1.1.................... moves to amend H.F. No. 1462 as follows:
1.2Delete everything after the enacting clause and insert:
1.3 "Section 1. Minnesota Statutes 2012, section 256B.75, is amended to read:
1.4256B.75 HOSPITAL OUTPATIENT REIMBURSEMENT.
1.5 (a) For outpatient hospital facility fee payments for services rendered on or after
1.6October 1, 1992, the commissioner of human services shall pay the lower of (1) submitted
1.7charge, or (2) 32 percent above the rate in effect on June 30, 1992, except for those
1.8services for which there is a federal maximum allowable payment. Effective for services
1.9rendered on or after January 1, 2000, payment rates for nonsurgical outpatient hospital
1.10facility fees and emergency room facility fees shall be increased by eight percent over the
1.11rates in effect on December 31, 1999, except for those services for which there is a federal
1.12maximum allowable payment. Services for which there is a federal maximum allowable
1.13payment shall be paid at the lower of (1) submitted charge, or (2) the federal maximum
1.14allowable payment. Total aggregate payment for outpatient hospital facility fee services
1.15shall not exceed the Medicare upper limit. If it is determined that a provision of this
1.16section conflicts with existing or future requirements of the United States government with
1.17respect to federal financial participation in medical assistance, the federal requirements
1.18prevail. The commissioner may, in the aggregate, prospectively reduce payment rates to
1.19avoid reduced federal financial participation resulting from rates that are in excess of
1.20the Medicare upper limitations.
1.21 (b) Notwithstanding paragraph (a), payment for outpatient, emergency, and
1.22ambulatory surgery hospital facility fee services for critical access hospitals designated
1.23under section
144.1483, clause (9), shall be paid on a cost-based payment system that is
1.24based on the cost-finding methods and allowable costs of the Medicare program.
1.25 (c) Effective for services provided on or after July 1, 2003, rates that are based
1.26on the Medicare outpatient prospective payment system shall be replaced by a budget
2.1neutral prospective payment system that is derived using medical assistance data. The
2.2commissioner shall provide a proposal to the 2003 legislature to define and implement
2.3this provision.
2.4 (d) For fee-for-service services provided on or after July 1, 2002, the total payment,
2.5before third-party liability and spenddown, made to hospitals for outpatient hospital
2.6facility services is reduced by .5 percent from the current statutory rate.
2.7 (e) In addition to the reduction in paragraph (d), the total payment for fee-for-service
2.8services provided on or after July 1, 2003, made to hospitals for outpatient hospital
2.9facility services before third-party liability and spenddown, is reduced five percent from
2.10the current statutory rates. Facilities defined under section
256.969, subdivision 16, are
2.11excluded from this paragraph.
2.12 (f) In addition to the reductions in paragraphs (d) and (e), the total payment for
2.13fee-for-service services provided on or after July 1, 2008, made to hospitals for outpatient
2.14hospital facility services before third-party liability and spenddown, is reduced three
2.15percent from the current statutory rates. Mental health services and facilities defined under
2.16section
256.969, subdivision 16, are excluded from this paragraph.
2.17 (g) Notwithstanding paragraphs (a), (d), (e), and (f), fee-for-service payments made
2.18for outpatient hospital facility services provided on or after July 1, 2013, to persons under
2.19age 21 shall be paid on a cost-based payment system that is based on the cost-finding
2.20methods and allowable costs of the Medicare program.
2.21 Sec. 2. Minnesota Statutes 2012, section 256B.766, is amended to read:
2.22256B.766 REIMBURSEMENT FOR BASIC CARE SERVICES.
2.23(a) Effective for services provided on or after July 1, 2009, total payments for basic
2.24care services, shall be reduced by three percent, except that for the period July 1, 2009,
2.25through June 30, 2011, total payments shall be reduced by 4.5 percent for the medical
2.26assistance and general assistance medical care programs, prior to third-party liability and
2.27spenddown calculation. Effective July 1, 2010, the commissioner shall classify physical
2.28therapy services, occupational therapy services, and speech-language pathology and
2.29related services as basic care services. The reduction in this paragraph shall apply to
2.30physical therapy services, occupational therapy services, and speech-language pathology
2.31and related services provided on or after July 1, 2010.
2.32(b) Payments made to managed care plans and county-based purchasing plans shall
2.33be reduced for services provided on or after October 1, 2009, to reflect the reduction
2.34effective July 1, 2009, and payments made to the plans shall be reduced effective October
2.351, 2010, to reflect the reduction effective July 1, 2010.
3.1(c) Effective for services provided on or after September 1, 2011, through June 30,
3.22013, total payments for outpatient hospital facility fees shall be reduced by five percent
3.3from the rates in effect on August 31, 2011.
3.4(d) Effective for services provided on or after September 1, 2011, through June
3.530, 2013, total payments for ambulatory surgery centers facility fees, medical supplies
3.6and durable medical equipment not subject to a volume purchase contract, prosthetics
3.7and orthotics, renal dialysis services, laboratory services, public health nursing services,
3.8physical therapy services, occupational therapy services, speech therapy services,
3.9eyeglasses not subject to a volume purchase contract, hearing aids not subject to a volume
3.10purchase contract, anesthesia services, and hospice services shall be reduced by three
3.11percent from the rates in effect on August 31, 2011.
3.12(e) This section does not apply to physician and professional services, inpatient
3.13hospital services, family planning services, mental health services, dental services,
3.14prescription drugs, medical transportation, federally qualified health centers, rural health
3.15centers, Indian health services, and Medicare cost-sharing.
3.16(f) For services provided on or after July 1, 2013, fee-for-service payments made to
3.17hospitals for the provision of outpatient basic care services to persons under age 21 shall
3.18be paid on a cost-based payment system that is based on the cost-finding methods and
3.19allowable costs of the Medicare program."
3.20Amend the title accordingly