with a
1.10disability begins to receive services from the district of a type that may be reimbursable,
1.11and shall request, but may not require, updated information after that as needed.
1.12(b) For children enrolled in medical assistance under chapter 256B or MinnesotaCare
1.13under chapter 256L who have no other health coverage, a district shall provide an initial
1.14and annual written notice to the enrolled child's parent or legal representative of its intent
1.15to seek reimbursement from medical assistance or MinnesotaCare for the individual
1.16individualized education plan program health-related services provided by the district.
1.17The initial notice must give the child's parent or legal representative the right to:
1.18(1) request a copy of the child's education records on the health-related services that
1.19the district provided to the child and disclosed to a third-party payer;
1.20(2) withdraw consent for the district to disclose information in a child's education
1.21record at any time without affecting a parent's eligibility for MinnesotaCare or medical
1.22assistance under section 256B.08, subdivision 1, including consent that the parent or
1.23legal representative gave as part of the application process for MinnesotaCare or medical
1.24assistance; and
1.25(3) receive a statement, consistent with clause (2), indicating that a decision to
1.26withdraw consent for the district to disclose information in a child's education record does
1.27not affect a parent's eligibility for MinnesotaCare or medical assistance.
2.1(c) The district shall give the parent or legal representative annual written notice of:
2.2(1) the district's intent to seek reimbursement from medical assistance or
2.3MinnesotaCare for individual education plan health-related services provided by the
2.4district;
2.5(2) the right of the parent or legal representative to request a copy of all records
2.6concerning individual education plan health-related services disclosed by the district to
2.7any third party; and
2.8(3) the right of the parent or legal representative to withdraw consent for disclosure
2.9of a child's records at any time without consequence, including consent that the parent
2.10or legal representative gave as part of the application process for any public assistance
2.11program that may result in a parent's eligibility for MinnesotaCare or medical assistance
2.12under section 256B.08, subdivision 1.
2.13The written notice shall be provided as part of the written notice required by Code of
2.14Federal Regulations, title 34, section 300.504. The department must ensure that the parent
2.15of a child with a disability is given notice, in understandable language, of federal and state
2.16procedural safeguards available to the parent under this paragraph and paragraph (b).
2.17(d) In order to access the private health care coverage of a child who is covered by
2.18private health care coverage in whole or in part, a district must:
2.19(1) obtain annual written informed consent from the parent or legal representative, in
2.20compliance with subdivision 5; and
2.21(2) inform the parent or legal representative that a refusal to permit the district
2.22or state Medicaid agency to access their private health care coverage does not relieve
2.23the district of its responsibility to provide all services necessary to provide free and
2.24appropriate public education at no cost to the parent or legal representative.
2.25(e) If the commissioner of human services obtains federal approval to exempt
2.26covered individual education plan health-related services from the requirement that private
2.27health care coverage refuse payment before medical assistance may be billed, paragraphs
2.28(b), (c), and (d) shall also apply to students with a combination of private health care
2.29coverage and health care coverage through medical assistance or MinnesotaCare.
2.30(f) In the event that Congress or any federal agency or the Minnesota legislature
2.31or any state agency establishes lifetime limits, limits for any health care services,
2.32cost-sharing provisions, or otherwise provides that individual education plan health-related
2.33services impact benefits for persons enrolled in medical assistance or MinnesotaCare, the
2.34amendments to this subdivision adopted in 2002 are repealed on the effective date of any
2.35federal or state law or regulation that imposes the limits. In that event, districts must
2.36obtain informed consent consistent with this subdivision as it existed prior to the 2002
3.1amendments and subdivision 5, before seeking reimbursement for children enrolled in
3.2medical assistance under chapter 256B or MinnesotaCare under chapter 256L who have
3.3no other health care coverage.
3.4EFFECTIVE DATE.This section is effective the day following final enactment.

3.5    Sec. 2. Minnesota Statutes 2010, section 125A.21, subdivision 3, is amended to read:
3.6    Subd. 3. Use of reimbursements. Of the reimbursements received, districts may:
3.7(1) retain an amount sufficient to compensate the district for its administrative costs
3.8of obtaining reimbursements;
3.9(2) regularly obtain from education- and health-related entities training and other
3.10appropriate technical assistance designed to improve the district's ability to determine
3.11which services are reimbursable and to seek timely reimbursement in a cost-effective
3.12manner access third-party payments for individualized education program health-related
3.13services; or
3.14(3) reallocate reimbursements for the benefit of students with special needs
3.15individualized education programs or individual family service plans in the district.
3.16EFFECTIVE DATE.This section is effective the day following final enactment.

3.17    Sec. 3. Minnesota Statutes 2010, section 125A.21, subdivision 5, is amended to read:
3.18    Subd. 5. Informed consent. When obtaining informed consent, consistent with
3.19sections 13.05, subdivision 4a; and, 256B.77, subdivision 2, paragraph (p), and Code of
3.20Federal Regulations, title 34, parts 99 and 300, to bill health plans for covered services, the
3.21school district must notify the legal representative (1) that the cost of the person's private
3.22health insurance premium may increase due to providing the covered service in the school
3.23setting, (2) that the school district may pay certain enrollee health plan costs, including
3.24but not limited to, co-payments, coinsurance, deductibles, premium increases or other
3.25enrollee cost-sharing amounts for health and related services required by an individual
3.26service plan, or individual family service plan, and (3) that the school's billing for each
3.27type of covered service may affect service limits and prior authorization thresholds. The
3.28informed consent may be revoked in writing at any time by the person authorizing the
3.29billing of the health plan.
3.30EFFECTIVE DATE.This section is effective the day following final enactment.

3.31    Sec. 4. Minnesota Statutes 2010, section 125A.21, subdivision 7, is amended to read:
4.1    Subd. 7. District disclosure of information. A school district may disclose
4.2information contained in a student's individual individualized education plan program,
4.3consistent with section 13.32, subdivision 3, paragraph (a), and Code of Federal
4.4Regulations, title 34, parts 99 and 300; including records of the student's diagnosis and
4.5treatment, to a health plan company only with the signed and dated consent of the student's
4.6parent, or other legally authorized individual, including consent that the parent or legal
4.7representative gave as part of the application process for MinnesotaCare or medical
4.8assistance under section 256B.08, subdivision 1. The school district shall disclose only
4.9that information necessary for the health plan company to decide matters of coverage and
4.10payment. A health plan company may use the information only for making decisions
4.11regarding coverage and payment, and for any other use permitted by law.
4.12EFFECTIVE DATE.This section is effective the day following final enactment.

4.13    Sec. 5. Laws 2009, chapter 79, article 5, section 60, as amended by Laws 2009, chapter
4.14173, article 1, section 37, is amended to read:
4.15    Sec. 60. Minnesota Statutes 2008, section 256L.05, is amended by adding a
4.16subdivision to read:
4.17    Subd. 1c. Open enrollment and streamlined application and enrollment
4.18process. (a) The commissioner and local agencies working in partnership must develop a
4.19streamlined and efficient application and enrollment process for medical assistance and
4.20MinnesotaCare enrollees that meets the criteria specified in this subdivision.
4.21(b) The commissioners of human services and education shall provide
4.22recommendations to the legislature by January 15, 2010, on the creation of an open
4.23enrollment process for medical assistance and MinnesotaCare that is coordinated with
4.24the public education system. The recommendations must:
4.25(1) be developed in consultation with medical assistance and MinnesotaCare
4.26enrollees and representatives from organizations that advocate on behalf of children and
4.27families, low-income persons and minority populations, counties, school administrators
4.28and nurses, health plans, and health care providers;
4.29(2) be based on enrollment and renewal procedures best practices;
4.30(3) simplify the enrollment and renewal processes wherever possible; and
4.31(4) establish a process:
4.32(i) to disseminate information on medical assistance and MinnesotaCare to all
4.33children in the public education system, including prekindergarten programs; and
4.34(ii) for the commissioner of human services to enroll children and other household
4.35members who are eligible.
5.1The commissioner of human services in coordination with the commissioner of
5.2education shall implement an open enrollment process by August 1, 2010, to be effective
5.3beginning with the 2010-2011 school year.
5.4(c) The commissioner and local agencies shall develop an online application process
5.5for medical assistance and MinnesotaCare.
5.6(d) The commissioner shall develop an application for children that is easily
5.7understandable and does not exceed four pages in length.
5.8(e) The commissioner of human services shall present to the legislature, by January
5.915, 2010, an implementation plan for the open enrollment period and online application
5.10process.
5.11(f) The commissioner of human services, after consulting with the commissioner of
5.12education, shall include on new and revised Minnesota health care program application
5.13forms, including electronic application forms, an authorization for consent that, if signed
5.14by the parent or legal representative of a child receiving health-related services through
5.15an individualized education program or an individual family services plan, would allow
5.16the school district or other provider of covered services to release information from the
5.17child's education record to the commissioner to permit the provider to be reimbursed by
5.18MinnesotaCare or medical assistance. The authorization for consent under this paragraph
5.19must conform to federal data practices law governing access to nonpublic data in a child's
5.20education record and indicate that the parent or legal representative of the child may
5.21withdraw his or her consent at any time without any consequence to the parent or child.
5.22The commissioner must include this authorization for consent on an application form at
5.23the time the commissioner reviews, revises, or replaces the form.
5.24EFFECTIVE DATE.This section is effective July 1, 2011.

5.25    Sec. 6. THIRD-PARTY BILLING.
5.26(a) To allow cost-effective billing of medical assistance for covered services that are
5.27not reimbursed by legally liable third party private payers, the commissioner of human
5.28services must:
5.29(1) summarize and document school district efforts to secure reimbursement from
5.30legally liable third parties; and
5.31(2) request initial and continuing waivers of the requirement to seek payment from
5.32a student's private health plan, consistent with the Code of Federal Regulations, title
5.3342, section 433.139, chapter IV, part 433, based on the determination by the Centers
5.34for Medicare and Medicaid Services that this requirement is not cost-effective. The
5.35waiver request must seek permission for the commissioner to allow school districts to
6.1bill Medicaid alone, without first billing private payers, when a child has both public
6.2and private coverage.
6.3(b) If the Centers for Medicare and Medicaid Services (CMS) do not grant ongoing
6.4permission to implement paragraph (a), clause (2), the commissioner of human services
6.5shall seek permission to implement clause (2) on a time-limited basis, with the opportunity
6.6to renew this time-limited permission as needed.
6.7EFFECTIVE DATE.This section is effective the day following final enactment."
6.8Amend the title accordingly