Legislative Session number- 86

Bill Name: SF0417

Relating to health

ARTICLE 1 - GENERAL PROVISIONS

"Minnesota Health Act";
establishing the Minnesota Health Plan to provide
residents all medically
necessary health care services; specifying health plan
requirements; defining
certain terms; providing for ethics and conflict of
interest; requiring certain
data sharing

ARTICLE 2 - ELIGIBILITY

Providing for eligibility to all
state residents; establishing residency
standards; requiring the Minnesota
health board to establish a procedure to
enroll residents and provide enrollees
with appropriate identification; allowing health care coverage for residents
temporarily residing out of state, visitors, nonresident persons working in the
state and retiree benefits; providing for presumptive eligibility

ARTICLE 3 -
BENEFITS

Authorizing eligible persons to receive services under the Minnesota
Health Plan from any licensed participating providers; prohibiting provider
patient care refusal based on unfair employment practice; specifying minimum
covered medical benefits; allowing the board to expand minimum benefits,
specifying certain exclusions; prohibiting payment for prescription drugs from
pharmaceutical companies directly marketing to consumers; prohibiting
deductibles, co-payments, co-insurance and other cost sharing; requiring primary
care provider use for patient care coordination

ARTICLE 4 -
FUNDING

Requiring the board to establish a Minnesota Health Fund to implement
the
Minnesota Health Plan and to receive premiums and other sources of revenue;
providing for fund accounts, budgets, program administration and training;
providing for revenue sources, specifying premium requirements and requiring the
board to submit a report to the governor and legislature by a certain date on
premium structure; permitting donations, requiring federal waivers and federal
preemption, providing for subrogation, plan reimbursement and defaults


ARTICLE 5 - PAYMENTS

Allowing plan participation to all licensed health
care providers; requiring
noninstitutional providers uniform fee schedule
establishment; providing for
payments to institutional providers; requiring the
board to develop a capital
investment plan

ARTICLE 6 -
GOVERNANCE

Providing certain conforming statutory changes; establishing a
Minnesota Health Plan executive officer and the Minnesota health board,
prescribing board composition, terms, compensation and duties; defining
metropolitan health planning region; prescribing regional health planning board
composition and duties; requiring the Minnesota health board to establish an
office of health quality and planning and prescribing duties, assessment and
benefits evaluation; creating the ombudsman office for patient advocacy,
prescribing duties; requiring the ombudsman to establish a grievance system for
complaints; requiring the attorney general to appoint an inspector general,
prescribing duties; requiring the legislative auditor to examine the books and
operating policies of the board

ARTICLE 7 - IMPLEMENTATION

Appropriating
money to the Minnesota health fund under the Minnesota Health Plan for
implementation
(rt)