1.1.................... moves to amend H.F. No. 1233, the delete everything amendment
1.2(A13-0408), as follows:
1.3Page 168, after line 16 insert:

1.4    "Sec. 15. Minnesota Statutes 2012, section 256B.76, subdivision 1, is amended to read:
1.5    Subdivision 1. Physician reimbursement. (a) Effective for services rendered on
1.6or after October 1, 1992, the commissioner shall make payments for physician services
1.7as follows:
1.8    (1) payment for level one Centers for Medicare and Medicaid Services' common
1.9procedural coding system codes titled "office and other outpatient services," "preventive
1.10medicine new and established patient," "delivery, antepartum, and postpartum care,"
1.11"critical care," cesarean delivery and pharmacologic management provided to psychiatric
1.12patients, and level three codes for enhanced services for prenatal high risk, shall be paid
1.13at the lower of (i) submitted charges, or (ii) 25 percent above the rate in effect on June
1.1430, 1992. If the rate on any procedure code within these categories is different than the
1.15rate that would have been paid under the methodology in section 256B.74, subdivision 2,
1.16then the larger rate shall be paid;
1.17    (2) payments for all other services shall be paid at the lower of (i) submitted charges,
1.18or (ii) 15.4 percent above the rate in effect on June 30, 1992; and
1.19    (3) all physician rates shall be converted from the 50th percentile of 1982 to the 50th
1.20percentile of 1989, less the percent in aggregate necessary to equal the above increases
1.21except that payment rates for home health agency services shall be the rates in effect
1.22on September 30, 1992.
1.23    (b) Effective for services rendered on or after January 1, 2000, payment rates for
1.24physician and professional services shall be increased by three percent over the rates
1.25in effect on December 31, 1999, except for home health agency and family planning
1.26agency services. The increases in this paragraph shall be implemented January 1, 2000,
1.27for managed care.
2.1(c) Effective for services rendered on or after July 1, 2009, payment rates for
2.2physician and professional services shall be reduced by five percent, except that for the
2.3period July 1, 2009, through June 30, 2010, payment rates shall be reduced by 6.5 percent
2.4for the medical assistance and general assistance medical care programs, over the rates in
2.5effect on June 30, 2009. This reduction and the reductions in paragraph (d) do not apply
2.6to office or other outpatient visits, preventive medicine visits and family planning visits
2.7billed by physicians, advanced practice nurses, or physician assistants in a family planning
2.8agency or in one of the following primary care practices: general practice, general internal
2.9medicine, general pediatrics, general geriatrics, and family medicine. This reduction
2.10and the reductions in paragraph (d) do not apply to federally qualified health centers,
2.11rural health centers, and Indian health services. Effective October 1, 2009, payments
2.12made to managed care plans and county-based purchasing plans under sections 256B.69,
2.13256B.692 , and 256L.12 shall reflect the payment reduction described in this paragraph.
2.14(d) Effective for services rendered on or after July 1, 2010, payment rates for
2.15physician and professional services shall be reduced an additional seven percent over
2.16the five percent reduction in rates described in paragraph (c). This additional reduction
2.17does not apply to physical therapy services, occupational therapy services, and speech
2.18pathology and related services provided on or after July 1, 2010. This additional reduction
2.19does not apply to physician services billed by a psychiatrist or an advanced practice nurse
2.20with a specialty in mental health. Effective October 1, 2010, payments made to managed
2.21care plans and county-based purchasing plans under sections 256B.69, 256B.692, and
2.22256L.12 shall reflect the payment reduction described in this paragraph.
2.23(e) Effective for services rendered on or after September 1, 2011, through June 30,
2.242013, payment rates for physician and professional services shall be reduced three percent
2.25from the rates in effect on August 31, 2011. This reduction does not apply to physical
2.26therapy services, occupational therapy services, and speech pathology and related services.
2.27(f) Effective for services rendered on or after July 1, 2014, payment rates for
2.28physician and professional services, including physical therapy, occupational therapy,
2.29speech pathology, and mental health services shall be increased by ... percent from the
2.30rates in effect on June 30, 2014. This increase does not apply to federally qualified health
2.31centers, rural health centers, and Indian health services. Payments made to managed care
2.32plans shall not be adjusted to reflect payments under this paragraph.
2.33(g) Effective for services rendered on or after July 1, 2015, payment rates for
2.34physician and professional services, including physical therapy, occupational therapy,
2.35speech pathology, and mental health services shall be increased by ... percent from the
2.36rates in effect on June 30, 2015. This increase does not apply to federally qualified health
3.1centers, rural health centers, and Indian health services. Payments made to managed care
3.2plans shall be adjusted to reflect payments under this paragraph."
3.3Page 169, after line 3 insert:

3.4    "Sec. 17. Minnesota Statutes 2012, section 256B.766, is amended to read:
3.5256B.766 REIMBURSEMENT FOR BASIC CARE SERVICES.
3.6(a) Effective for services provided on or after July 1, 2009, total payments for basic
3.7care services, shall be reduced by three percent, except that for the period July 1, 2009,
3.8through June 30, 2011, total payments shall be reduced by 4.5 percent for the medical
3.9assistance and general assistance medical care programs, prior to third-party liability and
3.10spenddown calculation. Effective July 1, 2010, the commissioner shall classify physical
3.11therapy services, occupational therapy services, and speech-language pathology and
3.12related services as basic care services. The reduction in this paragraph shall apply to
3.13physical therapy services, occupational therapy services, and speech-language pathology
3.14and related services provided on or after July 1, 2010.
3.15(b) Payments made to managed care plans and county-based purchasing plans shall
3.16be reduced for services provided on or after October 1, 2009, to reflect the reduction
3.17effective July 1, 2009, and payments made to the plans shall be reduced effective October
3.181, 2010, to reflect the reduction effective July 1, 2010.
3.19(c) Effective for services provided on or after September 1, 2011, through June 30,
3.202013, total payments for outpatient hospital facility fees shall be reduced by five percent
3.21from the rates in effect on August 31, 2011.
3.22(d) Effective for services provided on or after September 1, 2011, through June
3.2330, 2013, total payments for ambulatory surgery centers facility fees, medical supplies
3.24and durable medical equipment not subject to a volume purchase contract, prosthetics
3.25and orthotics, renal dialysis services, laboratory services, public health nursing services,
3.26physical therapy services, occupational therapy services, speech therapy services,
3.27eyeglasses not subject to a volume purchase contract, hearing aids not subject to a volume
3.28purchase contract, and anesthesia services, and hospice services shall be reduced by three
3.29percent from the rates in effect on August 31, 2011.
3.30(e) Effective for services provided on or after July 1, 2015, payments for ambulatory
3.31surgery centers facility fees, medical supplies and durable medical equipment not subject
3.32to a volume purchase contract, prosthetics and orthotics, hospice services, renal dialysis
3.33services, laboratory services, public health nursing services, eyeglasses not subject to a
3.34volume purchase contract, hearing aids not subject to a volume purchase contract, and
3.35outpatient hospital facility fees shall be increased by ... percent. Payments made to
3.36managed care plans shall be adjusted to reflect payments under this paragraph.
4.1(e) (f) This section does not apply to physician and professional services, inpatient
4.2hospital services, family planning services, mental health services, dental services,
4.3prescription drugs, medical transportation, federally qualified health centers, rural health
4.4centers, Indian health services, and Medicare cost-sharing."
4.5Page 454, after line 22, insert:
4.6"Transfer for provider rate increases.
4.7 Notwithstanding section 295.581, $....... in
4.8fiscal year 2015 and $....... in fiscal year 2016
4.9is transferred from the health care access fund
4.10to the general fund, for provider rate increases
4.11under Minnesota Statutes, section 256B.76,
4.12subdivision 1, paragraphs (f) and (g) and
4.13section 256B.766, paragraphs (e) and (f)."
4.14Adjust the totals and summaries by fund accordingly
4.15Renumber or reletter in sequence and correct internal references
4.16Amend the title accordingly