1.1 	A bill for an act
1.2 	relating to health; changing provisions covering health care, home care and nursing 
1.3 	homes, case mix assessments, and audiologists;amending Minnesota Statutes 
1.4 	2018, sections 62J.497, subdivisions 1, 3; 62J.498, subdivision 1; 62J.63, 
1.5 	subdivisions 1, 2; 62J.692, subdivisions 3, 4; 144.0724, subdivisions 4, 8; 144A.10, 
1.6 	subdivisions 6c, 6d, 6e, 7, 12, 14, 16; 144A.101, subdivisions 2, 5; 144A.43, 
1.7 	subdivisions 4, 26; 144A.473, subdivisions 1, 3; 144A.474, subdivision 12; 
1.8 	144A.4791, subdivision 9; 148.517, by adding a subdivision; repealing Minnesota 
1.9 	Statutes 2018, sections 62J.63, subdivision 3; 62J.692, subdivision 4a; 62Q.72, 
1.10 	subdivision 2; 144A.04, subdivision 10; 144A.10, subdivisions 6b, 11; 144A.101, 
1.11 	subdivision 3.
1.12 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.13 	ARTICLE 1
1.14 	HEALTH CARE

1.15 	Section 1. Minnesota Statutes 2018, section 62J.497, subdivision 1, is amended to read:
1.16 		Subdivision 1.Definitions. (a) For the purposes of this section, the following terms have 
1.17 	the meanings given.
1.18 	(b) "Backward compatible" means that the newer version of a data transmission standard 
1.19 	would retain, at a minimum, the full functionality of the versions previously adopted, and 
1.20 	would permit the successful completion of the applicable transactions with entities that 
1.21 	continue to use the older versions.
1.22 	(c) "Dispense" or "dispensing" has the meaning given in section 151.01, subdivision 30. 
1.23 	Dispensing does not include the direct administering of a controlled substance to a patient 
1.24 	by a licensed health care professional.
2.1 	(d) "Dispenser" means a person authorized by law to dispense a controlled substance, 
2.2 	pursuant to a valid prescription.
2.3 	(e) "Electronic media" has the meaning given under Code of Federal Regulations, title 
2.4 	45, part 160.103.
2.5 	(f) "E-prescribing" means the transmission using electronic media of prescription or 
2.6 	prescription-related information between a prescriber, dispenser, pharmacy benefit manager, 
2.7 	or group purchaser, either directly or through an intermediary, including an e-prescribing 
2.8 	network. E-prescribing includes, but is not limited to, two-way transmissions between the 
2.9 	point of care and the dispenser and two-way transmissions related to eligibility, formulary, 
2.10 	and medication history information.
2.11 	(g) "Electronic prescription drug program" means a program that provides for 
2.12 	e-prescribing.
2.13 	(h) "Group purchaser" has the meaning given in section 62J.03, subdivision 6.
2.14 	(i) "HL7 messages" means a standard approved by the standards development 
2.15 	organization known as Health Level Seven.
2.16 	(j) "National Provider Identifier" or "NPI" means the identifier described under Code 
2.17 	of Federal Regulations, title 45, part 162.406.
2.18 	(k) "NCPDP" means the National Council for Prescription Drug Programs, Inc.
2.19 	(l) "NCPDP Formulary and Benefits Standard" means the National Council for 
2.20 	Prescription Drug Programs Formulary and Benefits Standard, Implementation Guide, 
2.21 	Version ~~1~~ 3, Release 0, ~~October 2005.~~ or the most recent standard adopted by the Centers 
2.22 	for Medicare and Medicaid Services for e-prescribing under Medicare Part D as required 
2.23 	by section 1860D-4(e)(4)(D) of the Social Security Act, and regulations adopted under it. 
2.24 	The standard shall be implemented according to the Centers for Medicare and Medicaid 
2.25 	Services schedule for compliance. Subsequently released versions of the NCPDP Formulary 
2.26 	and Benefits Standard may be used, provided that the new version of the standard is backward 
2.27 	compatible to the current version adopted by the Centers for Medicare and Medicaid Services.
2.28 	(m) "NCPDP SCRIPT Standard" means the National Council for Prescription Drug 
2.29 	Programs Prescriber/Pharmacist Interface SCRIPT Standard, Implementation Guide Version 
2.30 	~~8~~ 10, Release ~~1~~ 6 (Version ~~8.1~~ 10.6), ~~October 2005,~~ or the most recent standard adopted by 
2.31 	the Centers for Medicare and Medicaid Services for e-prescribing under Medicare Part D 
2.32 	as required by section 1860D-4(e)(4)(D) of the Social Security Act, and regulations adopted 
2.33 	under it. The standards shall be implemented according to the Centers for Medicare and 
3.1 	Medicaid Services schedule for compliance. Subsequently released versions of the NCPDP 
3.2 	SCRIPT Standard may be used, provided that the new version of the standard is backward 
3.3 	compatible to the current version adopted by the Centers for Medicare and Medicaid Services.
3.4 	(n) "Pharmacy" has the meaning given in section 151.01, subdivision 2.
3.5 	(o) "Prescriber" means a licensed health care practitioner, other than a veterinarian, as 
3.6 	defined in section 151.01, subdivision 23.
3.7 	(p) "Prescription-related information" means information regarding eligibility for drug 
3.8 	benefits, medication history, or related health or drug information.
3.9 	(q) "Provider" or "health care provider" has the meaning given in section 62J.03, 
3.10 	subdivision 8.

3.11 	Sec. 2. Minnesota Statutes 2018, section 62J.497, subdivision 3, is amended to read:
3.12 		Subd. 3.Standards for electronic prescribing. (a) Prescribers and dispensers must use 
3.13 	the NCPDP SCRIPT Standard for the communication of a prescription or prescription-related 
3.14 	information. ~~The NCPDP SCRIPT Standard shall be used to conduct the following~~ 
3.15 	~~transactions:~~
3.16 	~~(1) get message transaction;~~
3.17 	~~(2) status response transaction;~~
3.18 	~~(3) error response transaction;~~
3.19 	~~(4) new prescription transaction;~~
3.20 	~~(5) prescription change request transaction;~~
3.21 	~~(6) prescription change response transaction;~~
3.22 	~~(7) refill prescription request transaction;~~
3.23 	~~(8) refill prescription response transaction;~~
3.24 	~~(9) verification transaction;~~
3.25 	~~(10) password change transaction;~~
3.26 	~~(11) cancel prescription request transaction; and~~
3.27 	~~(12) cancel prescription response transaction.~~
3.28 	(b) Providers, group purchasers, prescribers, and dispensers must use the NCPDP SCRIPT 
3.29 	Standard for communicating and transmitting medication history information.
4.1 	(c) Providers, group purchasers, prescribers, and dispensers must use the NCPDP 
4.2 	Formulary and Benefits Standard for communicating and transmitting formulary and benefit 
4.3 	information.
4.4 	(d) Providers, group purchasers, prescribers, and dispensers must use the national provider 
4.5 	identifier to identify a health care provider in e-prescribing or prescription-related transactions 
4.6 	when a health care provider's identifier is required.
4.7 	(e) Providers, group purchasers, prescribers, and dispensers must communicate eligibility 
4.8 	information and conduct health care eligibility benefit inquiry and response transactions 
4.9 	according to the requirements of section 62J.536.

4.10 	Sec. 3. Minnesota Statutes 2018, section 62J.498, subdivision 1, is amended to read:
4.11 		Subdivision 1.Definitions. (a) The following definitions apply to sections 62J.498 to 
4.12 	62J.4982:
4.13 	(b) "Clinical data repository" means a real time database that consolidates data from a 
4.14 	variety of clinical sources to present a unified view of a single patient and is used by a 
4.15 	state-certified health information exchange service provider to enable health information 
4.16 	exchange among health care providers that are not related health care entities as defined in 
4.17 	section 144.291, subdivision 2, paragraph ~~(j)~~ (k). This does not include clinical data that 
4.18 	are submitted to the commissioner for public health purposes required or permitted by law, 
4.19 	including any rules adopted by the commissioner.
4.20 	(c) "Clinical transaction" means any meaningful use transaction or other health 
4.21 	information exchange transaction that is not covered by section 62J.536.
4.22 	(d) "Commissioner" means the commissioner of health.
4.23 	(e) "Health care provider" or "provider" means a health care provider or provider as 
4.24 	defined in section 62J.03, subdivision 8.
4.25 	(f) "Health data intermediary" means an entity that provides the technical capabilities 
4.26 	or related products and services to enable health information exchange among health care 
4.27 	providers that are not related health care entities as defined in section 144.291, subdivision 
4.28 	2, paragraph ~~(j)~~ (k). This includes but is not limited to: health information service providers 
4.29 	(HISP), electronic health record vendors, and pharmaceutical electronic data intermediaries 
4.30 	as defined in section 62J.495.
4.31 	(g) "Health information exchange" means the electronic transmission of health-related 
4.32 	information between organizations according to nationally recognized standards.
5.1 	(h) "Health information exchange service provider" means a health data intermediary 
5.2 	or health information organization.
5.3 	(i) "Health information organization" means an organization that oversees, governs, and 
5.4 	facilitates health information exchange among health care providers that are not related 
5.5 	health care entities as defined in section 144.291, subdivision 2, paragraph ~~(j)~~ (k), to improve 
5.6 	coordination of patient care and the efficiency of health care delivery.
5.7 	(j) "HITECH Act" means the Health Information Technology for Economic and Clinical 
5.8 	Health Act as defined in section 62J.495.
5.9 	(k) "Major participating entity" means:
5.10 	(1) a participating entity that receives compensation for services that is greater than 30 
5.11 	percent of the health information organization's gross annual revenues from the health 
5.12 	information exchange service provider;
5.13 	(2) a participating entity providing administrative, financial, or management services to 
5.14 	the health information organization, if the total payment for all services provided by the 
5.15 	participating entity exceeds three percent of the gross revenue of the health information 
5.16 	organization; and
5.17 	(3) a participating entity that nominates or appoints 30 percent or more of the board of 
5.18 	directors or equivalent governing body of the health information organization.
5.19 	(l) "Master patient index" means an electronic database that holds unique identifiers of 
5.20 	patients registered at a care facility and is used by a state-certified health information 
5.21 	exchange service provider to enable health information exchange among health care providers 
5.22 	that are not related health care entities as defined in section 144.291, subdivision 2, paragraph 
5.23 	~~(j)~~ (k). This does not include data that are submitted to the commissioner for public health 
5.24 	purposes required or permitted by law, including any rules adopted by the commissioner.
5.25 	(m) "Meaningful use" means use of certified electronic health record technology to 
5.26 	improve quality, safety, and efficiency and reduce health disparities; engage patients and 
5.27 	families; improve care coordination and population and public health; and maintain privacy 
5.28 	and security of patient health information as established by the Centers for Medicare and 
5.29 	Medicaid Services and the Minnesota Department of Human Services pursuant to sections 
5.30 	4101, 4102, and 4201 of the HITECH Act.
5.31 	(n) "Meaningful use transaction" means an electronic transaction that a health care 
5.32 	provider must exchange to receive Medicare or Medicaid incentives or avoid Medicare 
5.33 	penalties pursuant to sections 4101, 4102, and 4201 of the HITECH Act.
6.1 	(o) "Participating entity" means any of the following persons, health care providers, 
6.2 	companies, or other organizations with which a health information organization or health 
6.3 	data intermediary has contracts or other agreements for the provision of health information 
6.4 	exchange services:
6.5 	(1) a health care facility licensed under sections 144.50 to 144.56, a nursing home 
6.6 	licensed under sections 144A.02 to 144A.10, and any other health care facility otherwise 
6.7 	licensed under the laws of this state or registered with the commissioner;
6.8 	(2) a health care provider, and any other health care professional otherwise licensed 
6.9 	under the laws of this state or registered with the commissioner;
6.10 	(3) a group, professional corporation, or other organization that provides the services of 
6.11 	individuals or entities identified in clause (2), including but not limited to a medical clinic, 
6.12 	a medical group, a home health care agency, an urgent care center, and an emergent care 
6.13 	center;
6.14 	(4) a health plan as defined in section 62A.011, subdivision 3; and
6.15 	(5) a state agency as defined in section 13.02, subdivision 17.
6.16 	(p) "Reciprocal agreement" means an arrangement in which two or more health 
6.17 	information exchange service providers agree to share in-kind services and resources to 
6.18 	allow for the pass-through of clinical transactions.
6.19 	(q) "State-certified health data intermediary" means a health data intermediary that has 
6.20 	been issued a certificate of authority to operate in Minnesota.
6.21 	(r) "State-certified health information organization" means a health information 
6.22 	organization that has been issued a certificate of authority to operate in Minnesota.

6.23 	Sec. 4. Minnesota Statutes 2018, section 62J.63, subdivision 1, is amended to read:
6.24 		Subdivision 1.Establishment; administration. The commissioner of health shall 
6.25 	~~establish and administer the Center for Health Care Purchasing Improvement as an~~ 
6.26 	~~administrative unit within the Department of Health. The Center for Health Care Purchasing~~ 
6.27 	~~Improvement shall~~ support the state in its efforts to be a more prudent and efficient purchaser 
6.28 	of quality health care services~~. The center shall~~, aid the state in developing and using more 
6.29 	common strategies and approaches for health care performance measurement and health 
6.30 	care purchasing~~. The common strategies and approaches shall~~, promote greater transparency 
6.31 	of health care costs and quality, and greater accountability for health care results and 
7.1 	improvement~~. The center shall also~~, and identify barriers to more efficient, effective, quality 
7.2 	health care and options for overcoming the barriers.

7.3 	Sec. 5. Minnesota Statutes 2018, section 62J.63, subdivision 2, is amended to read:
7.4 		Subd. 2.Staffing; duties; scope. ~~(a)~~ The commissioner of health may ~~appoint a director,~~ 
7.5 	~~and up to three additional senior-level staff or codirectors, and other staff as needed who~~ 
7.6 	~~are under the direction of the commissioner. The staff of the center are in the unclassified~~ 
7.7 	~~service.~~:
7.8 	~~(b) With the authorization of the commissioner of health, and in consultation or~~ 
7.9 	~~interagency agreement with the appropriate commissioners of state agencies, the director,~~ 
7.10 	~~or codirectors, may:~~
7.11 	~~(1) initiate projects to develop plan designs for state health care purchasing;~~
7.12 	~~(2)~~ (1) require reports or surveys to evaluate the performance of current health care 
7.13 	purchasing or administrative simplification strategies;
7.14 	~~(3)~~ (2) calculate fiscal impacts, including net savings and return on investment, of health 
7.15 	care purchasing strategies and initiatives;
7.16 	~~(4) conduct policy audits of state programs to measure conformity to state statute or~~ 
7.17 	~~other purchasing initiatives or objectives;~~
7.18 	~~(5)~~ (3) support the Administrative Uniformity Committee under ~~section~~ sections62J.50
7.19 	and 62J.536, and other relevant groups or activities to advance agreement on health care 
7.20 	administrative process streamlining;
7.21 	~~(6) consult with the Health Economics Unit of the Department of Health regarding~~ 
7.22 	~~reports and assessments of the health care marketplace;~~
7.23 	~~(7) consult with the Department of Commerce regarding health care regulatory issues~~ 
7.24 	~~and legislative initiatives;~~
7.25 	~~(8) work with appropriate Department of Human Services staff and the Centers for~~ 
7.26 	~~Medicare and Medicaid Services to address federal requirements and conformity issues for~~ 
7.27 	~~health care purchasing;~~
7.28 	~~(9) assist the Minnesota Comprehensive Health Association in health care purchasing~~ 
7.29 	~~strategies;~~
7.30 	~~(10) convene medical directors of agencies engaged in health care purchasing for advice,~~ 
7.31 	~~collaboration, and exploring possible synergies;~~
8.1 	~~(11)~~ (4) contact and participate with other relevant health care task forces, study activities, 
8.2 	and similar efforts with regard to health care performance measurement and 
8.3 	performance-based purchasing; and
8.4 	~~(12)~~ (5) assist in seeking external funding through appropriate grants or other funding 
8.5 	opportunities and may administer grants and externally funded projects.

8.6 	Sec. 6. Minnesota Statutes 2018, section 62J.692, subdivision 3, is amended to read:
8.7 		Subd. 3.Application process. (a) A clinical medical education program conducted in 
8.8 	Minnesota by a teaching institution to train physicians, doctor of pharmacy practitioners, 
8.9 	dentists, chiropractors, physician assistants, dental therapists and advanced dental therapists, 
8.10 	psychologists, clinical social workers, community paramedics, or community health workers 
8.11 	is eligible for funds under subdivision 4 if the program:
8.12 	(1) is funded, in part, by patient care revenues;
8.13 	(2) occurs in patient care settings that face increased financial pressure as a result of 
8.14 	competition with nonteaching patient care entities; and
8.15 	(3) emphasizes primary care or specialties that are in undersupply in Minnesota.
8.16 	(b) A clinical medical education program for advanced practice nursing is eligible for 
8.17 	funds under subdivision 4 if the program meets the eligibility requirements in paragraph 
8.18 	(a), clauses (1) to (3), and is sponsored by the University of Minnesota Academic Health 
8.19 	Center, the Mayo Foundation, or institutions that are part of the Minnesota State Colleges 
8.20 	and Universities system or members of the Minnesota Private College Council.
8.21 	(c) Applications must be submitted to the commissioner by a sponsoring institution on 
8.22 	behalf of an eligible clinical medical education program and must be received by October 
8.23 	31 of each year for distribution in the following year. An application for funds must contain 
8.24 	the following information:
8.25 	(1) the official name and address of the sponsoring institution and the official name and 
8.26 	site address of the clinical medical education programs on whose behalf the sponsoring 
8.27 	institution is applying;
8.28 	(2) the name, title, and business address of those persons responsible for administering 
8.29 	the funds;
8.30 	(3) for each clinical medical education program for which funds are being sought; the 
8.31 	type and specialty orientation of trainees in the program; the name, site address, and medical 
8.32 	assistance provider number and national provider identification number of each training 
9.1 	site used in the program; the federal tax identification number of each training site used in 
9.2 	the program, where available; the total number of trainees at each training site; and the total 
9.3 	number of eligible trainee FTEs at each site; and
9.4 	(4) other supporting information the commissioner deems necessary to determine program 
9.5 	eligibility based on the criteria in paragraphs (a) and (b) and to ensure the equitable 
9.6 	distribution of funds.
9.7 	~~(d) An application must include the information specified in clauses (1) to (3) for each~~ 
9.8 	~~clinical medical education program on an annual basis for three consecutive years. After~~ 
9.9 	~~that time, an application must include the information specified in clauses (1) to (3) when~~ 
9.10 	~~requested, at the discretion of the commissioner:~~
9.11 	~~(1) audited clinical training costs per trainee for each clinical medical education program~~ 
9.12 	~~when available or estimates of clinical training costs based on audited financial data;~~
9.13 	~~(2) a description of current sources of funding for clinical medical education costs,~~ 
9.14 	~~including a description and dollar amount of all state and federal financial support, including~~ 
9.15 	~~Medicare direct and indirect payments; and~~
9.16 	~~(3) other revenue received for the purposes of clinical training.~~
9.17 	~~(e)~~ (d) An applicant that does not provide information requested by the commissioner 
9.18 	shall not be eligible for funds for the current funding cycle.

9.19 	Sec. 7. Minnesota Statutes 2018, section 62J.692, subdivision 4, is amended to read:
9.20 		Subd. 4.Distribution of funds. (a) The commissioner shall annually distribute the 
9.21 	available medical education funds to all qualifying applicants based on a public program 
9.22 	volume factor, which is determined by the total volume of public program revenue received 
9.23 	by each training site as a percentage of all public program revenue received by all training 
9.24 	sites in the fund pool.
9.25 	Public program revenue for the distribution formula includes revenue from medical 
9.26 	assistance and prepaid medical assistance. Training sites that receive no public program 
9.27 	revenue are ineligible for funds available under this subdivision. ~~For purposes of determining~~ 
9.28 	~~training-site level grants to be distributed under this paragraph, total statewide average costs~~ 
9.29 	~~per trainee for medical residents is based on audited clinical training costs per trainee in~~ 
9.30 	~~primary care clinical medical education programs for medical residents. Total statewide~~ 
9.31 	~~average costs per trainee for dental residents is based on audited clinical training costs per~~ 
9.32 	~~trainee in clinical medical education programs for dental students. Total statewide average~~ 
9.33 	~~costs per trainee for pharmacy residents is based on audited clinical training costs per trainee~~ 
10.1 	~~in clinical medical education programs for pharmacy students.~~ Training sites whose training 
10.2 	site level grant is less than $5,000, based on the formula described in this paragraph, or that 
10.3 	train fewer than 0.1 FTE eligible trainees, are ineligible for funds available under this 
10.4 	subdivision. No training sites shall receive a grant per FTE trainee that is in excess of the 
10.5 	95th percentile grant per FTE across all eligible training sites; grants in excess of this amount 
10.6 	will be redistributed to other eligible sites based on the formula described in this paragraph.
10.7 	~~(b) For funds distributed in fiscal years 2014 and 2015, the distribution formula shall~~ 
10.8 	~~include a supplemental public program volume factor, which is determined by providing a~~ 
10.9 	~~supplemental payment to training sites whose public program revenue accounted for at least~~ 
10.10 	~~0.98 percent of the total public program revenue received by all eligible training sites. The~~ 
10.11 	~~supplemental public program volume factor shall be equal to ten percent of each training~~ 
10.12 	~~site's grant for funds distributed in fiscal year 2014 and for funds distributed in fiscal year~~ 
10.13 	~~2015. Grants to training sites whose public program revenue accounted for less than 0.98~~ 
10.14 	~~percent of the total public program revenue received by all eligible training sites shall be~~ 
10.15 	~~reduced by an amount equal to the total value of the supplemental payment. For fiscal year~~ 
10.16 	~~2016 and beyond, the distribution of funds shall be based solely on the public program~~ 
10.17 	~~volume factor as described in paragraph (a).~~
10.18 	~~(c)~~ (b) Funds distributed shall not be used to displace current funding appropriations 
10.19 	from federal or state sources.
10.20 	~~(d)~~ (c) Funds shall be distributed to the sponsoring institutions indicating the amount to 
10.21 	be distributed to each of the sponsor's clinical medical education programs based on the 
10.22 	criteria in this subdivision and in accordance with the commissioner's approval letter. Each 
10.23 	clinical medical education program must distribute funds allocated under ~~paragraphs~~
10.24 	paragraph (a) ~~and (b)~~ to the training sites as specified in the commissioner's approval letter. 
10.25 	Sponsoring institutions, which are accredited through an organization recognized by the 
10.26 	Department of Education or the Centers for Medicare and Medicaid Services, may contract 
10.27 	directly with training sites to provide clinical training. To ensure the quality of clinical 
10.28 	training, those accredited sponsoring institutions must:
10.29 	(1) develop contracts specifying the terms, expectations, and outcomes of the clinical 
10.30 	training conducted at sites; and
10.31 	(2) take necessary action if the contract requirements are not met. Action may include 
10.32 	the withholding of payments under this section or the removal of students from the site.
10.33 	~~(e)~~ (d) Use of funds is limited to expenses related to clinical training program costs for 
10.34 	eligible programs.
11.1 	~~(f)~~ (e) Any funds not distributed in accordance with the commissioner's approval letter 
11.2 	must be returned to the medical education and research fund within 30 days of receiving 
11.3 	notice from the commissioner. The commissioner shall distribute returned funds to the 
11.4 	appropriate training sites in accordance with the commissioner's approval letter.
11.5 	~~(g)~~ (f) A maximum of $150,000 of the funds dedicated to the commissioner under section 
11.6 	297F.10, subdivision 1, clause (2), may be used by the commissioner for administrative 
11.7 	expenses associated with implementing this section.

11.8 	ARTICLE 2
11.9 	NURSING HOMES AND HOME CARE

11.10 	Section 1. Minnesota Statutes 2018, section 144A.10, subdivision 6c, is amended to read:
11.11 		Subd. 6c.Overlap of fines. If a nursing home is subject to fines under both ~~subdivisions~~
11.12 	subdivision 6 ~~and 6b~~and federal law for the same requirement, condition, situation, or 
11.13 	practice, the commissioner shall assess either the fine provided by subdivision 6 or the 
11.14 	federal law fine ~~provided by subdivision 6b~~.

11.15 	Sec. 2. Minnesota Statutes 2018, section 144A.10, subdivision 6d, is amended to read:
11.16 		Subd. 6d.Schedule of fines. (a) The schedule of fines for noncompliance with correction 
11.17 	orders issued to nursing homes that was adopted under the provisions of section 144A.10, 
11.18 	subdivision 6, and in effect on May 1, 1989, is effective until repealed, modified, or 
11.19 	superseded by rule.
11.20 	(b) By September 1, 1990, the commissioner shall amend the schedule of fines to increase 
11.21 	to $250 the fines for violations of section 144.651, subdivisions 18, 20, 21, 22, 27, and 30, 
11.22 	and for repeated violations.
11.23 	~~(c) The commissioner shall adopt rules establishing the schedule of fines for deficiencies~~ 
11.24 	~~in the requirements of section 1919(b), (c), and (d), of the Social Security Act, or regulations~~ 
11.25 	~~adopted under that section of the Social Security Act.~~

11.26 	Sec. 3. Minnesota Statutes 2018, section 144A.10, subdivision 6e, is amended to read:
11.27 		Subd. 6e.Use of fines. When the commissioner of health determines the use of, or 
11.28 	provides recommendations on the use of ~~fines collected under subdivision 6 or 6b,~~ federal 
11.29 	civil monetary penalties, two representatives of the nursing home industry, appointed by 
11.30 	nursing home trade associations, and two consumer representatives as appointed by the 
11.31 	commissioner must be included in the process of developing or preparing any information, 
12.1 	reviews, or recommendations on the use of the fines. This includes, but is not limited to, 
12.2 	including two representatives of the nursing home industry in any committee designed to 
12.3 	provide information and recommendations for the use of the fines.

12.4 	Sec. 4. Minnesota Statutes 2018, section 144A.10, subdivision 7, is amended to read:
12.5 		Subd. 7.Accumulation of fines. A nursing home shall promptly notify the commissioner 
12.6 	of health in writing when a violation noted in a notice of noncompliance is corrected. Upon 
12.7 	receipt of written notification by the commissioner of health, the daily fine assessed for the 
12.8 	deficiency shall stop accruing. The facility shall be reinspected within three working days 
12.9 	after receipt of the notification. If upon reinspection the representative of the commissioner 
12.10 	of health determines that a deficiency has not been corrected as indicated by the notification 
12.11 	of compliance the daily fine assessment shall resume and the amount of fines which otherwise 
12.12 	would have accrued during the period prior to resumption shall be added to the total 
12.13 	assessment due from the nursing home. The commissioner of health shall notify the nursing 
12.14 	home of the resumption by certified mail or electronically to the administrator of the nursing 
12.15 	home. The nursing home may challenge the resumption as a contested case in accordance 
12.16 	with the provisions of chapter 14. Recovery of the resumed fine shall be stayed if a 
12.17 	controlling person or a legal representative on behalf of the nursing home makes a written 
12.18 	request for a hearing on the resumption within 15 days of receipt of the notice of resumption. 
12.19 	The cost of a reinspection conducted pursuant to this subdivision shall be added to the total 
12.20 	assessment due from the nursing home.

12.21 	Sec. 5. Minnesota Statutes 2018, section 144A.10, subdivision 12, is amended to read:
12.22 		Subd. 12.Data on follow-up surveys. (a) If requested, and not prohibited by federal 
12.23 	law, the commissioner shall make available to the nursing home associations ~~and~~ the public 
12.24 	~~photocopies of~~ statements of deficiencies and related letters from the department pertaining 
12.25 	to federal certification surveys. ~~The commissioner may charge for the actual cost of~~ 
12.26 	~~reproduction of these documents.~~
12.27 	(b) The commissioner shall also make available on a quarterly basis aggregate data for 
12.28 	all statements of deficiencies issued after federal certification follow-up surveys related to 
12.29 	surveys that were conducted in the quarter prior to the immediately preceding quarter. The 
12.30 	data shall include the number of facilities with deficiencies, the total number of deficiencies, 
12.31 	the number of facilities that did not have any deficiencies, the number of facilities for which 
12.32 	a resurvey or follow-up survey was not performed, and the average number of days between 
12.33 	the follow up or resurvey and the exit date of the preceding survey.

13.1 	Sec. 6. Minnesota Statutes 2018, section 144A.10, subdivision 14, is amended to read:
13.2 		Subd. 14.Immediate jeopardy. When conducting survey certification and enforcement 
13.3 	activities related to regular, expanded, or extended surveys and if consistent under Code of 
13.4 	Federal Regulations, title 42, part 488, the commissioner may not issue a finding of 
13.5 	immediate jeopardy unless the specific event or omission that constitutes the violation of 
13.6 	the requirements of participation poses an imminent risk of life-threatening or serious injury 
13.7 	to a resident. The commissioner may not issue any findings of immediate jeopardy after the 
13.8 	conclusion of a regular, expanded, or extended survey unless the survey team identified the 
13.9 	deficient practice or practices that constitute immediate jeopardy and the residents at risk 
13.10 	prior to the close of the exit conference if consistent with federal requirements.

13.11 	Sec. 7. Minnesota Statutes 2018, section 144A.10, subdivision 16, is amended to read:
13.12 		Subd. 16.Independent informal dispute resolution. (a) Notwithstanding subdivision 
13.13 	15, a facility certified under the federal Medicare or Medicaid programs may request from 
13.14 	the commissioner, in writing, an independent informal dispute resolution process regarding 
13.15 	any deficiency citation issued to the facility. The facility must specify in its written request 
13.16 	each deficiency citation that it disputes. The commissioner shall provide ~~a hearing under~~ 
13.17 	~~sections 14.57 to 14.62~~ an informal dispute resolution procedure consistent with federal 
13.18 	requirements. Upon the written request of the facility, ~~the parties must submit the issues~~ 
13.19 	~~raised to arbitration by an administrative law judge.~~ an informal dispute resolution proceeding 
13.20 	will be scheduled by the reviewer. The informal dispute resolution proceeding shall take 
13.21 	place within 90 days of the request. The commissioner may contract with the Office of 
13.22 	Administrative Hearings or another federally approved reviewer to conduct the informal 
13.23 	dispute resolution process.
13.24 	(b) Upon receipt of a written request for an ~~arbitration~~ informal dispute resolution
13.25 	proceeding, the commissioner shall file with the ~~Office of Administrative Hearings a request~~ 
13.26 	~~for the appointment of an arbitrator and simultaneously serve the facility with~~ reviewer a
13.27 	notice of the request. The ~~arbitrator~~ reviewer for the dispute shall be an administrative law 
13.28 	judge appointed by the Office of Administrative Hearings or another federally approved 
13.29 	reviewer. The disclosure provisions of section 572B.12 and the notice provisions of section 
13.30 	572B.15, subsection (c), apply. The facility ~~and the commissioner have~~ has the right to be 
13.31 	represented by an attorney at the expense of the facility.
13.32 	(c) The commissioner and the facility ~~may present written evidence, depositions, and~~ 
13.33 	~~oral statements and arguments at the arbitration proceeding.~~ must abide by the federal 
14.1 	requirements for informal dispute resolution proceedings. Oral statements and arguments 
14.2 	may be made by telephone.
14.3 	(d) Within ten working days of the close of the ~~arbitration~~ proceeding, the ~~administrative~~ 
14.4 	~~law judge~~ reviewer shall issue findings regarding each of the deficiencies in dispute. The 
14.5 	findings shall be one or more of the following:
14.6 	(1) Supported in full. The citation is supported in full, with no deletion of findings and 
14.7 	no change in the scope or severity assigned to the deficiency citation.
14.8 	(2) Supported in substance. The citation is supported, but one or more findings are 
14.9 	deleted without any change in the scope or severity assigned to the deficiency.
14.10 	(3) Deficient practice cited under wrong requirement of participation. The citation is 
14.11 	amended by moving it to the correct requirement of participation.
14.12 	(4) Scope not supported. The citation is amended through a change in the scope assigned 
14.13 	to the citation.
14.14 	(5) Severity not supported. The citation is amended through a change in the severity 
14.15 	assigned to the citation.
14.16 	(6) No deficient practice. The citation is deleted because the findings did not support 
14.17 	the citation or the negative resident outcome was unavoidable. The findings of the arbitrator 
14.18 	are not binding on the commissioner.
14.19 	~~(e) The commissioner shall reimburse the Office of Administrative Hearings for the~~ 
14.20 	~~costs incurred by that office for the arbitration proceeding. The facility shall reimburse the~~ 
14.21 	~~commissioner for the proportion of the costs that represent the sum of deficiency citations~~ 
14.22 	~~supported in full under paragraph (d), clause (1), or in substance under paragraph (d), clause~~ 
14.23 	~~(2), divided by the total number of deficiencies disputed. A deficiency citation for which~~ 
14.24 	~~the administrative law judge's sole finding is that the deficient practice was cited under the~~ 
14.25 	~~wrong requirements of participation shall not be counted in the numerator or denominator~~ 
14.26 	~~in the calculation of the proportion of costs.~~

14.27 	Sec. 8. Minnesota Statutes 2018, section 144A.101, subdivision 2, is amended to read:
14.28 		Subd. 2.Statement of deficiencies. The commissioner shall provide nursing facilities 
14.29 	~~with draft statements of deficiencies at the time of the survey exit process and shall provide~~ 
14.30 	~~facilities~~ with completed statements of deficiencies within 15 working days of the exit 
14.31 	process.

15.1 	Sec. 9. Minnesota Statutes 2018, section 144A.101, subdivision 5, is amended to read:
15.2 		Subd. 5.Survey revisits. The commissioner shall conduct survey revisits ~~within 15~~ 
15.3 	~~calendar days of the date by which corrections will be completed, as specified by the provider~~ 
15.4 	~~in its plan of correction, in cases where category 2 or category 3 remedies are in place~~
15.5 	consistent with federal requirements. The commissioner may conduct survey revisits by 
15.6 	telephone or written communications for facilities at which the highest scope and severity 
15.7 	score for a violation was level E or lower.

15.8 	Sec. 10. Minnesota Statutes 2018, section 144A.43, subdivision 4, is amended to read:
15.9 		Subd. 4.Home care provider. "Home care provider" means an individual, organization, 
15.10 	association, corporation, unit of government, or other entity that is regularly engaged in the 
15.11 	delivery of at least one home care service, directly and not by contract, in a client's home 
15.12 	for a fee and who has a valid current temporary license or license issued under sections 
15.13 	144A.43 to 144A.482.

15.14 	Sec. 11. Minnesota Statutes 2018, section 144A.43, subdivision 26, is amended to read:
15.15 		Subd. 26.Revenues. "Revenues" means all money received by a licensee ~~derived~~ from 
15.16 	the provision of home care services, including ~~fees for services and appropriations of public~~ 
15.17 	~~money for home care services~~ from clients and liable third parties.

15.18 	Sec. 12. Minnesota Statutes 2018, section 144A.473, subdivision 1, is amended to read:
15.19 		Subdivision 1.Temporary license and renewal of license. (a) The department shall 
15.20 	review each application to determine the applicant's knowledge of and compliance with 
15.21 	Minnesota home care regulations. Before granting a temporary license or renewing a license, 
15.22 	the commissioner may further evaluate the applicant or licensee by requesting additional 
15.23 	information or documentation or by conducting an on-site survey of the applicant to 
15.24 	determine compliance with sections 144A.43 to 144A.482.
15.25 	(b) Within 14 calendar days after receiving an application for a license, the commissioner 
15.26 	shall acknowledge receipt of the application in writing. The acknowledgment must indicate 
15.27 	whether the application appears to be complete or whether additional information is required 
15.28 	before the application will be considered complete.
15.29 	(c) Within ~~90~~ 60 days after receiving a complete application, the commissioner shall 
15.30 	issue a temporary license, renew the license, or deny the license.
16.1 	(d) The commissioner shall issue a license that contains the home care provider's name, 
16.2 	address, license level, expiration date of the license, and unique license number. All licenses 
16.3 	are valid for one year from the date of issuance.

16.4 	Sec. 13. Minnesota Statutes 2018, section 144A.473, subdivision 3, is amended to read:
16.5 		Subd. 3.Temporary licensee survey. (a) If the temporary licensee is in substantial 
16.6 	compliance with the survey, the commissioner shall issue either a basic or comprehensive 
16.7 	home care license. If the temporary licensee is not in substantial compliance with the survey, 
16.8 	the commissioner shall not issue a basic or comprehensive license and there will be no 
16.9 	contested hearing right under chapter 14.
16.10 	(b) If the temporary licensee whose basic or comprehensive license has been denied 
16.11 	disagrees with the conclusions of the commissioner, then the licensee may request a 
16.12 	reconsideration by the commissioner or commissioner's designee. The reconsideration 
16.13 	request process must be conducted internally by the commissioner or commissioner's 
16.14 	designee, and chapter 14 does not apply.
16.15 	(c) ~~The temporary licensee requesting reconsideration must make the request in writing~~ 
16.16 	~~and must list and~~To be considered, the request for reconsideration must:
16.17 	(1) be in writing;
16.18 	(2) be received by the commissioner within 15 calendar days from the date the provider 
16.19 	receives the denial notice;
16.20 	(3) include documents and other evidence to support the request; and
16.21 	(4) describe the reasons why the licensee disagrees with the decision to deny the basic 
16.22 	or comprehensive home care license.
16.23 	(d) A temporary licensee whose license is denied must comply with the requirements 
16.24 	for notification and transfer of clients in section 144A.475, subdivision 5.

16.25 	Sec. 14. Minnesota Statutes 2018, section 144A.474, subdivision 12, is amended to read:
16.26 		Subd. 12.Reconsideration. (a) The commissioner shall make available to home care 
16.27 	providers a correction order reconsideration process. This process may be used to challenge 
16.28 	the correction order issued, including the level and scope described in subdivision 11, and 
16.29 	any fine assessed. During the correction order reconsideration request, the issuance for the 
16.30 	correction orders under reconsideration are not stayed, but the department shall post 
17.1 	information on the website with the correction order that the licensee has requested a 
17.2 	reconsideration and that the review is pending.
17.3 	(b) A licensed home care provider may request from the commissioner~~, in writing,~~ a 
17.4 	correction order reconsideration regarding any correction order issued to the provider. The 
17.5 	~~written~~ request for reconsideration must:
17.6 	(1) be in writing;
17.7 	(2) be received by the commissioner within 15 calendar days of the correction order 
17.8 	receipt date~~.~~;
17.9 	(3) list each correction order, level, scope, and fine the provider does not agree with and 
17.10 	an explanation about why they do not agree;
17.11 	(4) include documents and other evidence to support the request; and
17.12 	(5) describe the reasons why the licensee disagrees with the orders, level, scope, or fine.
17.13 	The correction order reconsideration shall not be reviewed by any surveyor, investigator, 
17.14 	or supervisor that participated in the writing or reviewing of the correction order being 
17.15 	disputed. The correction order reconsiderations may be conducted in person, by telephone, 
17.16 	by another electronic form, or in writing, as determined by the commissioner. The 
17.17 	commissioner shall respond in writing to the request from a home care provider for a 
17.18 	correction order reconsideration within 60 days of the date the provider requests a 
17.19 	reconsideration. The commissioner's response shall identify the commissioner's decision 
17.20 	regarding each citation challenged by the home care provider.
17.21 	(c) The findings of a correction order reconsideration process shall be one or more of 
17.22 	the following:
17.23 	(1) supported in full, the correction order is supported in full, with no deletion of findings 
17.24 	to the citation;
17.25 	(2) supported in substance, the correction order is supported, but one or more findings 
17.26 	are deleted or modified without any change in the citation;
17.27 	(3) correction order cited an incorrect home care licensing requirement, the correction 
17.28 	order is amended by changing the correction order to the appropriate statutory reference;
17.29 	(4) correction order was issued under an incorrect citation, the correction order is amended 
17.30 	to be issued under the more appropriate correction order citation;
17.31 	(5) the correction order is rescinded;
18.1 	(6) fine is amended, it is determined that the fine assigned to the correction order was 
18.2 	applied incorrectly; or
18.3 	(7) the level or scope of the citation is modified based on the reconsideration.
18.4 	(d) If the correction order findings are changed by the commissioner, the commissioner 
18.5 	shall update the correction order website.
18.6 	(e) This subdivision does not apply to temporary licensees.

18.7 	Sec. 15. Minnesota Statutes 2018, section 144A.4791, subdivision 9, is amended to read:
18.8 		Subd. 9.Service plan, implementation, and revisions to service plan. (a) No later 
18.9 	than 14 days after the initiation of services, a home care provider shall finalize a current 
18.10 	written service plan.
18.11 	(b) The service plan and any revisions must include a dated signature or other 
18.12 	authentication by the home care provider and by the client or the client's representative 
18.13 	documenting agreement on the services to be provided. The service plan must be revised, 
18.14 	if needed, based on client review or reassessment under subdivisions 7 and 8. The provider 
18.15 	must provide information to the client about changes to the provider's fee for services and 
18.16 	how to contact the Office of the Ombudsman for Long-Term Care.
18.17 	(c) The home care provider must implement and provide all services required by the 
18.18 	current service plan.
18.19 	(d) The service plan and revised service plan must be entered into the client's record, 
18.20 	including notice of a change in a client's fees when applicable.
18.21 	(e) Staff providing home care services must be informed of the current written service 
18.22 	plan.
18.23 	(f) The service plan must include:
18.24 	(1) a description of the home care services to be provided, the fees for services, and the 
18.25 	frequency of each service, according to the client's current review or assessment and client 
18.26 	preferences;
18.27 	(2) the identification of the staff or categories of staff who will provide the services;
18.28 	(3) the schedule and methods of monitoring reviews or assessments of the client;
18.29 	(4) the frequency of sessions of supervision of staff and type of personnel who will 
18.30 	supervise staff; and
18.31 	(5) a contingency plan that includes:
19.1 	(i) the action to be taken by the home care provider and by the client or client's 
19.2 	representative if the scheduled service cannot be provided;
19.3 	(ii) information and a method for a client or client's representative to contact the home 
19.4 	care provider;
19.5 	(iii) names and contact information of persons the client wishes to have notified in an 
19.6 	emergency or if there is a significant adverse change in the client's condition, including 
19.7 	identification of and information as to who has authority to sign for the client in an 
19.8 	emergency; and
19.9 	(iv) the circumstances in which emergency medical services are not to be summoned 
19.10 	consistent with chapters 145B and 145C, and declarations made by the client under those 
19.11 	chapters.

19.12 	ARTICLE 3
19.13 	CASE MIX

19.14 	Section 1. Minnesota Statutes 2018, section 144.0724, subdivision 4, is amended to read:
19.15 		Subd. 4.Resident assessment schedule. (a) A facility must conduct and electronically 
19.16 	submit to the commissioner of health MDS assessments that conform with the assessment 
19.17 	schedule defined by Code of Federal Regulations, title 42, section 483.20, and published 
19.18 	by the United States Department of Health and Human Services, Centers for Medicare and 
19.19 	Medicaid Services, in the Long Term Care Assessment Instrument User's Manual, version 
19.20 	3.0, and subsequent updates when issued by the Centers for Medicare and Medicaid Services. 
19.21 	The commissioner of health may substitute successor manuals or question and answer 
19.22 	documents published by the United States Department of Health and Human Services, 
19.23 	Centers for Medicare and Medicaid Services, to replace or supplement the current version 
19.24 	of the manual or document.
19.25 	(b) The assessments used to determine a case mix classification for reimbursement 
19.26 	include the following:
19.27 	(1) a new admission assessment;
19.28 	(2) an annual assessment which must have an assessment reference date (ARD) within 
19.29 	92 days of the previous assessment and the previous comprehensive assessment;
19.30 	(3) a significant change in status assessment must be completed within 14 days of the 
19.31 	identification of a significant change, whether improvement or decline, and regardless of 
19.32 	the amount of time since the last significant change in status assessment;
20.1 	(4) all quarterly assessments must have an assessment reference date (ARD) within 92 
20.2 	days of the ARD of the previous assessment;
20.3 	(5) any significant correction to a prior comprehensive assessment, if the assessment 
20.4 	being corrected is the current one being used for RUG classification; ~~and~~
20.5 	(6) any significant correction to a prior quarterly assessment, if the assessment being 
20.6 	corrected is the current one being used for RUG classification~~.~~; and
20.7 	(7) modifications to the most recent assessments of clauses (1) to (6).
20.8 	(c) In addition to the assessments listed in paragraph (b), the assessments used to 
20.9 	determine nursing facility level of care include the following:
20.10 	(1) preadmission screening completed under section 256.975, subdivisions 7a to 7c, by 
20.11 	the Senior LinkAge Line or other organization under contract with the Minnesota Board on 
20.12 	Aging; and
20.13 	(2) a nursing facility level of care determination as provided for under section 256B.0911, 
20.14 	subdivision 4e, as part of a face-to-face long-term care consultation assessment completed 
20.15 	under section 256B.0911, by a county, tribe, or managed care organization under contract 
20.16 	with the Department of Human Services.

20.17 	Sec. 2. Minnesota Statutes 2018, section 144.0724, subdivision 8, is amended to read:
20.18 		Subd. 8.Request for reconsideration of resident classifications. (a) The resident, or 
20.19 	resident's representative, or the nursing facility or boarding care home may request that the 
20.20 	commissioner of health reconsider the assigned reimbursement classification, including any 
20.21 	items changed during the audit process. The request for reconsideration must be submitted 
20.22 	in writing to the commissioner within 30 days of the day the resident or the resident's 
20.23 	representative receives the resident classification notice. The request for reconsideration 
20.24 	must include the name of the resident, the name and address of the facility in which the 
20.25 	resident resides, the reasons for the reconsideration, and documentation supporting the 
20.26 	request. The documentation accompanying the reconsideration request is limited to ~~a copy~~ 
20.27 	~~of the MDS that determined the classification and other~~ documents that would support or 
20.28 	change the MDS findings.
20.29 	(b) Upon request, the nursing facility must give the resident or the resident's representative 
20.30 	a copy of the assessment form and the other documentation that was given to the 
20.31 	commissioner of health to support the assessment findings. The nursing facility shall also 
20.32 	provide access to and a copy of other information from the resident's record that has been 
20.33 	requested by or on behalf of the resident to support a resident's reconsideration request. A 
21.1 	copy of any requested material must be provided within three working days of receipt of a 
21.2 	written request for the information. Notwithstanding any law to the contrary, the facility 
21.3 	may not charge a fee for providing copies of the requested documentation. If a facility fails 
21.4 	to provide the material within this time, it is subject to the issuance of a correction order 
21.5 	and penalty assessment under sections 144.653 and 144A.10. Notwithstanding those sections, 
21.6 	any correction order issued under this subdivision must require that the nursing facility 
21.7 	immediately comply with the request for information and that as of the date of the issuance 
21.8 	of the correction order, the facility shall forfeit to the state a $100 fine for the first day of 
21.9 	noncompliance, and an increase in the $100 fine by $50 increments for each day the 
21.10 	noncompliance continues.
21.11 	(c) In addition to the information required under paragraphs (a) and (b), a reconsideration 
21.12 	request from a nursing facility must contain the following information: (i) the date the 
21.13 	reimbursement classification notices were received by the facility; (ii) the date the 
21.14 	classification notices were distributed to the resident or the resident's representative; and 
21.15 	(iii) a copy of a notice sent to the resident or to the resident's representative. This notice 
21.16 	must inform the resident or the resident's representative that a reconsideration of the resident's 
21.17 	classification is being requested, the reason for the request, that the resident's rate will change 
21.18 	if the request is approved by the commissioner, the extent of the change, that copies of the 
21.19 	facility's request and supporting documentation are available for review, and that the resident 
21.20 	also has the right to request a reconsideration. If the facility fails to provide the required 
21.21 	information listed in item (iii) with the reconsideration request, the commissioner may 
21.22 	request that the facility provide the information within 14 calendar days. The reconsideration 
21.23 	request must be denied if the information is then not provided, and the facility may not 
21.24 	make further reconsideration requests on that specific reimbursement classification.
21.25 	(d) Reconsideration by the commissioner must be made by individuals not involved in 
21.26 	reviewing the assessment, audit, or reconsideration that established the disputed classification. 
21.27 	The reconsideration must be based upon the assessment that determined the classification 
21.28 	and upon the information provided to the commissioner under paragraphs (a) and (b). If 
21.29 	necessary for evaluating the reconsideration request, the commissioner may conduct on-site 
21.30 	reviews. Within 15 working days of receiving the request for reconsideration, the 
21.31 	commissioner shall affirm or modify the original resident classification. The original 
21.32 	classification must be modified if the commissioner determines that the assessment resulting 
21.33 	in the classification did not accurately reflect characteristics of the resident at the time of 
21.34 	the assessment. The resident and the nursing facility or boarding care home shall be notified 
21.35 	within five working days after the decision is made. A decision by the commissioner under 
22.1 	this subdivision is the final administrative decision of the agency for the party requesting 
22.2 	reconsideration.
22.3 	(e) The resident classification established by the commissioner shall be the classification 
22.4 	that applies to the resident while the request for reconsideration is pending. If a request for 
22.5 	reconsideration applies to an assessment used to determine nursing facility level of care 
22.6 	under subdivision 4, paragraph (c), the resident shall continue to be eligible for nursing 
22.7 	facility level of care while the request for reconsideration is pending.
22.8 	(f) The commissioner may request additional documentation regarding a reconsideration 
22.9 	necessary to make an accurate reconsideration determination.

22.10 	ARTICLE 4
22.11 	AUDIOLOGISTS

22.12 	Section 1. Minnesota Statutes 2018, section 148.517, is amended by adding a subdivision 
22.13 	to read:
22.14 		Subd. 5.Dispensing audiologist exam requirements. Audiologists must submit 
22.15 	documentation of receiving a qualifying score on an examination meeting the requirements 
22.16 	of section 148.515, subdivision 6.

22.17 	Sec. 2.  REPEALER.
 22.18 	Minnesota Statutes 2018, sections 62J.63, subdivision 3; 62J.692, subdivision 4a; 62Q.72, 
22.19 	subdivision 2; 144A.04, subdivision 10; 144A.10, subdivisions 6b and 11; and 144A.101, 
22.20 	subdivision 3, are repealed.

APPENDIX 

Repealed Minnesota Statutes: 19-0361 

62J.63 CENTER FOR HEALTH CARE PURCHASING IMPROVEMENT.Subd. 3.Report. 
The commissioner of health must report annually to the legislature and the governor on the operations, activities, and impacts of the center. The report must be posted on the Department of Health website and must be available to the public. The report must include a description of the state's efforts to develop and use more common strategies for health care performance measurement and health care purchasing. The report must also include an assessment of the impacts of these efforts, especially in promoting greater transparency of health care costs and quality, and greater accountability for health care results and improvement. 

62J.692 MEDICAL EDUCATION.Subd. 4a.Alternative distribution. 
If federal approval is not received for the formula described in subdivision 4, paragraphs (a) and (b), 100 percent of available medical education and research funds shall be distributed based on a distribution formula that reflects a summation of two factors: 

(1) a public program volume factor, that is determined by the total volume of public program revenue received by each training site as a percentage of all public program revenue received by all training sites in the fund pool; and 

(2) a supplemental public program volume factor, that is determined by providing a supplemental payment of 20 percent of each training site's grant to training sites whose public program revenue accounted for at least 0.98 percent of the total public program revenue received by all eligible training sites. Grants to training sites whose public program revenue accounted for less than 0.98 percent of the total public program revenue received by all eligible training sites shall be reduced by an amount equal to the total value of the supplemental payment. 

62Q.72 RECORD KEEPING; REPORTING.Subd. 2.Reporting. 
Each health plan company shall submit to the appropriate commissioner, as part of the company's annual filing, data on the number and type of complaints that are not resolved within 30 days, or 30 business days as provided under section 72A.201, subdivision 4, clause (3), for insurance companies licensed under chapter 60A. The commissioner shall also make this information available to the public upon request. 

144A.04 QUALIFICATIONS FOR LICENSE.Subd. 10.Assessments for short-stay residents. 
Upon federal approval, a nursing home is not required to perform a resident assessment on a resident expected to remain in the facility for 30 days or less. A short-stay resident transferring from a hospital to a nursing home must have a plan of care developed at the hospital before admission to the nursing home. If a short-stay resident remains in the nursing home longer than 30 days, the nursing home must perform the resident assessment in accordance with sections 144.0721 and 144.0722 within 40 days of the resident's admission. 

144A.10 INSPECTION; COMMISSIONER OF HEALTH; FINES.Subd. 6b.Fines for federal certification deficiencies. 
If the commissioner determines that a nursing home or certified boarding care home does not meet a requirement of section 1919(b), (c), or (d), of the Social Security Act, or any regulation adopted under that section of the Social Security Act, the nursing home or certified boarding care home may be assessed a civil fine for each day of noncompliance and until a notice of correction is received by the commissioner under subdivision 7. Money collected because of these fines must be applied to the protection of the health or property of residents of nursing facilities the commissioner finds deficient. A fine for a specific deficiency may not exceed $500 for each day of noncompliance. The commissioner shall adopt rules establishing a schedule of fines. 

Subd. 11.Facilities cited for immediate jeopardy. 
(a) The provisions of this subdivision apply to Minnesota nursing facilities: 

(1) that received immediate jeopardy citations between April 1, 1998, and January 13, 1999, for violations of regulations governing the use of physical restraints; and 

(2) on whose behalf the commissioner recommended to the federal government that fines for these citations not be imposed or be rescinded. 

(b) The commissioner: 

(1) shall grant all possible waivers for the continuation of an approved nurse aide training program, an approved competency evaluation program, or an approved nurse aide training and competency evaluation program conducted by or on the site of a facility referred to in this subdivision; and 

(2) shall notify the Board of Nursing Home Administrators by June 1, 1999, that the commissioner has recommended to the federal government that fines not be imposed on the facilities referred to in this subdivision or that any fines imposed on these facilities for violations of regulations governing use of physical restraints be rescinded. 

144A.101 PROCEDURES FOR FEDERALLY REQUIRED SURVEY PROCESS.Subd. 3.Surveyor notes. 
The commissioner, upon the request of a nursing facility, shall provide the facility with copies of formal surveyor notes taken during the survey, with the exception of interview forms, at the time of the exit conference or at the time the completed statement of deficiency is provided to the facility. The survey notes shall be redacted to protect the confidentiality of individuals providing information to the surveyors. A facility requesting formal surveyor notes must agree to pay the commissioner for the cost of copying and redacting.