1.1                          A bill for an act 
  1.2             relating to human services; amending the time period 
  1.3             of disenrollment to the MinnesotaCare program for 
  1.4             failing to apply for medical assistance; amending 
  1.5             Minnesota Statutes 1997 Supplement, sections 256L.03, 
  1.6             subdivision 3; and 256L.13, subdivision 6. 
  1.7   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.8      Section 1.  Minnesota Statutes 1997 Supplement, section 
  1.9   256L.03, subdivision 3, is amended to read: 
  1.10     Subd. 3.  [INPATIENT HOSPITAL SERVICES.] (a) Beginning July 
  1.11  1, 1993, covered health services shall include inpatient 
  1.12  hospital services, including inpatient hospital mental health 
  1.13  services and inpatient hospital and residential chemical 
  1.14  dependency treatment, subject to those limitations necessary to 
  1.15  coordinate the provision of these services with eligibility 
  1.16  under the medical assistance spenddown.  Prior to July 1, 1997, 
  1.17  the inpatient hospital benefit for adult enrollees is subject to 
  1.18  an annual benefit limit of $10,000.  Effective July 1, 1997, the 
  1.19  inpatient hospital benefit for adult enrollees who qualify under 
  1.20  section 256L.04, subdivision 7, or who qualify under section 
  1.21  256L.04, subdivisions 1 to 6, or 256L.13 with family gross 
  1.22  income that exceeds 175 percent of the federal poverty 
  1.23  guidelines and who are not pregnant, is subject to an annual 
  1.24  limit of $10,000.  
  1.25     (b) Enrollees who qualify under section 256L.04, 
  1.26  subdivision 7, or who qualify under section 256L.04, 
  2.1   subdivisions 1 to 6, or 256L.13 with family gross income that 
  2.2   exceeds 175 percent of the federal poverty guidelines and who 
  2.3   are not pregnant, and are determined by the commissioner to have 
  2.4   a basis of eligibility for medical assistance shall apply for 
  2.5   and cooperate with the requirements of medical assistance by the 
  2.6   last day of the third month following admission to an inpatient 
  2.7   hospital.  If an enrollee fails to apply for medical assistance 
  2.8   within this time period, the enrollee and the enrollee's family 
  2.9   shall be disenrolled from the plan and they may not reenroll 
  2.10  until 12 four calendar months have elapsed.  Enrollees and 
  2.11  enrollees' families disenrolled for not applying for or not 
  2.12  cooperating with medical assistance may not reenroll. 
  2.13     (c) Admissions for inpatient hospital services paid for 
  2.14  under section 256L.11, subdivision 3, must be certified as 
  2.15  medically necessary in accordance with Minnesota Rules, parts 
  2.16  9505.0500 to 9505.0540, except as provided in clauses (1) and 
  2.17  (2): 
  2.18     (1) all admissions must be certified, except those 
  2.19  authorized under rules established under section 254A.03, 
  2.20  subdivision 3, or approved under Medicare; and 
  2.21     (2) payment under section 256L.11, subdivision 3, shall be 
  2.22  reduced by five percent for admissions for which certification 
  2.23  is requested more than 30 days after the day of admission.  The 
  2.24  hospital may not seek payment from the enrollee for the amount 
  2.25  of the payment reduction under this clause. 
  2.26     (d) Any enrollee or family member of an enrollee who has 
  2.27  previously been permanently disenrolled from MinnesotaCare for 
  2.28  not applying for and cooperating with medical assistance shall 
  2.29  be eligible to reenroll if 12 four calendar months have elapsed 
  2.30  since the date of disenrollment.  A family member of the 
  2.31  enrollee may reenroll at any time. 
  2.32     Sec. 2.  Minnesota Statutes 1997 Supplement, section 
  2.33  256L.13, subdivision 6, is amended to read: 
  2.34     Subd. 6.  [COOPERATION WITH MEDICAL ASSISTANCE.] Pregnant 
  2.35  women and children applying for MinnesotaCare under this section 
  2.36  are not required to apply for the medical assistance program as 
  3.1   a condition of enrollment.  Other adults enrolled in 
  3.2   MinnesotaCare determined by the commissioner to have a basis of 
  3.3   eligibility for medical assistance must cooperate in completing 
  3.4   an application for medical assistance by the last day of the 
  3.5   third month following admission to an inpatient hospital.  If an 
  3.6   enrollee fails to complete an application for medical assistance 
  3.7   within this time period, the enrollee shall be disenrolled and 
  3.8   may not reenroll until four calendar months have elapsed.