Legislative Session number- 84

Bill Name: SF0065

2E Relating to health care; modifying certain health insurance premium rate
restrictions, requiring and providing for the commissioner of health to set
annual premium growth limits for health plan companies; expanding the
requirement for the commissioner to establish cost containment goals to a
requirement to establish annual health care expenditure limits for health plan
companies, prohibiting the limits from exceeding the premium limits and
expanding the definition of health plan company; requiring health plan companies
to annually provide to enrollees information on the increased personal health
risks and additional costs to the health care system due to obesity and to the
use of tobacco, exception, and the commissioner in consultation with the
Minnesota medical association to develop an information sheet to be posted on
the department web site; requiring the commissioner to distinguish between the
individual, small group and large group markets in the collection of certain
cost containment data from group purchasers; requesting clinical medical
education programs training pediatricians to include curriculum in case and
medication management for children suffering from mental illness; requiring
health care providers for appeal of utilization review initial determinations
not to certify services for prepaid health care programs under medical
assistance (MA), general assistance medical care or MinnesotaCare to follow
certain published evidence based care guidelines; expanding eligibility under
the health professional education loan forgiveness program to the field of
pediatric psychiatry; requiring and providing for the commissioner of human
services to establish and administer the prescription drug discount program,
specifying eligibility requirements, prescribing the application procedure and
regulating rebates, establishing the Minnesota prescription drug dedicated fund
to be used to reimburse participating pharmacies for prescription drug discounts
provided to enrollees, requiring crediting of rebates to the fund and the
payment of an enrollment fee to cover administrative expenses; expanding
eligibility under the continuing care program for persons with mental illness to
persons eligible for general assistance medical care; modifying the definition
of telemedicine consultation for medical assistance coverage purposes,
authorizing telephone conversations relating to the management of medications
for children with mental health needs; requiring and providing for the
commissioner of human services in consultation with the commissioner of health
to biennially establish a list of health care services (diagnosis/treatment
pairings) not eligible for medical assistance, GAMC and the MinnesotaCare
program; prohibiting assessments relating to the need for home care services
under medical assistance by the same agency, individual or organization
providing the care services and modifying the delegation authority of
responsible parties; excluding certain additional services from medical
assistance coverage of personal care assistant services and requiring the
commissioner to establish an ongoing audit process for potential fraud and abuse
for the services; providing for recipient or responsible party determination of
the flexible use of personal care assistant hours as an appropriate option,
authorizing commissioner denial, revocation suspension of authorizations to use
hours flexibly under certain conditions; providing for healthy lifestyle waivers
from copayment requirements; requiring and providing for the commissioner to
establish a performance reporting and payment system for health care providers
providing health care services to medical assistance, GAMC and MinnesotaCare
program participants, providing for bonuses to providers achieving certain
levels of performance established by the commissioner and specifying certain
commissioner system description and results reporting requirements; requiring
the commissioner to increase scholarship reimbursements to certain providers to
be used for certain employee scholarship costs and training in English as a
second language (ESL); providing a MinnesotaCare option for small employers;
limiting coverage of health care services under the medical assistance, GAMC and
MinnesotaCare programs, requiring and providing for prior authorization and
review of certain services before addition to public programs benefit sets and
restricting the authority of state human services referees to overturn prior
authorization decisions; requiring the commissioner of health in consultation
with the commissioners of human services and education to convene a task force
to study and make recommendations on reducing the rate of obesity among children
in the state, requiring a commissioner of health report of the recommendations
to the legislature by a certain date; requiring the commissioner of health in
consultation with the electronic health record planning work group to develop a
statewide plan for hospitals and physician group practices to implement
interoperable electronic health records systems by a certain date, specifying
certain factors to be considered by the commissioner in developing the plan and
to provide certain reports to the legislature; appropriating money to the board
of trustees of the Minnesota state colleges and universities (MnSCU) for a
nursing and health care education plan and to the commissioner of health for the
loan forgiveness program
(mk, ja)