Vetoed by Governor Tim Pawlenty

Full Bill Text
Veto Letter

Vote Smart's Synopsis:

Vote to adopt a conference report that makes various health and human services appropriations and amendments.

Highlights:

-Increase hospital payments to the medical assistance account from 1.4 percent of revenues to 2.63 percent of revenues beginning July 1, 2010 and reducing the payment to 2.30 percent beginning October 1, 2011 (Art. 1, Sec. 1). -Increase HMO payments to the commissioner of human services from 0.6 percent of total premium revenues to 1.45 percent of total premium revenues (Art. 1, Sec. 2). -Increases fee-for-service payments from July 1, 2010 until June 30, 2011 by 5 percent and reduces the rate of increase to 1.96 percent beginning July 1, 2011 (Art. 1, Sec. 4). -Increases payment rates at Minnesota private not-for-profit hospitals (Art. 1, Sec. 7). -Reduces the income eligibility requirement for medical assistance from 100 percent of the federal poverty guideline to 75 percent of the federal poverty guideline (Art. 1, Sec. 10). -Authorizes medical assistance to cover payments to licensed birth centers providing services that would otherwise be covered if provided in a hospital (Art. 1, Sec. 18). -Reduce co-payments of non-emergency visits to emergency rooms from $6.00 to $3.50 (Art. 1, Sec. 19). -Requires that outpatient prescription drug coverage be provided if the delivery method qualifies for federal prescription drug rebates (Art. 1, Sec. 23). -Increases by 1.28 percent the total payment made to managed care plans and county-based purchasing plans under the medical assistance program (Art. 1, Sec. 26). -Reduces payment rates to physician and professional services by 7 percent for services provided after July 1, 2010 (Art. 1, Sec. 30). -Sets the reimbursement rate for dental services at the Medicare reimbursement rate (Art. 1, Sec. 31). -Reduces payment rates for physical therapy services, occupational therapy services, and speech language pathology by 3 percent (Art. 1, Sec. 33). -Requires that fee-for-service payment rates for physician and professional services along with basic care services not exceed the Medicare payment rate for that service (Art. 1, Sec. 34). -Requires the commissioner of human services to submit a Medicaid state plan amendment to receive federal fund participation for adults without children whose income is equal to 75 percent or less of the federal poverty line (Art. 1, Sec. 53). -Increases the ICF/MR license surcharge from $1,040 per license bed to $4,037 per license bed (Art. 2, Sec. 9). -Decreases the number of hours per month a personal care assistant can be paid for providing assistance from 310 to 275 (Art. 2, Sec. 12). -Requires that after December 31, 2010, enrollment in the Minnesota disability health options program will cease until program costs are reduced and consumer choice is increased to an acceptable level (Art. 2, Sec. 17, 20). -Increases the daily rate for the intermediate care facility for the developmentally disabled in Clearwater County from $112.38 to $138.23 (Art. 2, Sec. 22). -Amends the requirements for receiving food stamps from having assets of $7,000 or less to having an income no greater than 165 percent of the federal poverty guideline (Art. 3, Sec. 1). -Authorizes the coverage of private nursing services for certain persons enrolled in the medical assistance program, subjecting participants to the same co-insurance, deductible, co-payment, and other requirements that apply to participants in the medical assistance program (Art. 4, Sec. 1). -Authorizes the Board of Regents of the University of Minnesota to develop a Couples on the Brink Project to develop and evaluate methods for promoting the reconciliation of married couples who are considering a marriage dissolution proceeding (Art. 4, Sec. 2). -Establishes the Advisory Group on Administrative Expenses to make recommendations on the development of consistent guidelines and reporting requirements for HMO's and county-based purchasing plans that participate in publicly funded programs (Art. 5, Sec. 2). -Requires the commissioner to provide medical assistance coverage of health home services for individuals with chronic conditions who select a designated provider, a team of health care professionals, or a health team as the individual's health home (Art. 7, Sec. 2). -Requires the Governor to convene a Health Care Reform Task Force to advise and assist the office of governor and the legislature regarding state implementation of federal health care reform legislation (Art. 7, Sec. 4).

Full Bill Text

Vote Smart's Synopsis:

Vote to adopt a conference report that makes various health and human services appropriations and amendments.

Highlights:

-Increase hospital payments to the medical assistance account from 1.4 percent of revenues to 2.63 percent of revenues beginning July 1, 2010 and reducing the payment to 2.30 percent beginning October 1, 2011 (Art. 1, Sec. 1). -Increase HMO payments to the commissioner of human services from 0.6 percent of total premium revenues to 1.45 percent of total premium revenues (Art. 1, Sec. 2). -Increases fee-for-service payments from July 1, 2010 until June 30, 2011 by 5 percent and reduces the rate of increase to 1.96 percent beginning July 1, 2011 (Art. 1, Sec. 4). -Increases payment rates at Minnesota private not-for-profit hospitals (Art. 1, Sec. 7). -Reduces the income eligibility requirement for medical assistance from 100 percent of the federal poverty guideline to 75 percent of the federal poverty guideline (Art. 1, Sec. 10). -Authorizes medical assistance to cover payments to licensed birth centers providing services that would otherwise be covered if provided in a hospital (Art. 1, Sec. 18). -Reduce co-payments of non-emergency visits to emergency rooms from $6.00 to $3.50 (Art. 1, Sec. 19). -Requires that outpatient prescription drug coverage be provided if the delivery method qualifies for federal prescription drug rebates (Art. 1, Sec. 23). -Increases by 1.28 percent the total payment made to managed care plans and county-based purchasing plans under the medical assistance program (Art. 1, Sec. 26). -Reduces payment rates to physician and professional services by 7 percent for services provided after July 1, 2010 (Art. 1, Sec. 30). -Sets the reimbursement rate for dental services at the Medicare reimbursement rate (Art. 1, Sec. 31). -Reduces payment rates for physical therapy services, occupational therapy services, and speech language pathology by 3 percent (Art. 1, Sec. 33). -Requires that fee-for-service payment rates for physician and professional services along with basic care services not exceed the Medicare payment rate for that service (Art. 1, Sec. 34). -Requires the commissioner of human services to submit a Medicaid state plan amendment to receive federal fund participation for adults without children whose income is equal to 75 percent or less of the federal poverty line (Art. 1, Sec. 53). -Increases the ICF/MR license surcharge from $1,040 per license bed to $4,037 per license bed (Art. 2, Sec. 9). -Decreases the number of hours per month a personal care assistant can be paid for providing assistance from 310 to 275 (Art. 2, Sec. 12). -Requires that after December 31, 2010, enrollment in the Minnesota disability health options program will cease until program costs are reduced and consumer choice is increased to an acceptable level (Art. 2, Sec. 17, 20). -Increases the daily rate for the intermediate care facility for the developmentally disabled in Clearwater County from $112.38 to $138.23 (Art. 2, Sec. 22). -Amends the requirements for receiving food stamps from having assets of $7,000 or less to having an income no greater than 165 percent of the federal poverty guideline (Art. 3, Sec. 1). -Authorizes the coverage of private nursing services for certain persons enrolled in the medical assistance program, subjecting participants to the same co-insurance, deductible, co-payment, and other requirements that apply to participants in the medical assistance program (Art. 4, Sec. 1). -Authorizes the Board of Regents of the University of Minnesota to develop a Couples on the Brink Project to develop and evaluate methods for promoting the reconciliation of married couples who are considering a marriage dissolution proceeding (Art. 4, Sec. 2). -Establishes the Advisory Group on Administrative Expenses to make recommendations on the development of consistent guidelines and reporting requirements for HMO's and county-based purchasing plans that participate in publicly funded programs (Art. 5, Sec. 2). -Requires the commissioner to provide medical assistance coverage of health home services for individuals with chronic conditions who select a designated provider, a team of health care professionals, or a health team as the individual's health home (Art. 7, Sec. 2). -Requires the Governor to convene a Health Care Reform Task Force to advise and assist the office of governor and the legislature regarding state implementation of federal health care reform legislation (Art. 7, Sec. 4).

Full Bill Text

Vote Smart's Synopsis:

Vote to pass an omnibus health and human services bill that increases funding from the federal government to the Minnesota health care system and reduces overall costs for state health care programs.

Highlights:

-Requires the commissioner to review all ongoing studies, reports, and program evaluations by the Department of Human Services between fiscal years 2006 and 2010; report on the legislature's appropriation and cost of the work to determine which ones require program evaluations and will repeat this review every 5 fiscal years (Article 2, Sec. 2). -Requires that each county-based plan must pay the commissioner a surcharge of 2.5 percent of the total premium revenues of the plan as of June 1, 2010(Article 2, Sec. 3). -Reduces, between July 1, 2011 and June 30, 2013, the total payment for fee-for-service admissions to 4.5 percent and increases the assistance admissions for diagnosis-related groups at a percentage calculated to cost no more than $7.2 million per fiscal year (Article 2, Sec 4). -Prohibits any funds to be expended for neither sex-selection abortion nor for health benefits coverage that includes coverage of sex-selection abortion (Article 2, Sec. 5). -Authorizes medical assistance to be paid for a person, as follows (Article 2, Sec. 7):

-Between the ages of 21 and 65; -Not pregnant; -Not entitled to Medicare Part A or enrolled in Medicare Part B under the Social Security Act; and -Not an adult in a family with children.

-Requires a person may have gross countable income up to 75 percent of the federal poverty guidelines for family size to be eligible for medical assistance (Article 2, Sec. 10). -Requires the commissioner to estimate the acquisition cost of a drug at the average wholesale price minus 12.5 percent or wholesale acquisition cost plus 5 percent, whichever is lower (Article 2, Sec. 16). -Authorizes medical assistance coverage for services provided in a birth center, as follows (Article 2, Sec. 20):

-If the service would otherwise be covered if provided in a hospital; -Shall be paid at the lower rate of billed charges; and -70 percent of the statewide average for a facility payment rate is made to a hospital for an uncomplicated vaginal birth.

-Requires services provided by traditional midwives to be paid at the lower rate of billed charges or 100 percent of the rate paid to a physician performing the same services (Article 2, Sec. 20). -Requires the commissioner of human services along with the commissioner of health to establish a payment reform demonstration project implementing an alternative payment system for health care providers serving an identified group of patients who are enrolled in a state health care program (Article 2, Sec. 25). -Increases the operating payment rate of each facility reimbursed by 2 percent through June 30, 2011, then by 1.5 percent effective July 1, 2011(Article 2, Sec. 27). -Reduces the health plan's emergency room utilization rate by 5 percent and requires that the withheld funds be returned and for this process to continue until the emergency room utilization rate for state health care program enrollees is reduced by 25 percent (Article 2, Sec. 29). -Reduces total payments made to health care plans for providing covered services under the medical assistance and Minnesota Care programs by 1 percent (Article 2, Sec. 30). -Requires the net income of a managed care plan providing covered services under the public programs to not exceed 6 percent of the total monthly revenues that the managed care plan receives from the program (Article 2, Sec. 31). -Requires that all outpatient and emergency services provided prior to December 31, 2007 must have 50 percent of the costs paid by 2014; 100 percent of the costs paid by 2019, if they have received payment to support the training of residents (Article 2, Sec. 35). -Requires the commissioner to pay critical access dental provider payments to clinics when at least 40 percent of the patients are uninsured or covered by medical assistance, general assistance medical care, or MinnesotaCare (Article 2, Sec. 38). -Repeals the decrease in premium subsidies by 10 percent for families with gross annual income at or below 200 percent of the federal poverty guidelines; requiring applicants to be uninsured for at least 6 months prior to eligibility in the MinnesotaCare program (Article 2, Sec. 45). -Prohibits reimbursement to fee-for-service providers and payments to be increased because of reduced co-payments (Article 2, Sec. 48). -Limits the annual inpatient hospital costs to $10,000 for families with a gross income greater than 215 percent of the federal poverty guidelines, making them responsible for costs exceeding the annual limit (Article 2, Sec. 50). -Authorizes the applicant or recipient to choose among the care providing services within 25 miles of the individual's community of residence or the commissioner may assign them to a care delivery system within the same radius (Article 2, Sec. 60). -Reduces the salaries of the commissioner of human services, the assistant commissioner for chemical and mental health services, and all managerial employees of state-operated services who are not subject to a collective bargaining agreement by 20 percent until those who have been subject to a 20 percent reduction in hours have been offered the opportunity to return to full-time employment (Article 2, Sec. 72). -Specifies that a family with at least 1 parent under the age of 21 or one that does not have a high school diploma and is in a school district that provides childcare and other programs, then the family's eligibility shall be deferred beyond 6 months, but not to exceed 12 months (Article 4, Sec. 1). -Requires food stamp households to demonstrate that their gross income is equal to or less than 165 percent of the federal poverty guidelines (Article 4, Sec. 4). -Prohibits MFIP recipients from using their monthly cash assistance payments to purchase tobacco products, alcoholic beverages, or lottery tickets (Article 4, Sec. 11). -Prohibits health plans from requiring higher co-payments, deductibles, or coinsurance for cancer chemotherapy treatment patience being prescribed orally administered anticancer medication (Article 5, Sec. 1). -Prohibits a health plan company from refusing to renew or reissue, terminate, or restrict coverage of an individual solely because the individual is diagnosed with an autism spectrum disorder (Article 5, Sec. 2). -Authorizes a period of private duty nursing services to be subject to the co-payment, coinsurance, deductible, or other enrollee cost-sharing requirements that apply under the health plan (Article 5, Sec. 4). -Prohibits any dental organization from offering or providing dental care services that are not covered under the dental plan or contract (Article 5, Sec. 6). -Authorizes a health insurer to sell, offer, or issue an out-of-state health plan to residents in Minnesota if, among other things, the out-of-state plan is in compliance with all applicable Minnesota laws that apply to the type of health plan offered (Article 5, Sec. 9). -Requires the commissioner to create an Office of Health Care Inspector General within the Department of Human Services to enhance antifraud activities; protect the integrity of the state health care programs (Article 5, Sec. 26). -Requires that reciprocal agreements between 2 health information organizations or between a health information organization and a health data intermediary must include a fair and equitable model for charges between the entities (Article 6, Sec. 7). -Appropriates an increase in Medical Assistance Basic Health Care for Families and Children, but a decrease by $63.94 million for the elderly and disabled (Article 9, Sec. 2). -Appropriates a total of $14.07 million to the commissioner of human services by the year 2011 (Article 10, Sec. 3). -Increases annual capitation payments to the metropolitan health plan by approximately $6.8 million to recognize higher than average medical education costs (Article 10, Sec. 7).

Full Bill Text

Vote Smart's Synopsis:

Vote to pass an omnibus health and human services bill that increases funding from the federal government to the Minnesota health care system and reduces overall costs for state health care programs.

Highlights:

-Authorizes a reconsideration decision for disqualified individuals and if they remain disqualified, allows them to request a fair hearing (Article 1, Sec. 1). -Requires the commissioner to review all ongoing studies, reports, and program evaluations by the Department of Human Services between fiscal years 2006 and 2010; report on the legislature's appropriation and cost of the work to determine which ones require program evaluations and will repeat this review every 5 fiscal years (Article 2, Sec. 2). -Specifies that as of June 1, 2010, the surcharge is increased to 2.5 percent, and that each county-based plan must pay the commissioner a surcharge of 2.5 percent of the total premium revenues of the plan (Article 2, Sec. 3). -Specifies that between July 1, 2011 and June 30, 2013, the total payment for fee-for-service admissions is reduced 4.5 percent and the assistance admissions for diagnosis-related groups shall be increased at a percentage calculated to cost no more than $7.2 million per fiscal year (Article 2, Sec 4). -Prohibits any funds to be expended neither for sex-selection abortion nor for health benefits coverage that includes coverage of sex-selection abortion (Article 2, Sec. 5). -Authorizes medical assistance to be paid for a person who meets the following requirements (Article 2, Sec. 7):

-Between the ages of 21 and 65; -Not pregnant; -Not entitled to Medicare Part A or enrolled in Medicare Part B under the Social Security Act; and -Not an adult in a family with children.

-Authorizes a person with a gross countable income up to 75 percent of the federal poverty guidelines for family size to be eligible for medical assistance (Article 2, Sec. 10). -Requires the commissioner to estimate the acquisition cost of a drug at the average wholesale price minus 12.5 percent or wholesale acquisition cost plus 5 percent, whichever is lower (Article 2, Sec. 16). -Authorizes medical assistance coverage for services provided in a birth center, as follows (Article 2, Sec. 20):

-If the service would otherwise be covered if provided in a hospital; -Shall be paid at the lower rate of billed charges; or -70 percent of the statewide average for a facility payment rate is made to a hospital for an uncomplicated vaginal birth.

-Requires that services provided by traditional midwives be paid at the lower rate of billed charges or 100 percent of the rate paid to a physician performing the same services (Article 2, Sec. 20). -Requires the commissioner of human services along with the commissioner of health to establish a payment reform demonstration project implementing an alternative payment system for health care providers serving an identified group of patients who are enrolled in a state health care program (Article 2, Sec. 25). -Increases the operating payment rate of each facility reimbursed by 2 percent through June 30, 2011, then by 1.5 percent effective July 1, 2011 (Article 2, Sec. 27). -Requires the commissioner to reduce the health plan's emergency room utilization rate by 5 percent and that the withheld funds be returned and for this process to continue until the emergency room utilization rate for state health care program enrollees is reduced by 25 percent (Article 2, Sec. 28). -Reduces the total payments made to health care plans for providing covered services under the medical assistance and Minnesota Care programs by 1 percent (Article 2, Sec. 30). -Prohibits the net income of a managed care plan providing covered services under the public programs from exceeding 6 percent of the total monthly revenues that the managed care plan receives from the program (Article 2, Sec. 31). -Requires the commissioner to use 100 percent of the savings in costs to the state to provide equal percentage increases in operating payment rates for nursing facilities (Article 2, Sec. 31). -Requires that all outpatient and emergency services provided prior to December 31, 2007 have 50 percent of the costs paid by 2014; 100 percent of the costs paid by 2019, if they have received payment to support the training of residents (Article 2, Sec. 35). -Requires the commissioner to pay critical access dental provider payments to clinics when at least 40 percent of the patients are uninsured or covered by medical assistance, general assistance medical care, or MinnesotaCare (Article 2, Sec. 38). -Reduces total payments for basic care services including physical therapy, occupational therapy, and speech language pathology by 3 percent prior to third-party liability and spend down calculation (Article 2, Sec. 40). -Repeals the decrease in premium subsidies by 10 percent for families with gross annual income at or below 200 percent of the federal poverty guidelines, as well as requiring applicants to be uninsured for at least 6 months prior to eligibility in the MinnesotaCare program (Article 2, Sec. 45). -Authorizes the commissioner to offer MinnesotaCare applicants the opportunity to purchase supplemental hospital coverage to cover inpatient expenses, with premiums varying only for age (Article 2, Sec. 47). -Prohibits reimbursement to fee-for-service providers and payments to be increased because of reduced co-payments (Article 2, Sec. 48). -Limits the annual inpatient hospital costs to $10,000 for families with a gross income greater than 215 percent of the federal poverty guidelines, making them responsible for costs exceeding the annual limit (Article 2, Sec. 50). -Authorizes the applicant or recipient to choose among the care providing services within 25 miles of the individual's community of residence or the commissioner may assign them to a care delivery system within the same radius (Article 2, Sec. 60). -Authorizes the commissioner to establish a pilot program in Hennepin or Ramsey County to test alternative and innovative integrated health care delivery networks (Article 2, Sec. 69). -Requires the commissioner to increase grants, allocations, reimbursement rates, or rate limits by 2 percent, beginning July 1, 2010 - June 30, 2011, after which an increase of 1.5 percent shall be enacted. (Article 2, Sec. 71). -Reduces the salaries of the commissioner of human services, the assistant commissioner for chemical and mental health services, and all managerial employees of state-operated services who are not subject to a collective bargaining agreement by 20 percent until those who have been subject to a 20 percent reduction in hours have been offered the opportunity to return to full-time employment (Article 2, Sec. 72). -Authorizes the Minnesota State Council on Disability, the Minnesota Consortium for Citizens with Disabilities and the Arc of Minnesota to submit an annual report describing the existing state policies and goals for programs serving people with disabilities (Article 3, Sec. 2). -Requires the commission of human services to standardize and simplify processes, standards, and timelines for administrative functions within the Department of Human Services, Disability Services Division (Article 3, Sec. 8). -Requires the commissioner of human services to seek federal financial participation for eligible activity related to fiscal years 2010 and 2011 grants to Advocating Change Together to establish a statewide self-advocacy network for persons with developmental disabilities and for eligible activities under any future grants to the organization (Article 3, Sec. 10). -Specifies that if family has at least 1 parent under the age of 21 or one that does not have a high school diploma and is in a school district that provides childcare and other programs, then the family's eligibility shall be deferred beyond 6 months, but not to exceed 12 months (Article 4, Sec. 1). -Requires food stamp households to demonstrate that their gross income is equal to or less than 165 percent of the federal poverty guidelines (Article 4, Sec. 4). -Prohibits MFIP recipients from using their monthly cash assistance payments to purchase tobacco products, alcoholic beverages, or lottery tickets (Article 4, Sec. 11). -Prohibits health plans from requiring higher co-payments, deductibles, or coinsurance for cancer chemotherapy treatment patients being prescribed orally administered anticancer medication (Article 5, Sec. 1). -Prohibits a health plan company from refusing to renew or reissue, terminate, or restrict coverage of an individual solely because the individual is diagnosed with an autism spectrum disorder (Article 5, Sec. 2). -Authorizes a period of private duty nursing services to be subject to the co-payment, coinsurance, deductible, or other enrollee cost-sharing requirements that apply under the health plan (Article 5, Sec. 4). -Prohibits any dental organization from offering or providing dental care services that are not covered under the dental plan or contract (Article 5, Sec. 6). -Authorizes a health insurer to sell, offer, or issue an out-of-state health plan to residents in Minnesota if, among other things, the out-of-state plan is in compliance with all applicable Minnesota laws that apply to the type of health plan offered (Article 5, Sec. 9). -Establishes the Advisory Group on State-Operated Services Redesign to make recommendations to the commissioner of human services and the legislature on the continuum of services needed to provide individuals with complex conditions including mental illness and developmental disabilities access to quality care. In addition to, the appropriate level of care across the state to promote wellness, reduce cost, and improve efficiency while also seeking financing mechanisms that include all possible revenue sources to maximize federal funding (Article 5, Sec. 13). -Authorizes the commissioner to approve and implement pilot projects to provide alternatives to and enhance coordination of the delivery of chemical health services (Article 5, Sec. 26). -Establishes an Office of Health Care Inspector General within the Department of Human Services to enhance antifraud activities, and protect the integrity of the state health care programs (Article 5, Sec. 27). -Appropriates a decrease of $63.94 million for Medical Assistance Basic Health Care for the elderly and disabled (Article 9, Sec. 2). -Appropriates a total of $14.07 million to the commissioner of human services by the year 2011 (Article 10, Sec. 3). -Increases annual capitation payments to the metropolitan health plan by approximately $6.8 million to recognize higher than average medical education costs (Article 10, Sec. 7).

Full Bill Text