1.1 	A bill for an act
1.2 	relating to human services; making changes to health care services; amending 
1.3 	data management; Medicaid reimbursement; providing lead risk assessment 
1.4 	services; changing the prepayment demonstration project; general assistance 
1.5 	medical care; medical assistance provisions; eligibility requirements; the 
1.6 	long-term care partnership program; treatment of assets; covered services;
1.7 	amending Minnesota Statutes 2006, sections 144.9507, by adding a subdivision; 
1.8 	256B.055, subdivision 14; 256B.056, subdivisions 2, 11, by adding a subdivision; 
1.9 	256B.057, subdivision 1; 256B.0571, subdivisions 6, 9; 256B.058; 256B.059, 
1.10 	subdivisions 1, 1a; 256B.0594; 256B.0595, subdivisions 1, 2, 3, 4; 256B.0625, 
1.11 	subdivisions 5a, 5j, by adding a subdivision; 256B.69, subdivisions 6, 23, 27; 
1.12 	256D.03, subdivision 3; 256L.035; repealing Minnesota Statutes 2006, section 
1.13 	256B.0571, subdivision 8a.
1.14 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.15 	Section 1. Minnesota Statutes 2006, section 144.9507, is amended by adding a 
1.16 	subdivision to read:
1.17 		Subd. 6.Medicaid reimbursement. Medicaid reimbursement for lead risk 
1.18 	assessment services may not be used to replace or decrease existing state or local funding 
1.19 	for lead services and lead-related activities.

1.20 	Sec. 2. Minnesota Statutes 2006, section 256B.055, subdivision 14, is amended to read:
1.21 		Subd. 14.Persons detained by law. (a) Medical assistance may be paid for an 
1.22 	inmate of a correctional facility who is conditionally released as authorized under section 
1.23 	241.26, 244.065, or 631.425, if the individual does not require the security of a public 
1.24 	detention facility and is housed in a halfway house or community correction center, or 
1.25 	under house arrest and monitored by electronic surveillance in a residence approved 
1.26 	by the commissioner of corrections, and if the individual meets the other eligibility 
1.27 	requirements of this chapter.
2.1 	(b) An individual, regardless of age, who is considered an inmate of a public 
2.2 	institution as defined in Code of Federal Regulations, title 42, section 435.1009 435.1010, 
2.3 	is not eligible for medical assistance.

2.4 	Sec. 3. Minnesota Statutes 2006, section 256B.056, subdivision 2, is amended to read:
2.5 		Subd. 2.Homestead exclusion and homestead equity limit for institutionalized 
2.6 	persons individuals residing in a long-term care facility. (a) The homestead shall 
2.7 	be excluded for the first six calendar months of a person's an individual's stay in a 
2.8 	long-term care facility and shall continue to be excluded for as long as the recipient can 
2.9 	be reasonably expected to return to the homestead. For purposes of this subdivision, 
2.10 	"reasonably expected to return to the homestead" means the recipient's attending physician 
2.11 	has certified that the expectation is reasonable, and the recipient can show that the cost of 
2.12 	care upon returning home will be met through medical assistance or other sources. The 
2.13 	homestead shall continue to be excluded for persons individuals residing in a long-term 
2.14 	care facility if it is used as a primary residence by one of the following individuals:
2.15 	(1) the spouse;
2.16 	(2) a child under age 21;
2.17 	(3) a child of any age who is blind or permanently and totally disabled as defined in 
2.18 	the supplemental security income program;
2.19 	(4) a sibling who has equity interest in the home and who resided in the home for 
2.20 	at least one year immediately before the date of the person's individual's admission to 
2.21 	the facility; or
2.22 	(5) a child of any age, or, subject to federal approval, a grandchild of any age, who 
2.23 	resided in the home for at least two years immediately before the date of the person's
2.24 	individual's admission to the facility, and who provided care to the person individual that 
2.25 	permitted the person individual to reside at home rather than in an institution.
2.26 	(b) Effective for applications filed on or after July 1, 2006, and for renewals after 
2.27 	July 1, 2006, for persons who first applied for payment of long-term care services on 
2.28 	or after January 2, 2006, the equity interest in the homestead of an individual whose 
2.29 	eligibility for long-term care services is determined on or after January 1, 2006, shall not 
2.30 	exceed $500,000, unless it is the lawful residence of the individual's spouse or child 
2.31 	who is under age 21, blind, or disabled. The amount specified in this paragraph shall be 
2.32 	increased beginning in year 2011, from year to year based on the percentage increase in 
2.33 	the Consumer Price Index for all urban consumers (all items; United States city average), 
2.34 	rounded to the nearest $1,000. This provision may be waived in the case of demonstrated 
3.1 	hardship by a process to be determined by the secretary of health and human services 
3.2 	pursuant to section 6014 of the Deficit Reduction Act of 2005, Public Law 109-171.

3.3 	Sec. 4. Minnesota Statutes 2006, section 256B.056, is amended by adding a 
3.4 	subdivision to read:
3.5 		Subd. 2a.Home equity limit for medical assistance payment of long-term care 
3.6 	services. (a) Effective for requests of medical assistance payment of long-term care 
3.7 	services filed on or after July 1, 2006, and for renewals on or after July 1, 2006, for 
3.8 	individuals who received payment of long-term care services under a request filed on or 
3.9 	after January 1, 2006, the equity interest in the home of an individual whose eligibility 
3.10 	for long-term care services is determined on or after January 1, 2006, shall not exceed 
3.11 	$500,000, unless it is the lawful residence of the individual's spouse or child who is under 
3.12 	age 21, or a child of any age who is blind or permanently and totally disabled as defined 
3.13 	in the Supplemental Security Income program. The amount specified in this paragraph 
3.14 	shall be increased beginning in year 2011, from year to year based on the percentage 
3.15 	increase in the Consumer Price Index for all urban consumers (all items; United States city 
3.16 	average), rounded to the nearest $1,000.
3.17 	(b) For purposes of this subdivision, a "home" means any real or personal property 
3.18 	interest, including an agricultural homestead as defined under section 273.124, subdivision 
3.19 	1, owned by the individual requesting medical assistance payment of long-term care 
3.20 	services that is the primary dwelling of the individual or was the primary dwelling of the 
3.21 	individual before receipt of long-term care services began outside of the home.
3.22 	(c) An individual denied or terminated from medical assistance payment of 
3.23 	long-term care services because the individual's home equity exceeds the home equity 
3.24 	limit may seek a waiver based upon a hardship by filing a written request with the county 
3.25 	agency. Hardship is an imminent threat to the individual's health and well-being that is 
3.26 	demonstrated by documentation of no alternatives for payment of long-term care services. 
3.27 	The county agency shall make a decision regarding the written request to waive the home 
3.28 	equity limit within 30 days if all necessary information has been provided. The county 
3.29 	agency shall send the individual and the individual's representative a written notice of 
3.30 	decision on the request for a demonstrated hardship waiver that also advises the client of 
3.31 	appeal rights under the fair hearing process of section 256.045.

3.32 	Sec. 5. Minnesota Statutes 2006, section 256B.056, subdivision 11, is amended to read:
3.33 		Subd. 11.Treatment of annuities. (a) Any individual applying for or seeking 
3.34 	recertification of eligibility for person requesting medical assistance payment of long-term 
4.1 	care services shall provide a complete description of any interest either the individual
4.2 	person or the individual'sperson's spouse has in annuities on a form designated by the 
4.3 	department. The form shall include a statement that the state becomes a preferred 
4.4 	remainder beneficiary of annuities or similar financial instruments by virtue of the receipt 
4.5 	of medical assistance payment of long-term care services. The individualperson and the 
4.6 	individual'sperson's spouse shall furnish the agency responsible for determining eligibility 
4.7 	with complete current copies of their annuities and related documents for review as part 
4.8 	of the application process on disclosure forms provided by the department as part of 
4.9 	their application and complete the form designating the state as the preferred remainder 
4.10 	beneficiary for each annuity in which the person or the person's spouse has an interest.
4.11 	(b) The disclosure form shall include a statement that the department becomes the 
4.12 	remainder beneficiary under the annuity or similar financial instrument by virtue of the 
4.13 	receipt of medical assistance. The disclosure form department shall include a provide
4.14 	notice to the issuer of the department's right under this section as a preferred remainder 
4.15 	beneficiary under the annuity or similar financial instrument for medical assistance 
4.16 	furnished to the individualperson or the individual'sperson's spouse, and require the 
4.17 	issuer to provide confirmation that a remainder beneficiary designation has been made 
4.18 	and to notify the county agency when there is a change in the amount of the income or 
4.19 	principal being withdrawn from the annuity or other similar financial instrument at the 
4.20 	time of the most recent disclosure required under this section. The individual and the 
4.21 	individual's spouse shall execute separate disclosure forms for each annuity or similar 
4.22 	financial instrument that they are required to disclose under this section and in which they 
4.23 	have an interest. provide notice of the issuer's responsibilities as provided in paragraph (c).
4.24 	(c) An issuer of an annuity or similar financial instrument who receives notice 
4.25 	on a disclosure form of the state's right to be named a preferred remainder beneficiary
4.26 	as described in paragraph (b) shall provide confirmation to the requesting agency that 
4.27 	a remainder beneficiary designating the state has been made and a preferred remainder 
4.28 	beneficiary. The issuer shall also notify the county agency when there is a change in the 
4.29 	amount of income or principal being withdrawn from the annuity or other similar financial 
4.30 	instrument or a change in the state's preferred remainder beneficiary designation under 
4.31 	the annuity or other similar financial instrument occurs. The county agency shall provide 
4.32 	the issuer with the name, address, and telephone number of a unit within the department 
4.33 	that the issuer can contact to comply with this paragraph.
4.34 	(d) "Preferred remainder beneficiary" for this subdivision and sections 256B.0594 
4.35 	and 256B.0595 means the state is a remainder beneficiary in the first position in an amount 
4.36 	equal to the amount of medical assistance paid on behalf of the institutionalized person, or 
5.1 	is a remainder beneficiary in the second position if the institutionalized person designates 
5.2 	and is survived by (1) a remainder beneficiary not receiving medical assistance payment 
5.3 	of long-term care services, (2) a minor child, or (3) a child of any age who is blind or 
5.4 	permanently and totally disabled as defined in the Supplemental Security Income program. 
5.5 	Notwithstanding this paragraph, the state is the remainder beneficiary in the first position 
5.6 	if the spouse or child disposes of the remainder for less than fair market value.
5.7 	(e) For purposes of this subdivision, "institutionalized person" and "long-term care 
5.8 	services" have the meanings given in section 256B.0595, subdivision 1, paragraph (h).
5.9 	(f) For purposes of this subdivision, "medical institution" has the meaning given in 
5.10 	section 256B.15, subdivision 1a, paragraph (b).

5.11 	Sec. 6. Minnesota Statutes 2006, section 256B.057, subdivision 1, is amended to read:
5.12 		Subdivision 1.Infants and pregnant women. (a)(1) An infant less than one year of 
5.13 	age or a pregnant woman who has written verification of a positive pregnancy test from a 
5.14 	physician or licensed registered nurse is eligible for medical assistance if countable family 
5.15 	income is equal to or less than 275 percent of the federal poverty guideline for the same 
5.16 	family size. A pregnant woman who has written verification of a positive pregnancy test 
5.17 	from a physician or licensed registered nurse is eligible for medical assistance if countable 
5.18 	family income is equal to or less than 200 percent of the federal poverty guideline for the 
5.19 	same family size. For purposes of this subdivision, "countable family income" means the 
5.20 	amount of income considered available using the methodology of the AFDC program 
5.21 	under the state's AFDC plan as of July 16, 1996, as required by the Personal Responsibility 
5.22 	and Work Opportunity Reconciliation Act of 1996 (PRWORA), Public Law 104-193, 
5.23 	except for the earned income disregard and employment deductions.
5.24 	(2) For applications processed within one calendar month prior to the effective date, 
5.25 	eligibility shall be determined by applying the income standards and methodologies in 
5.26 	effect prior to the effective date for any months in the six-month budget period before 
5.27 	that date and the income standards and methodologies in effect on the effective date for 
5.28 	any months in the six-month budget period on or after that date. The income standards 
5.29 	for each month shall be added together and compared to the applicant's total countable 
5.30 	income for the six-month budget period to determine eligibility.
5.31 	(b)(1) [Expired, 1Sp2003 c 14 art 12 s 19]
5.32 	(2) For applications processed within one calendar month prior to July 1, 2003, 
5.33 	eligibility shall be determined by applying the income standards and methodologies in 
5.34 	effect prior to July 1, 2003, for any months in the six-month budget period before July 1, 
5.35 	2003, and the income standards and methodologies in effect on the expiration date for any 
6.1 	months in the six-month budget period on or after July 1, 2003. The income standards 
6.2 	for each month shall be added together and compared to the applicant's total countable 
6.3 	income for the six-month budget period to determine eligibility.
6.4 	(3) An amount equal to the amount of earned income exceeding 275 percent of 
6.5 	the federal poverty guideline, up to a maximum of the amount by which the combined 
6.6 	total of 185 percent of the federal poverty guideline plus the earned income disregards 
6.7 	and deductions allowed under the state's AFDC plan as of July 16, 1996, as required 
6.8 	by the Personal Responsibility and Work Opportunity Act of 1996 (PRWORA), Public 
6.9 	Law 104-193, exceeds 275 percent of the federal poverty guideline will be deducted for 
6.10 	pregnant women and infants less than one year of age.
6.11 	(c) Dependent care and child support paid under court order shall be deducted from 
6.12 	the countable income of pregnant women.
6.13 	(d) An infant born on or after January 1, 1991, to a woman who was eligible for and 
6.14 	receiving medical assistance on the date of the child's birth shall continue to be eligible for 
6.15 	medical assistance without redetermination until the child's first birthday, as long as the 
6.16 	child remains in the woman's household.

6.17 	Sec. 7. Minnesota Statutes 2006, section 256B.0571, subdivision 6, is amended to read:
6.18 		Subd. 6.Partnership policy. "Partnership policy" means a long-term care insurance 
6.19 	policy that meets the requirements under subdivision 10 and was issued on or after the 
6.20 	effective date of the state plan amendment implementing the partnership program in 
6.21 	Minnesota. Policies that are exchanged or that have riders or endorsements added on or 
6.22 	after the effective date of the state plan amendment as authorized by the commissioner of 
6.23 	commerce qualify as a partnership policy.

6.24 	Sec. 8. Minnesota Statutes 2006, section 256B.0571, subdivision 9, is amended to read:
6.25 		Subd. 9.Medical assistance eligibility. (a) Upon applicationrequest for medical 
6.26 	assistance program payment of long-term care services by an individual who meets the 
6.27 	requirements described in subdivision 8, the commissioner shall determine the individual's 
6.28 	eligibility for medical assistance according to paragraphs (b) to (i).
6.29 	(b) After determining assets subject to the asset limit under section 256B.056, 
6.30 	subdivision 3 or 3c, or 256B.057, subdivision 9 or 10, the commissioner shall allow 
6.31 	the individual to designate assets to be protected from recovery under subdivisions 13 
6.32 	and 15 up to the dollar amount of the benefits utilized under the partnership policy. 
6.33 	Designated assets shall be disregarded for purposes of determining eligibility for payment 
6.34 	of long-term care services.
7.1 	(c) The individual shall identify the designated assets and the full fair market value 
7.2 	of those assets and designate them as assets to be protected at the time of initial application 
7.3 	for medical assistance. The full fair market value of real property or interests in real 
7.4 	property shall be based on the most recent full assessed value for property tax purposes 
7.5 	for the real property, unless the individual provides a complete professional appraisal by 
7.6 	a licensed appraiser to establish the full fair market value. The extent of a life estate in 
7.7 	real property shall be determined using the life estate table in the health care program's 
7.8 	manual. Ownership of any asset in joint tenancy shall be treated as ownership as tenants 
7.9 	in common for purposes of its designation as a disregarded asset. The unprotected value 
7.10 	of any protected asset is subject to estate recovery according to subdivisions 13 and 15.
7.11 	(d) The right to designate assets to be protected is personal to the individual and 
7.12 	ends when the individual dies, except as otherwise provided in subdivisions 13 and 
7.13 	15. It does not include the increase in the value of the protected asset and the income, 
7.14 	dividends, or profits from the asset. It may be exercised by the individual or by anyone 
7.15 	with the legal authority to do so on the individual's behalf. It shall not be sold, assigned, 
7.16 	transferred, or given away.
7.17 	(e) If the dollar amount of the benefits utilized under a partnership policy is greater 
7.18 	than the full fair market value of all assets protected at the time of the application for 
7.19 	medical assistance long-term care services, the individual may designate additional assets 
7.20 	that become available during the individual's lifetime for protection under this section. 
7.21 	The individual must make the designation in writing to the county agency no later than 
7.22 	the last date on which the individual must report a change in circumstances to the county 
7.23 	agency, as provided for under the medical assistance program ten days from the date the 
7.24 	designation is requested by the county agency. Any excess used for this purpose shall not 
7.25 	be available to the individual's estate to protect assets in the estate from recovery under 
7.26 	section 256B.15 or 524.3-1202, or otherwise.
7.27 	(f) This section applies only to estate recovery under United States Code, title 42, 
7.28 	section 1396p, subsections (a) and (b), and does not apply to recovery authorized by other 
7.29 	provisions of federal law, including, but not limited to, recovery from trusts under United 
7.30 	States Code, title 42, section 1396p, subsection (d)(4)(A) and (C), or to recovery from 
7.31 	annuities, or similar legal instruments, subject to section 6012, subsections (a) and (b), of 
7.32 	the Deficit Reduction Act of 2005, Public Law 109-171.
7.33 	(g) An individual's protected assets owned by the individual's spouse who applies 
7.34 	for payment of medical assistance long-term care services shall not be protected assets or 
7.35 	disregarded for purposes of eligibility of the individual's spouse solely because they were 
7.36 	protected assets of the individual.
8.1 	(h) Assets designated under this subdivision shall not be subject to penalty under 
8.2 	section 256B.0595.
8.3 	(i) The commissioner shall otherwise determine the individual's eligibility 
8.4 	for payment of long-term care services according to medical assistance eligibility 
8.5 	requirements.

8.6 	Sec. 9. Minnesota Statutes 2006, section 256B.058, is amended to read:
8.7 	256B.058 TREATMENT OF INCOME OF INSTITUTIONALIZED SPOUSE.
8.8 		Subdivision 1.Income not available. The income described in subdivisions 2 and 3 
8.9 	shall be deducted from an institutionalized spouse's monthly income and is not considered 
8.10 	available for payment of the monthly costs of an institutionalized personspouse in the 
8.11 	institution after the person has been determined eligible for medical assistance.
8.12 		Subd. 2.Monthly income allowance for community spouse. (a) For an 
8.13 	institutionalized spouse with a spouse residing in the community, monthly income may be 
8.14 	allocated to the community spouse as a monthly income allowance for the community 
8.15 	spouse. Beginning with the first full calendar month the institutionalized spouse is 
8.16 	in the institution, the monthly income allowance is not considered available to the 
8.17 	institutionalized spouse for monthly payment of costs of care in the institution as long as 
8.18 	the income is made available to the community spouse.
8.19 	(b) The monthly income allowance is the amount by which the community spouse's 
8.20 	monthly maintenance needs allowance under paragraphs (c) and (d) exceeds the amount 
8.21 	of monthly income otherwise available to the community spouse.
8.22 	(c) The community spouse's monthly maintenance needs allowance is the lesser of 
8.23 	$1,500 or 122 percent of the monthly federal poverty guideline for a family of two plus 
8.24 	an excess shelter allowance. The excess shelter allowance is for the amount of shelter 
8.25 	expenses that exceed 30 percent of 122 percent of the federal poverty guideline line for a 
8.26 	family of two. Shelter expenses are the community spouse's expenses for rent, mortgage 
8.27 	payments including principal and interest, taxes, insurance, required maintenance charges 
8.28 	for a cooperative or condominium that is the community spouse's principal residence, 
8.29 	and the standard utility allowance under section 5(e) of the federal Food Stamp Act of 
8.30 	1977. If the community spouse has a required maintenance charge for a cooperative or 
8.31 	condominium, the standard utility allowance must be reduced by the amount of utility 
8.32 	expenses included in the required maintenance charge.
8.33 	If the community or institutionalized spouse establishes that the community spouse 
8.34 	needs income greater than the monthly maintenance needs allowance determined in this 
8.35 	paragraph due to exceptional circumstances resulting in significant financial duress, the 
9.1 	monthly maintenance needs allowance may be increased to an amount that provides 
9.2 	needed additional income.
9.3 	(d) The percentage of the federal poverty guideline used to determine the monthly 
9.4 	maintenance needs allowance in paragraph (c) is increased to 133 percent on July 1, 
9.5 	1991, and to 150 percent on July 1, 1992. Adjustments in the income limits due to annual 
9.6 	changes in the federal poverty guidelines shall be implemented the first day of July 
9.7 	following publication of the annual changes. The $1,500 maximum must be adjusted 
9.8 	January 1, 1990, and every January 1 after that by the same percentage increase in the 
9.9 	Consumer Price Index for all urban consumers (all items; United States city average) 
9.10 	between the two previous Septembers.
9.11 	(e) If a court has entered an order against an institutionalized spouse for monthly 
9.12 	income for support of the community spouse, the community spouse's monthly income 
9.13 	allowance under this subdivision shall not be less than the amount of the monthly income 
9.14 	ordered.
9.15 		Subd. 3.Family allowance. (a) A family allowance determined under paragraph 
9.16 	(b) is not considered available to the institutionalized spouse for monthly payment of costs 
9.17 	of care in the institution.
9.18 	(b) The family allowance is equal to one-third of the amount by which 122 percent 
9.19 	of the monthly federal poverty guideline for a family of two exceeds the monthly income 
9.20 	for that family member.
9.21 	(c) For purposes of this subdivision, the term family member only includes a 
9.22 	minor or dependent child as defined in the Internal Revenue Code, dependent parent, or 
9.23 	dependent sibling of the institutionalized or community spouse if the sibling resides with 
9.24 	the community spouse.
9.25 	(d) The percentage of the federal poverty guideline used to determine the family 
9.26 	allowance in paragraph (b) is increased to 133 percent on July 1, 1991, and to 150 percent 
9.27 	on July 1, 1992. Adjustments in the income limits due to annual changes in the federal 
9.28 	poverty guidelines shall be implemented the first day of July following publication of 
9.29 	the annual changes.
9.30 		Subd. 4.Treatment of income. (a) No income of the community spouse will 
9.31 	be considered available to an eligible institutionalized spouse, beginning the first full 
9.32 	calendar month of institutionalization, except as provided in this subdivision.
9.33 	(b) In determining the income of an institutionalized spouse or community spouse, 
9.34 	after the institutionalized spouse has been determined eligible for medical assistance, 
9.35 	the following rules apply.
10.1 	(1) For income that is not from a trust, availability is determined according to items 
10.2 	(i) to (v), unless the instrument providing the income otherwise specifically provides:
10.3 	(i) if payment is made solely in the name of one spouse, the income is considered 
10.4 	available only to that spouse;
10.5 	(ii) if payment is made in the names of both spouses, one-half of the income is 
10.6 	considered available to each;
10.7 	(iii) if payment is made in the names of one or both spouses together with one or 
10.8 	more other persons, the income is considered available to each spouse according to the 
10.9 	spouse's interest, or one-half of the joint interest is considered available to each spouse 
10.10 	if each spouse's interest is not specified;
10.11 	(iv) if there is no instrument that establishes ownership, one-half of the income is 
10.12 	considered available to each spouse; and
10.13 	(v) either spouse may rebut the determination of availability of income by showing 
10.14 	by a preponderance of the evidence that ownership interests are different than provided 
10.15 	above.
10.16 	(2) For income from a trust, income is considered available to each spouse as 
10.17 	provided in the trust. If the trust does not specify an amount available to either or both 
10.18 	spouses, availability will be determined according to items (i) to (iii):
10.19 	(i) if payment of income is made only to one spouse, the income is considered 
10.20 	available only to that spouse;
10.21 	(ii) if payment of income is made to both spouses, one-half is considered available to 
10.22 	each; and
10.23 	(iii) if payment is made to either or both spouses and one or more other persons, 
10.24 	the income is considered available to each spouse in proportion to each spouse's interest, 
10.25 	or if no such interest is specified, one-half of the joint interest is considered available 
10.26 	to each spouse.

10.27 	Sec. 10. Minnesota Statutes 2006, section 256B.059, subdivision 1, is amended to read:
10.28 		Subdivision 1.Definitions. (a) For purposes of this section and section sections 
10.29 	256B.058 and256B.0595, the terms defined in this subdivision have the meanings given 
10.30 	them. 
10.31 	(b) "Community spouse" means the spouse of an institutionalized spouse.
10.32 	(c) "Spousal share" means one-half of the total value of all assets, to the extent that 
10.33 	either the institutionalized spouse or the community spouse had an ownership interest at 
10.34 	the time of the first continuous period of institutionalization.
11.1 	(d) "Assets otherwise available to the community spouse" means assets individually 
11.2 	or jointly owned by the community spouse, other than assets excluded by subdivision 5, 
11.3 	paragraph (c).
11.4 	(e) "Community spouse asset allowance" is the value of assets that can be transferred 
11.5 	under subdivision 3.
11.6 	(f) "Institutionalized spouse" means a person who is:
11.7 	(1) in a hospital, nursing facility, or intermediate care facility for persons with 
11.8 	developmental disabilities, or receiving home and community-based services under 
11.9 	section 256B.0915or 256B.49, and is expected to remain in the facility or institution or 
11.10 	receive the home and community-based services for at least 30 consecutive days; and 
11.11 	(2) married to a person who is not in a hospital, nursing facility, or intermediate 
11.12 	care facility for persons with developmental disabilities, and is not receiving home and 
11.13 	community-based services under section 256B.0915 or 256B.49. 
11.14 	(g) "For the sole benefit of" means no other individual or entity can benefit in any 
11.15 	way from the assets or income at the time of a transfer or at any time in the future.
11.16 	(h) "Continuous period of institutionalization" means a 30-consecutive-day period 
11.17 	of time in which a person is expected to stay in a medical or long-term care facility, 
11.18 	or receive home and community-based services that would qualify for coverage under 
11.19 	the elderly waiver (EW) or alternative care (AC) programs. For a stay in a facility, the 
11.20 	30-consecutive-day period begins on the date of entry into a medical or long-term care 
11.21 	facility. For receipt of home and community-based services, the 30-consecutive-day 
11.22 	period begins on the date that the following conditions are met:
11.23 	(1) the person is receiving services that meet the nursing facility level of care 
11.24 	determined by a long-term care consultation;
11.25 	(2) the person has received the long-term care consultation within the past 60 days;
11.26 	(3) the services are paid by the EW program under section 256B.0915 or the AC 
11.27 	program under section 256B.0913 or would qualify for payment under the EW or AC 
11.28 	programs if the person were otherwise eligible for either program, and but for the receipt 
11.29 	of such services the person would have resided in a nursing facility; and
11.30 	(4) the services are provided by a licensed provider qualified to provide home and 
11.31 	community-based services.

11.32 	Sec. 11. Minnesota Statutes 2006, section 256B.059, subdivision 1a, is amended to 
11.33 	read:
12.1 		Subd. 1a.Institutionalized spouse. The provisions of this section apply only 
12.2 	when a spouse is institutionalized for abegins the first continuous period beginningof 
12.3 	institutionalization on or after October 1, 1989.

12.4 	Sec. 12. Minnesota Statutes 2006, section 256B.0594, is amended to read:
12.5 	256B.0594 PAYMENT OF BENEFITS FROM AN ANNUITY.
12.6 	When payment becomes due under an annuity that names the department a 
12.7 	remainder beneficiary as described in section 256B.056, subdivision 11, the issuer shall 
12.8 	request and the department shall, within 45 days after receipt of the request, provide 
12.9 	a written statement of the total amount of the medical assistance paid or confirmation 
12.10 	that any family member designated as a remainder beneficiary meets requirements for 
12.11 	qualification as a beneficiary in the first position. Upon timely receipt of the written 
12.12 	statement of the amount of medical assistance paid, the issuer shall pay the department an 
12.13 	amount equal to the lesser of the amount due the department under the annuity or the total 
12.14 	amount of medical assistance paid on behalf of the individual or the individual's spouse. 
12.15 	Any amounts remaining after the issuer's payment to the department shall be payable 
12.16 	according to the terms of the annuity or similar financial instrument. The county agency 
12.17 	or the department shall provide the issuer with the name, address, and telephone number 
12.18 	of a unit within the department the issuer can contact to comply with this section. The 
12.19 	requirements of section 72A.201, subdivision 4, clause (3), shall not apply to payments 
12.20 	made under this section until the issuer has received final payment information from the 
12.21 	department, if the issuer has notified the beneficiary of the requirements of this section at 
12.22 	the time it initially requests payment information from the department.

12.23 	Sec. 13. Minnesota Statutes 2006, section 256B.0595, subdivision 1, is amended to 
12.24 	read:
12.25 		Subdivision 1.Prohibited transfers. (a) For transfers of assets made on or before 
12.26 	August 10, 1993, if a an institutionalized person or the institutionalized person's spouse 
12.27 	has given away, sold, or disposed of, for less than fair market value, any asset or interest 
12.28 	therein, except assets other than the homestead that are excluded under the supplemental 
12.29 	security program, within 30 months before or any time after the date of institutionalization 
12.30 	if the person has been determined eligible for medical assistance, or within 30 months 
12.31 	before or any time after the date of the first approved application for medical assistance 
12.32 	if the person has not yet been determined eligible for medical assistance, the person is 
12.33 	ineligible for long-term care services for the period of time determined under subdivision 
12.34 	2.
13.1 	(b) Effective for transfers made after August 10, 1993, a an institutionalized person, 
13.2 	a an institutionalized person's spouse, or any person, court, or administrative body with 
13.3 	legal authority to act in place of, on behalf of, at the direction of, or upon the request of the 
13.4 	institutionalized person or institutionalized person's spouse, may not give away, sell, or 
13.5 	dispose of, for less than fair market value, any asset or interest therein, except assets other 
13.6 	than the homestead that are excluded under the supplemental security income program, 
13.7 	for the purpose of establishing or maintaining medical assistance eligibility. This applies 
13.8 	to all transfers, including those made by a community spouse after the month in which 
13.9 	the institutionalized spouse is determined eligible for medical assistance. For purposes of 
13.10 	determining eligibility for long-term care services, any transfer of such assets within 36 
13.11 	months before or any time after an institutionalized person applies forrequests medical 
13.12 	assistance payment of long-term care services, or 36 months before or any time after a 
13.13 	medical assistance recipient becomes institutionalized, for less than fair market value 
13.14 	may be considered. Any such transfer is presumed to have been made for the purpose 
13.15 	of establishing or maintaining medical assistance eligibility and the institutionalized
13.16 	person is ineligible for long-term care services for the period of time determined under 
13.17 	subdivision 2, unless the institutionalized person furnishes convincing evidence to 
13.18 	establish that the transaction was exclusively for another purpose, or unless the transfer 
13.19 	is permitted under subdivision 3 or 4.  In the case of payments from a trust or portions 
13.20 	of a trust that are considered transfers of assets under federal law, or in the case of any 
13.21 	other disposal of assets made on or after February 8, 2006, any transfers made within 60 
13.22 	months before or any time after an institutionalized person applies forrequests medical 
13.23 	assistance payment of long-term care services and within 60 months before or any time 
13.24 	after a medical assistance recipient becomes institutionalized, may be considered.
13.25 	(c) This section applies to transfers, for less than fair market value, of income 
13.26 	or assets, including assets that are considered income in the month received, such as 
13.27 	inheritances, court settlements, and retroactive benefit payments or income to which the
13.28 	institutionalized person or the institutionalized person's spouse is entitled but does not 
13.29 	receive due to action by the institutionalized person, the institutionalized person's spouse, 
13.30 	or any person, court, or administrative body with legal authority to act in place of, on 
13.31 	behalf of, at the direction of, or upon the request of the institutionalized person or the
13.32 	institutionalized person's spouse.
13.33 	(d) This section applies to payments for care or personal services provided by a 
13.34 	relative, unless the compensation was stipulated in a notarized, written agreement which 
13.35 	was in existence when the service was performed, the care or services directly benefited 
13.36 	the person, and the payments made represented reasonable compensation for the care 
14.1 	or services provided. A notarized written agreement is not required if payment for the 
14.2 	services was made within 60 days after the service was provided.
14.3 	(e) This section applies to the portion of any asset or interest that a an institutionalized
14.4 	person, a an institutionalized person's spouse, or any person, court, or administrative body 
14.5 	with legal authority to act in place of, on behalf of, at the direction of, or upon the request 
14.6 	of the institutionalized person or the institutionalized person's spouse, transfers to any 
14.7 	annuity that exceeds the value of the benefit likely to be returned to the institutionalized 
14.8 	person or institutionalized person's spouse while alive, based on estimated life expectancy 
14.9 	using the life expectancy tables employed by the supplemental security income program 
14.10 	to determine the value of an agreement for services for life. The commissioner may adopt 
14.11 	rules reducing life expectancies based on the need for long-term care. This section applies 
14.12 	to an annuity described in this paragraph purchased on or after March 1, 2002, that:
14.13 	(1) is not purchased from an insurance company or financial institution that is 
14.14 	subject to licensing or regulation by the Minnesota Department of Commerce or a similar 
14.15 	regulatory agency of another state;
14.16 	(2) does not pay out principal and interest in equal monthly installments; or
14.17 	(3) does not begin payment at the earliest possible date after annuitization.
14.18 	(f) Effective for transactions, including the purchase of an annuity, occurring on 
14.19 	or after February 8, 2006, the purchase of an annuity by or on behalf of an individual
14.20 	institutionalized person who has applied for or is receiving long-term care services or the 
14.21 	individual's institutionalized person's spouse shall be treated as the disposal of an asset for 
14.22 	less than fair market value unless the department is named as the a preferred remainder 
14.23 	beneficiary in first position for an amount equal to at least the total amount of medical 
14.24 	assistance paid on behalf of the individual or the individual's spouse; or the department 
14.25 	is named as the remainder beneficiary in second position for an amount equal to at least 
14.26 	the total amount of medical assistance paid on behalf of the individual or the individual's 
14.27 	spouse after the individual's community spouse or minor or disabled child and is named as 
14.28 	the remainder beneficiary in the first position if the community spouse or a representative 
14.29 	of the minor or disabled child disposes of the remainder for less than fair market value  as 
14.30 	described in section 256B.056, subdivision 11. Any subsequent change to the designation 
14.31 	of the department as a preferred remainder beneficiary shall result in the annuity being 
14.32 	treated as a disposal of assets for less than fair market value. The amount of such transfer 
14.33 	shall be the maximum amount the individual institutionalized person or the individual's
14.34 	institutionalized person's spouse could receive from the annuity or similar financial 
14.35 	instrument. Any change in the amount of the income or principal being withdrawn 
14.36 	from the annuity or other similar financial instrument at the time of the most recent 
15.1 	disclosure shall be deemed to be a transfer of assets for less than fair market value unless 
15.2 	the individual institutionalized person or the individual's institutionalized person's spouse 
15.3 	demonstrates that the transaction was for fair market value. In the event a distribution 
15.4 	of income or principal has been improperly distributed or disbursed from an annuity or 
15.5 	other retirement planning instrument of an institutionalized person or the institutionalized 
15.6 	person's spouse, a cause of action exists against the individual receiving the improper 
15.7 	distribution for the cost of medical assistance services provided or the amount of the 
15.8 	improper distribution, whichever is less. The action may be brought by the state or the 
15.9 	local agency responsible for providing medical assistance under chapter 256B.
15.10 	(g) Effective for transactions, including the purchase of an annuity, occurring on 
15.11 	or after February 8, 2006, the purchase of an annuity by or on behalf of an individual
15.12 	institutionalized person applying for or receiving long-term care services shall be treated 
15.13 	as a disposal of assets for less than fair market value unless it is:
15.14 	(i) an annuity described in subsection (b) or (q) of section 408 of the Internal 
15.15 	Revenue Code of 1986; or 
15.16 	(ii) purchased with proceeds from:
15.17 	(A) an account or trust described in subsection (a), (c), or (p) of section 408 of the 
15.18 	Internal Revenue Code;
15.19 	(B) a simplified employee pension within the meaning of section 408(k) of the 
15.20 	Internal Revenue Code; or
15.21 	(C) a Roth IRA described in section 408A of the Internal Revenue Code; or
15.22 	(iii) an annuity that is irrevocable and nonassignable; is actuarially sound as 
15.23 	determined in accordance with actuarial publications of the Office of the Chief Actuary of 
15.24 	the Social Security Administration; and provides for payments in equal amounts during 
15.25 	the term of the annuity, with no deferral and no balloon payments made.
15.26 	 (h) For purposes of this section, long-term care services include services in a nursing 
15.27 	facility, services that are eligible for payment according to section 256B.0625, subdivision 
15.28 	2, because they are provided in a swing bed, intermediate care facility for persons with 
15.29 	developmental disabilities, and home and community-based services provided pursuant 
15.30 	to sections 256B.0915, 256B.092, and 256B.49. For purposes of this subdivision and 
15.31 	subdivisions 2, 3, and 4, "institutionalized person" includes a person who is an inpatient 
15.32 	in a nursing facility or in a swing bed, or intermediate care facility for persons with 
15.33 	developmental disabilities or who is receiving home and community-based services under 
15.34 	sections 256B.0915, 256B.092, and 256B.49. 
15.35 	(i) This section applies to funds used to purchase a promissory note, loan, or 
15.36 	mortgage unless the note, loan, or mortgage:
16.1 	(1) has a repayment term that is actuarially sound;
16.2 	(2) provides for payments to be made in equal amounts during the term of the loan, 
16.3 	with no deferral and no balloon payments made; and
16.4 	(3) prohibits the cancellation of the balance upon the death of the lender.
16.5 	In the case of a promissory note, loan, or mortgage that does not meet an exception 
16.6 	in clauses (1) to (3), the value of such note, loan, or mortgage shall be the outstanding 
16.7 	balance due as of the date of the individual's applicationinstitutionalized person's request 
16.8 	for medical assistance payment of long-term care services.
16.9 	(j) This section applies to the purchase of a life estate interest in another individual's
16.10 	person's home unless the purchaser resides in the home for a period of at least one year 
16.11 	after the date of purchase.

16.12 	Sec. 14. Minnesota Statutes 2006, section 256B.0595, subdivision 2, is amended to 
16.13 	read:
16.14 		Subd. 2.Period of ineligibility. (a) For any uncompensated transfer occurring on or 
16.15 	before August 10, 1993, the number of months of ineligibility for long-term care services 
16.16 	shall be the lesser of 30 months, or the uncompensated transfer amount divided by the 
16.17 	average medical assistance rate for nursing facility services in the state in effect on the 
16.18 	date of application. The amount used to calculate the average medical assistance payment 
16.19 	rate shall be adjusted each July 1 to reflect payment rates for the previous calendar year. 
16.20 	The period of ineligibility begins with the month in which the assets were transferred. 
16.21 	If the transfer was not reported to the local agency at the time of application, and the 
16.22 	applicant received long-term care services during what would have been the period of 
16.23 	ineligibility if the transfer had been reported, a cause of action exists against the transferee 
16.24 	for the cost of long-term care services provided during the period of ineligibility, or for the 
16.25 	uncompensated amount of the transfer, whichever is less. The action may be brought by 
16.26 	the state or the local agency responsible for providing medical assistance under chapter 
16.27 	256G. The uncompensated transfer amount is the fair market value of the asset at the time 
16.28 	it was given away, sold, or disposed of, less the amount of compensation received.
16.29 	(b) For uncompensated transfers made after August 10, 1993, the number of months 
16.30 	of ineligibility for long-term care services shall be the total uncompensated value of the 
16.31 	resources transferred divided by the average medical assistance rate for nursing facility 
16.32 	services in the state in effect on the date of application. The amount used to calculate the 
16.33 	average medical assistance payment rate shall be adjusted each July 1 to reflect payment 
16.34 	rates for the previous calendar year. The period of ineligibility begins with the first day 
16.35 	of the month after the month in which the assets were transferred except that if one or 
17.1 	more uncompensated transfers are made during a period of ineligibility, the total assets 
17.2 	transferred during the ineligibility period shall be combined and a penalty period calculated 
17.3 	to begin on the first day of the month after the month in which the first uncompensated 
17.4 	transfer was made. If the transfer was reported to the local agency after the date that 
17.5 	advance notice of a period of ineligibility that affects the next month could be provided to 
17.6 	the recipient and the recipient received medical assistance services or the transfer was not 
17.7 	reported to the local agency, and the applicant or recipient received medical assistance 
17.8 	services during what would have been the period of ineligibility if the transfer had been 
17.9 	reported, a cause of action exists against the transferee for the cost of medical assistance 
17.10 	services provided during the period of ineligibility, or for the uncompensated amount of 
17.11 	the transfer, whichever is less. The action may be brought by the state or the local agency 
17.12 	responsible for providing medical assistance under chapter 256G. The uncompensated 
17.13 	transfer amount is the fair market value of the asset at the time it was given away, sold, or 
17.14 	disposed of, less the amount of compensation received. Effective for transfers made on or 
17.15 	after March 1, 1996, involving persons who apply for medical assistance on or after April 
17.16 	13, 1996, no cause of action exists for a transfer unless:
17.17 	(1) the transferee knew or should have known that the transfer was being made by a 
17.18 	person who was a resident of a long-term care facility or was receiving that level of care in 
17.19 	the community at the time of the transfer;
17.20 	(2) the transferee knew or should have known that the transfer was being made to 
17.21 	assist the person to qualify for or retain medical assistance eligibility; or
17.22 	(3) the transferee actively solicited the transfer with intent to assist the person to 
17.23 	qualify for or retain eligibility for medical assistance.
17.24 	(c) For uncompensated transfers made on or after February 8, 2006, the period 
17.25 	of ineligibility:
17.26 	(1) for uncompensated transfers by or on behalf of individuals receiving medical 
17.27 	assistance payment of long-term care services, begins on the first day of the month 
17.28 	in which following advance notice can be given following of the penalty period, but no 
17.29 	later than the first day of the month in which assets have been transferred for less than 
17.30 	fair market value, that follows three full calendar months from the date of the report 
17.31 	or discovery of the transfer; or 
17.32 	(2) for uncompensated transfers by individuals requesting medical assistance 
17.33 	payment of long-term care services, begins the date on which the individual is eligible 
17.34 	for medical assistance under the Medicaid state plan and would otherwise be receiving 
17.35 	long-term care services based on an approved application for such care but for the 
17.36 	application of the penalty period, whichever is later,; and which does not occur
18.1 	(3) cannot begin during any other period of ineligibility.
18.2 	(d) If a calculation of a penalty period results in a partial month, payments for 
18.3 	long-term care services shall be reduced in an amount equal to the fraction. 
18.4 	(e) In the case of multiple fractional transfers of assets in more than one month for 
18.5 	less than fair market value on or after February 8, 2006, the period of ineligibility is 
18.6 	calculated by treating the total, cumulative, uncompensated value of all assets transferred 
18.7 	during all months on or after February 8, 2006, as one transfer.

18.8 	Sec. 15. Minnesota Statutes 2006, section 256B.0595, subdivision 3, is amended to 
18.9 	read:
18.10 		Subd. 3.Homestead exception to transfer prohibition. (a) An institutionalized 
18.11 	person is not ineligible for long-term care services due to a transfer of assets for less than 
18.12 	fair market value if the asset transferred was a homestead and:
18.13 	(1) title to the homestead was transferred to the individual's:
18.14 	(i) spouse;
18.15 	(ii) child who is under age 21;
18.16 	(iii) blind or permanently and totally disabled child as defined in the supplemental 
18.17 	security income program;
18.18 	(iv) sibling who has equity interest in the home and who was residing in the home 
18.19 	for a period of at least one year immediately before the date of the individual's admission 
18.20 	to the facility; or
18.21 	(v) son or daughter who was residing in the individual's home for a period of at least 
18.22 	two years immediately before the date of the individual's admission to the facility the 
18.23 	individual became an institutionalized person, and who provided care to the individual 
18.24 	that, as certified by the individual's attending physician, permitted the individual to 
18.25 	reside at home rather than receive care in an institution or facility, or from home and 
18.26 	community-based services under sections 256B.0915, 256B.092, and 256B.49;
18.27 	(2) a satisfactory showing is made that the individual intended to dispose of the 
18.28 	homestead at fair market value or for other valuable consideration; or
18.29 	(3) the local agency grants a waiver of a penalty resulting from a transfer for less 
18.30 	than fair market value because denial of eligibility would cause undue hardship for the 
18.31 	individual, based on imminent threat to the individual's health and well-being. Whenever 
18.32 	an applicant or recipient is denied eligibility because of a transfer for less than fair market 
18.33 	value, the local agency shall notify the applicant or recipient that the applicant or recipient 
18.34 	may request a waiver of the penalty if the denial of eligibility will cause undue hardship. 
18.35 	With the written consent of the individual or the personal representative of the individual, 
19.1 	a long-term care facility in which an individual is residing may file an undue hardship 
19.2 	waiver request, on behalf of the individual who is denied eligibility for long-term care 
19.3 	services on or after July 1, 2006, due to a period of ineligibility resulting from a transfer on 
19.4 	or after February 8, 2006. In evaluating a waiver, the local agency shall take into account 
19.5 	whether the individual was the victim of financial exploitation, whether the individual has 
19.6 	made reasonable efforts to recover the transferred property or resource, and other factors 
19.7 	relevant to a determination of hardship. If the local agency does not approve a hardship 
19.8 	waiver, the local agency shall issue a written notice to the individual stating the reasons 
19.9 	for the denial and the process for appealing the local agency's decision.
19.10 	(b) When a waiver is granted under paragraph (a), clause (3), a cause of action exists 
19.11 	against the person to whom the homestead was transferred for that portion of long-term 
19.12 	care services granted within:
19.13 	(1) 30 months of a transfer made on or before August 10, 1993;
19.14 	(2) 60 months if the homestead was transferred after August 10, 1993, to a trust or 
19.15 	portion of a trust that is considered a transfer of assets under federal law; 
19.16 	(3) 36 months if transferred in any other manner after August 10, 1993, but prior 
19.17 	to February 8, 2006; or
19.18 	(4) 60 months if the homestead was transferred on or after February 8, 2006,
19.19 	or the amount of the uncompensated transfer, whichever is less, together with the 
19.20 	costs incurred due to the action. The action shall be brought by the state unless the 
19.21 	state delegates this responsibility to the local agency responsible for providing medical 
19.22 	assistance under chapter 256G.

19.23 	Sec. 16. Minnesota Statutes 2006, section 256B.0595, subdivision 4, is amended to 
19.24 	read:
19.25 		Subd. 4.Other exceptions to transfer prohibition. An institutionalized person 
19.26 	who has made, or whose spouse has made a transfer prohibited by subdivision 1, is not 
19.27 	ineligible for long-term care services if one of the following conditions applies:
19.28 	(1) the assets were transferred to the individual's spouse or to another for the sole 
19.29 	benefit of the spouse; or
19.30 	(2) the institutionalized spouse, prior to being institutionalized, transferred assets 
19.31 	to a spouse, provided that the spouse to whom the assets were transferred does not then 
19.32 	transfer those assets to another person for less than fair market value. (At the time when 
19.33 	one spouse is institutionalized, assets must be allocated between the spouses as provided 
19.34 	under section 256B.059); or
20.1 	(3) the assets were transferred to the individual's child who is blind or permanently 
20.2 	and totally disabled as determined in the supplemental security income program; or
20.3 	(4) a satisfactory showing is made that the individual intended to dispose of the 
20.4 	assets either at fair market value or for other valuable consideration; or
20.5 	(5) the local agency determines that denial of eligibility for long-term care services 
20.6 	would work an undue hardship and grants a waiver of a penalty resulting from a transfer 
20.7 	for less than fair market value based on an imminent threat to the individual's health 
20.8 	and well-being. Whenever an applicant or recipient is denied eligibility because of a 
20.9 	transfer for less than fair market value, the local agency shall notify the applicant or 
20.10 	recipient that the applicant or recipient may request a waiver of the penalty if the denial of 
20.11 	eligibility will cause undue hardship. With the written consent of the individual or the 
20.12 	personal representative of the individual, a long-term care facility in which an individual 
20.13 	is residing may file an undue hardship waiver request, on behalf of the individual who 
20.14 	is denied eligibility for long-term care services on or after July 1, 2006, due to a period 
20.15 	of ineligibility resulting from a transfer on or after February 8, 2006. In evaluating a 
20.16 	waiver, the local agency shall take into account whether the individual was the victim of 
20.17 	financial exploitation, whether the individual has made reasonable efforts to recover the 
20.18 	transferred property or resource, whether the individual has taken any action to prevent 
20.19 	the designation of the department as a remainder beneficiary on an annuity as described 
20.20 	in section 256B.056, subdivision 11, and other factors relevant to a determination of 
20.21 	hardship. The local agency shall make a determination within 30 days of the receipt of all 
20.22 	necessary information needed to make such a determination. If the local agency does not 
20.23 	approve a hardship waiver, the local agency shall issue a written notice to the individual 
20.24 	stating the reasons for the denial and the process for appealing the local agency's decision. 
20.25 	When a waiver is granted, a cause of action exists against the person to whom the assets 
20.26 	were transferred for that portion of long-term care services granted within:
20.27 	(i) 30 months of a transfer made on or before August 10, 1993;
20.28 	(ii) 60 months of a transfer if the assets were transferred after August 30, 1993, to a 
20.29 	trust or portion of a trust that is considered a transfer of assets under federal law; 
20.30 	(iii) 36 months of a transfer if transferred in any other manner after August 10, 1993, 
20.31 	but prior to February 8, 2006; or
20.32 	(iv) 60 months of any transfer made on or after February 8, 2006,
20.33 	or the amount of the uncompensated transfer, whichever is less, together with the 
20.34 	costs incurred due to the action. The action shall be brought by the state unless the 
20.35 	state delegates this responsibility to the local agency responsible for providing medical 
20.36 	assistance under this chapter; or
21.1 	(6) for transfers occurring after August 10, 1993, the assets were transferred by 
21.2 	the person or person's spouse: (i) into a trust established for the sole benefit of a son or 
21.3 	daughter of any age who is blind or disabled as defined by the Supplemental Security 
21.4 	Income program; or (ii) into a trust established for the sole benefit of an individual who is 
21.5 	under 65 years of age who is disabled as defined by the Supplemental Security Income 
21.6 	program.
21.7 	"For the sole benefit of" has the meaning found in section 256B.059, subdivision 1. 

21.8 	Sec. 17. Minnesota Statutes 2006, section 256B.0625, subdivision 5a, is amended to 
21.9 	read:
21.10 		Subd. 5a.Services for children with autism spectrum disorders. (a) Subject 
21.11 	to federal approval, medical assistance covers home-based intensive early intervention 
21.12 	behavior therapy for children with autism spectrum disorders, effective July 1, 2007. 
21.13 	Children with autism spectrum disorder, and their custodial parents or foster parents, may 
21.14 	access other covered services to treat autism spectrum disorder, and are not required to 
21.15 	receive intensive early intervention behavior therapy services under this subdivision.
21.16 	(b) Intensive early intervention behavior therapy does not include coverage for 
21.17 	services to treat developmental disorders of language, early onset psychosis, Rett's 
21.18 	disorder, selective mutism, social anxiety disorder, stereotypic movement disorder, 
21.19 	dementia, obsessive compulsive disorder, schizoid personality disorder, avoidant 
21.20 	personality disorder, or reactive attachment disorder.
21.21 	(c) If a child with autism spectrum disorder is diagnosed to have one or more of 
21.22 	these conditions, intensive early intervention behavior therapy includes coverage only for 
21.23 	services necessary to treat the autism spectrum disorder.

21.24 	EFFECTIVE DATE. This section is effective the day following final enactment.

21.25 	Sec. 18. Minnesota Statutes 2006, section 256B.0625, subdivision 5j, is amended to 
21.26 	read:
21.27 		Subd. 5j.Payment rates. The following payment rates apply:
21.28 	(1) for an IEIBTS clinical supervisor practitioner under supervision of a mental 
21.29 	health professional, the lower of the submitted charge or $67 per hour unit;
21.30 	(2) for an IEIBTS senior behavior therapist practitioner under supervision of a 
21.31 	mental health professional, the lower of the submitted charge or $37 per hour unit; or
21.32 	(3) for an IEIBTS behavior therapist practitioner under supervision of a mental 
21.33 	health professional, the lower of the submitted charge or $27 per hour unit.
22.1 	An IEIBTS practitioner may receive payment for travel time which exceeds 50 minutes 
22.2 	one-way. The maximum payment allowed will be $0.51 per minute for up to a maximum 
22.3 	of 300 hours per year.
22.4 	For any week during which the above charges are made to medical assistance, 
22.5 	payments for the following services are excluded: supervising mental health professional 
22.6 	hours and, personal care attendant, home-based mental health, family-community support
22.7 	children's therapeutic services and supports, or mental health behavioral aide hours.

22.8 	EFFECTIVE DATE. This section is effective the day following final enactment.

22.9 	Sec. 19. Minnesota Statutes 2006, section 256B.0625, is amended by adding a 
22.10 	subdivision to read:
22.11 		Subd. 49.Lead risk assessment services. (a) Effective July 1, 2007, or six months 
22.12 	after federal approval, whichever is later, medical assistance covers lead risk assessment 
22.13 	provided by a lead risk assessor, who is licensed by the commissioner of health as defined 
22.14 	in section 144.9505 and employed by an assessing agency as defined in section 144.9501. 
22.15 	Medical assistance covers one lead risk assessment per case to enrolled individuals under 
22.16 	age 21 who have a venous blood lead level of 15 micrograms per deciliter or higher. 
22.17 	Medical assistance coverage of lead risk assessments is not included in the capitated 
22.18 	services for children enrolled in health plans through the prepaid medical assistance 
22.19 	program and the MinnesotaCare program.
22.20 	(b) A medical assistance covered lead risk assessment is defined as a onetime, 
22.21 	on-site investigation of the child's home or primary residence to determine the existence of 
22.22 	lead. Medical assistance reimbursement covers the lead risk assessor's time to complete 
22.23 	the following activities: gathering samples, interviewing family members, gathering data 
22.24 	including meter readings, and providing a report with the results of the investigation and 
22.25 	options for reducing lead-based paint hazards. Medical assistance coverage of lead risk 
22.26 	assessment does not include testing of environmental substances such as water, paint, 
22.27 	soil, or any laboratory services.
22.28 	(c) Payment for lead risk assessment must be cost-based and must meet the criteria 
22.29 	for federal financial participation under the Medicaid program. The rate must be based on 
22.30 	allowable expenditures from cost information gathered. Pursuant to section 144.9507, 
22.31 	subdivision 5, federal medical assistance funds may not replace existing funding for 
22.32 	lead-related activities. The nonfederal share of costs for services provided under this 
22.33 	subdivision must be from state or local funds and is the responsibility of the agency 
22.34 	providing the risk assessment. Eligible expenditures for the nonfederal share of costs may 
23.1 	not be made from federal funds or funds used to match other federal funds. Any federal 
23.2 	disallowances are the responsibility of the agency providing risk assessment services.

23.3 	Sec. 20. Minnesota Statutes 2006, section 256B.69, subdivision 6, is amended to read:
23.4 		Subd. 6.Service delivery. (a) Each demonstration provider shall be responsible for 
23.5 	the health care coordination for eligible individuals. Demonstration providers:
23.6 	(1) shall authorize and arrange for the provision of all needed health services 
23.7 	including but not limited to the full range of services listed in sections 256B.02, 
23.8 	subdivision 8, and 256B.0625 in order to ensure appropriate health care is delivered 
23.9 	to enrollees; notwithstanding section 256B.0621, demonstration providers that provide 
23.10 	nursing home and community-based services under this section will provide relocation 
23.11 	service coordination to enrolled persons age 65 and over;
23.12 	(2) shall accept the prospective, per capita payment from the commissioner in return 
23.13 	for the provision of comprehensive and coordinated health care services for eligible 
23.14 	individuals enrolled in the program;
23.15 	(3) may contract with other health care and social service practitioners to provide 
23.16 	services to enrollees; and
23.17 	(4) shall institute recipient grievance procedures according to the method established 
23.18 	by the project, utilizing applicable requirements of chapter 62D. Disputes not resolved 
23.19 	through this process shall be appealable to the commissioner as provided in subdivision 11.
23.20 	(b) Demonstration providers must comply with the standards for claims settlement 
23.21 	under section 72A.201, subdivisions 4, 5, 7, and 8, when contracting with other health 
23.22 	care and social service practitioners to provide services to enrollees. A demonstration 
23.23 	provider must pay a clean claim, as defined in Code of Federal Regulations, title 42, 
23.24 	section 447.45(b), within 30 business days of the date of acceptance of the claim. 

23.25 	Sec. 21. Minnesota Statutes 2006, section 256B.69, subdivision 23, is amended to read:
23.26 		Subd. 23.Alternative services; elderly and disabled persons. (a) The 
23.27 	commissioner may implement demonstration projects to create alternative integrated 
23.28 	delivery systems for acute and long-term care services to elderly persons and persons 
23.29 	with disabilities as defined in section 256B.77, subdivision 7a, that provide increased 
23.30 	coordination, improve access to quality services, and mitigate future cost increases. 
23.31 	The commissioner may seek federal authority to combine Medicare and Medicaid 
23.32 	capitation payments for the purpose of such demonstrations and may contract with 
23.33 	Medicare-approved special needs plans to provide Medicaid services. Medicare funds and 
23.34 	services shall be administered according to the terms and conditions of the federal contract 
24.1 	and demonstration provisions. For the purpose of administering medical assistance funds, 
24.2 	demonstrations under this subdivision are subject to subdivisions 1 to 22. The provisions 
24.3 	of Minnesota Rules, parts 9500.1450 to 9500.1464, apply to these demonstrations, 
24.4 	with the exceptions of parts 9500.1452, subpart 2, item B; and 9500.1457, subpart 1, 
24.5 	items B and C, which do not apply to persons enrolling in demonstrations under this 
24.6 	section. An initial open enrollment period may be provided. Persons who disenroll from 
24.7 	demonstrations under this subdivision remain subject to Minnesota Rules, parts 9500.1450
24.8 	to 9500.1464. When a person is enrolled in a health plan under these demonstrations and 
24.9 	the health plan's participation is subsequently terminated for any reason, the person shall 
24.10 	be provided an opportunity to select a new health plan and shall have the right to change 
24.11 	health plans within the first 60 days of enrollment in the second health plan. Persons 
24.12 	required to participate in health plans under this section who fail to make a choice of 
24.13 	health plan shall not be randomly assigned to health plans under these demonstrations. 
24.14 	Notwithstanding section 256L.12, subdivision 5, and Minnesota Rules, part 9505.5220, 
24.15 	subpart 1, item A, if adopted, for the purpose of demonstrations under this subdivision, 
24.16 	the commissioner may contract with managed care organizations, including counties, to 
24.17 	serve only elderly persons eligible for medical assistance, elderly and disabled persons, or 
24.18 	disabled persons only. For persons with a primary diagnosis of developmental disability, 
24.19 	serious and persistent mental illness, or serious emotional disturbance, the commissioner 
24.20 	must ensure that the county authority has approved the demonstration and contracting 
24.21 	design. Enrollment in these projects for persons with disabilities shall be voluntary. The 
24.22 	commissioner shall not implement any demonstration project under this subdivision for 
24.23 	persons with a primary diagnosis of developmental disabilities, serious and persistent 
24.24 	mental illness, or serious emotional disturbance, without approval of the county board of 
24.25 	the county in which the demonstration is being implemented.
24.26 	(b) Notwithstanding chapter 245B, sections 252.40 to 252.46, 256B.092, 256B.501
24.27 	to 256B.5015, and Minnesota Rules, parts 9525.0004 to 9525.0036, 9525.1200 to 
24.28 	9525.1330, 9525.1580, and 9525.1800 to 9525.1930, the commissioner may implement 
24.29 	under this section projects for persons with developmental disabilities. The commissioner 
24.30 	may capitate payments for ICF/MR services, waivered services for developmental 
24.31 	disabilities, including case management services, day training and habilitation and 
24.32 	alternative active treatment services, and other services as approved by the state and by 
24.33 	the federal government. Case management and active treatment must be individualized 
24.34 	and developed in accordance with a person-centered plan. Costs under these projects may 
24.35 	not exceed costs that would have been incurred under fee-for-service. Beginning July 1, 
24.36 	2003, and until two four years after the pilot project implementation date, subcontractor 
25.1 	participation in the long-term care developmental disability pilot is limited to a nonprofit 
25.2 	long-term care system providing ICF/MR services, home and community-based waiver 
25.3 	services, and in-home services to no more than 120 consumers with developmental 
25.4 	disabilities in Carver, Hennepin, and Scott Counties. The commissioner shall report to the 
25.5 	legislature prior to expansion of the developmental disability pilot project. This paragraph 
25.6 	expires two four years after the implementation date of the pilot project.
25.7 	(c) Before implementation of a demonstration project for disabled persons, the 
25.8 	commissioner must provide information to appropriate committees of the house of 
25.9 	representatives and senate and must involve representatives of affected disability groups 
25.10 	in the design of the demonstration projects.
25.11 	(d) A nursing facility reimbursed under the alternative reimbursement methodology 
25.12 	in section 256B.434 may, in collaboration with a hospital, clinic, or other health care entity 
25.13 	provide services under paragraph (a). The commissioner shall amend the state plan and 
25.14 	seek any federal waivers necessary to implement this paragraph.
25.15 	(e) The commissioner, in consultation with the commissioners of commerce and 
25.16 	health, may approve and implement programs for all-inclusive care for the elderly (PACE) 
25.17 	according to federal laws and regulations governing that program and state laws or rules 
25.18 	applicable to participating providers. The process for approval of these programs shall 
25.19 	begin only after the commissioner receives grant money in an amount sufficient to cover 
25.20 	the state share of the administrative and actuarial costs to implement the programs during 
25.21 	state fiscal years 2006 and 2007. Grant amounts for this purpose shall be deposited in an 
25.22 	account in the special revenue fund and are appropriated to the commissioner to be used 
25.23 	solely for the purpose of PACE administrative and actuarial costs. A PACE provider is 
25.24 	not required to be licensed or certified as a health plan company as defined in section 
25.25 	62Q.01, subdivision 4. Persons age 55 and older who have been screened by the county 
25.26 	and found to be eligible for services under the elderly waiver or community alternatives 
25.27 	for disabled individuals or who are already eligible for Medicaid but meet level of 
25.28 	care criteria for receipt of waiver services may choose to enroll in the PACE program. 
25.29 	Medicare and Medicaid services will be provided according to this subdivision and 
25.30 	federal Medicare and Medicaid requirements governing PACE providers and programs. 
25.31 	PACE enrollees will receive Medicaid home and community-based services through the 
25.32 	PACE provider as an alternative to services for which they would otherwise be eligible 
25.33 	through home and community-based waiver programs and Medicaid State Plan Services. 
25.34 	The commissioner shall establish Medicaid rates for PACE providers that do not exceed 
25.35 	costs that would have been incurred under fee-for-service or other relevant managed care 
25.36 	programs operated by the state.
26.1 	(f) The commissioner shall seek federal approval to expand the Minnesota disability 
26.2 	health options (MnDHO) program established under this subdivision in stages, first to 
26.3 	regional population centers outside the seven-county metro area and then to all areas 
26.4 	of the state. Until January 1, 2008, expansion for MnDHO projects that include home 
26.5 	and community-based services is limited to the two projects and service areas in effect 
26.6 	on March 1, 2006.  Enrollment in integrated MnDHO programs that include home and 
26.7 	community-based services shall remain voluntary. Costs for home and community-based 
26.8 	services included under MnDHO must not exceed costs that would have been incurred 
26.9 	under the fee-for-service program. In developing program specifications for expansion of 
26.10 	integrated programs, the commissioner shall involve and consult the state-level stakeholder 
26.11 	group established in subdivision 28, paragraph (d), including consultation on whether and 
26.12 	how to include home and community-based waiver programs. Plans for further expansion 
26.13 	of MnDHO projects shall be presented to the chairs of the house and senate committees 
26.14 	with jurisdiction over health and human services policy and finance by February 1, 2007.
26.15 	(g) Notwithstanding section 256B.0261 256B.0621, health plans providing services 
26.16 	under this section are responsible for home care targeted case management and relocation 
26.17 	targeted case management. Services must be provided according to the terms of the 
26.18 	waivers and contracts approved by the federal government.

26.19 	Sec. 22. Minnesota Statutes 2006, section 256B.69, subdivision 27, is amended to read:
26.20 		Subd. 27.Information for persons with limited English-language proficiency.
 26.21 	Managed care contracts entered into under this section and sections 256D.03, subdivision 
26.22 	4, paragraph (c), and 256L.12 must require demonstration providers to inform enrollees 
26.23 	that upon request the enrollee can obtain a certificate of coverage in the following 
26.24 	languages: Spanish, Hmong, Laotian, Russian, Somali, Vietnamese, or Cambodian. 
26.25 	Upon request, the demonstration provider must provide the enrollee with a certificate of 
26.26 	coverage in the specified language of preference provide language assistance to enrollees 
26.27 	that ensures meaningful access to its programs and services according to Title VI of the 
26.28 	Civil Rights Act and federal regulations adopted under that law or any guidance from the 
26.29 	United States Department of Health and Human Services. 

26.30 	Sec. 23. Minnesota Statutes 2006, section 256D.03, subdivision 3, is amended to read:
26.31 		Subd. 3.General assistance medical care; eligibility. (a) General assistance 
26.32 	medical care may be paid for any person who is not eligible for medical assistance under 
26.33 	chapter 256B, including eligibility for medical assistance based on a spenddown of excess 
27.1 	income according to section 256B.056, subdivision 5, or MinnesotaCare as defined in 
27.2 	paragraph (b), except as provided in paragraph (c), and:
27.3 	(1) who is receiving assistance under section 256D.05, except for families with 
27.4 	children who are eligible under Minnesota family investment program (MFIP), or who is 
27.5 	having a payment made on the person's behalf under sections 256I.01 to 256I.06; or
27.6 	(2) who is a resident of Minnesota; and
27.7 	(i) who has gross countable income not in excess of 75 percent of the federal poverty 
27.8 	guidelines for the family size, using a six-month budget period and whose equity in assets 
27.9 	is not in excess of $1,000 per assistance unit. General assistance medical care is not 
27.10 	available for applicants or enrollees who are otherwise eligible for medical assistance but 
27.11 	fail to verify their assets. Enrollees who become eligible for medical assistance shall be 
27.12 	terminated and transferred to medical assistance. Exempt assets, the reduction of excess 
27.13 	assets, and the waiver of excess assets must conform to the medical assistance program in 
27.14 	section 256B.056, subdivision 3, with the following exception: the maximum amount of 
27.15 	undistributed funds in a trust that could be distributed to or on behalf of the beneficiary by 
27.16 	the trustee, assuming the full exercise of the trustee's discretion under the terms of the 
27.17 	trust, must be applied toward the asset maximum;
27.18 	(ii) who has gross countable income above 75 percent of the federal poverty 
27.19 	guidelines but not in excess of 175 percent of the federal poverty guidelines for the 
27.20 	family size, using a six-month budget period, whose equity in assets is not in excess 
27.21 	of the limits in section 256B.056, subdivision 3c, and who applies during an inpatient 
27.22 	hospitalization; or
27.23 	(iii) the commissioner shall adjust the income standards under this section each July 
27.24 	1 by the annual update of the federal poverty guidelines following publication by the 
27.25 	United States Department of Health and Human Services.
27.26 	(b) Effective for applications and renewals processed on or after September 1, 2006, 
27.27 	general assistance medical care may not be paid for applicants or recipients who are adults 
27.28 	with dependent children under 21 whose gross family income is equal to or less than 275 
27.29 	percent of the federal poverty guidelines who are not described in paragraph (e).
27.30 	(c) Effective for applications and renewals processed on or after September 1, 2006, 
27.31 	general assistance medical care may be paid for applicants and recipients who meet all 
27.32 	eligibility requirements of paragraph (a), clause (2), item (i), for a temporary period 
27.33 	beginning the date of application. Immediately following approval of general assistance 
27.34 	medical care, enrollees shall be enrolled in MinnesotaCare under section 256L.04, 
27.35 	subdivision 7, with covered services as provided in section 256L.03 for the rest of the 
27.36 	six-month eligibility period, until their six-month renewal.
28.1 	(d) To be eligible for general assistance medical care following enrollment in 
28.2 	MinnesotaCare as required by paragraph (c), an individual must complete a new 
28.3 	application.
28.4 	(e) The following applicants and recipients eligible under paragraph (a), clause (1);, 
28.5 	are exempt from the MinnesotaCare enrollment requirements in this subdivision who:
28.6 	(1) have applied for and are awaiting a determination of blindness or disability by 
28.7 	the state medical review team or a determination of eligibility for Supplemental Security 
28.8 	Income or Social Security Disability Insurance by the Social Security Administration; who
28.9 	(2) fail to meet the requirements of section 256L.09, subdivision 2; who
28.10 	(3) are classified as end-stage renal disease beneficiaries in the Medicare program; 
28.11 	who
28.12 	(4) are enrolled in private health care coverage as defined in section 256B.02, 
28.13 	subdivision 9; who
28.14 	(5) are eligible under paragraph (j); or who
28.15 	(6) receive treatment funded pursuant to section 254B.02; or
28.16 	are exempt from the MinnesotaCare enrollment requirements of this subdivision (7) 
28.17 	reside in the Minnesota sex offender program defined in chapter 246B.
28.18 	(f) For applications received on or after October 1, 2003, eligibility may begin no 
28.19 	earlier than the date of application. For individuals eligible under paragraph (a), clause 
28.20 	(2), item (i), a redetermination of eligibility must occur every 12 months. Individuals are 
28.21 	eligible under paragraph (a), clause (2), item (ii), only during inpatient hospitalization but 
28.22 	may reapply if there is a subsequent period of inpatient hospitalization.
28.23 	(g) Beginning September 1, 2006, Minnesota health care program applications and 
28.24 	renewals completed by recipients and applicants who are persons described in paragraph 
28.25 	(c) and submitted to the county agency shall be determined for MinnesotaCare eligibility 
28.26 	by the county agency. If all other eligibility requirements of this subdivision are met, 
28.27 	eligibility for general assistance medical care shall be available in any month during which 
28.28 	MinnesotaCare enrollment is pending. Upon notification of eligibility for MinnesotaCare, 
28.29 	notice of termination for eligibility for general assistance medical care shall be sent to 
28.30 	an applicant or recipient. If all other eligibility requirements of this subdivision are 
28.31 	met, eligibility for general assistance medical care shall be available until enrollment in 
28.32 	MinnesotaCare subject to the provisions of paragraphs (c), (e), and (f).
28.33 	(h) The date of an initial Minnesota health care program application necessary to 
28.34 	begin a determination of eligibility shall be the date the applicant has provided a name, 
28.35 	address, and Social Security number, signed and dated, to the county agency or the 
28.36 	Department of Human Services. If the applicant is unable to provide a name, address, 
29.1 	Social Security number, and signature when health care is delivered due to a medical 
29.2 	condition or disability, a health care provider may act on an applicant's behalf to establish 
29.3 	the date of an initial Minnesota health care program application by providing the county 
29.4 	agency or Department of Human Services with provider identification and a temporary 
29.5 	unique identifier for the applicant. The applicant must complete the remainder of the 
29.6 	application and provide necessary verification before eligibility can be determined. The 
29.7 	county agency must assist the applicant in obtaining verification if necessary.
29.8 	(i) County agencies are authorized to use all automated databases containing 
29.9 	information regarding recipients' or applicants' income in order to determine eligibility for 
29.10 	general assistance medical care or MinnesotaCare. Such use shall be considered sufficient 
29.11 	in order to determine eligibility and premium payments by the county agency.
29.12 	(j) General assistance medical care is not available for a person in a correctional 
29.13 	facility unless the person is detained by law for less than one year in a county correctional 
29.14 	or detention facility as a person accused or convicted of a crime, or admitted as an 
29.15 	inpatient to a hospital on a criminal hold order, and the person is a recipient of general 
29.16 	assistance medical care at the time the person is detained by law or admitted on a criminal 
29.17 	hold order and as long as the person continues to meet other eligibility requirements 
29.18 	of this subdivision.
29.19 	(k) General assistance medical care is not available for applicants or recipients who 
29.20 	do not cooperate with the county agency to meet the requirements of medical assistance.
29.21 	(l) In determining the amount of assets of an individual eligible under paragraph 
29.22 	(a), clause (2), item (i), there shall be included any asset or interest in an asset, including 
29.23 	an asset excluded under paragraph (a), that was given away, sold, or disposed of for 
29.24 	less than fair market value within the 60 months preceding application for general 
29.25 	assistance medical care or during the period of eligibility. Any transfer described in this 
29.26 	paragraph shall be presumed to have been for the purpose of establishing eligibility for 
29.27 	general assistance medical care, unless the individual furnishes convincing evidence to 
29.28 	establish that the transaction was exclusively for another purpose. For purposes of this 
29.29 	paragraph, the value of the asset or interest shall be the fair market value at the time it 
29.30 	was given away, sold, or disposed of, less the amount of compensation received. For any 
29.31 	uncompensated transfer, the number of months of ineligibility, including partial months, 
29.32 	shall be calculated by dividing the uncompensated transfer amount by the average monthly 
29.33 	per person payment made by the medical assistance program to skilled nursing facilities 
29.34 	for the previous calendar year. The individual shall remain ineligible until this fixed period 
29.35 	has expired. The period of ineligibility may exceed 30 months, and a reapplication for 
29.36 	benefits after 30 months from the date of the transfer shall not result in eligibility unless 
30.1 	and until the period of ineligibility has expired. The period of ineligibility begins in the 
30.2 	month the transfer was reported to the county agency, or if the transfer was not reported, 
30.3 	the month in which the county agency discovered the transfer, whichever comes first. For 
30.4 	applicants, the period of ineligibility begins on the date of the first approved application.
30.5 	(m) When determining eligibility for any state benefits under this subdivision, 
30.6 	the income and resources of all noncitizens shall be deemed to include their sponsor's 
30.7 	income and resources as defined in the Personal Responsibility and Work Opportunity 
30.8 	Reconciliation Act of 1996, title IV, Public Law 104-193, sections 421 and 422, and 
30.9 	subsequently set out in federal rules.
30.10 	(n) Undocumented noncitizens and nonimmigrants are ineligible for general 
30.11 	assistance medical care. For purposes of this subdivision, a nonimmigrant is an individual 
30.12 	in one or more of the classes listed in United States Code, title 8, section 1101(a)(15), and 
30.13 	an undocumented noncitizen is an individual who resides in the United States without the 
30.14 	approval or acquiescence of the Immigration and Naturalization Service.
30.15 	(o) Notwithstanding any other provision of law, a noncitizen who is ineligible for 
30.16 	medical assistance due to the deeming of a sponsor's income and resources, is ineligible 
30.17 	for general assistance medical care.
30.18 	(p) Effective July 1, 2003, general assistance medical care emergency services end.

30.19 	EFFECTIVE DATE. This section is effective the day following final enactment.

30.20 	Sec. 24. Minnesota Statutes 2006, section 256L.035, is amended to read:
30.21 	256L.035 LIMITED BENEFITS COVERAGE FOR CERTAIN SINGLE 
30.22 	ADULTS AND HOUSEHOLDS WITHOUT CHILDREN.
30.23 	(a) "Covered health services" for individuals under section 256L.04, subdivision 
30.24 	7, with income above 75 percent, but not exceeding 175 percent, of the federal poverty 
30.25 	guideline means:
30.26 	(1) inpatient hospitalization benefits with a ten percent co-payment up to $1,000 and 
30.27 	subject to an annual limitation of $10,000;
30.28 	(2) physician services provided during an inpatient stay; and
30.29 	(3) physician services not provided during an inpatient stay; outpatient hospital 
30.30 	services; freestanding ambulatory surgical center services; chiropractic services; lab and 
30.31 	diagnostic services; diabetic supplies and equipment; and prescription drugs; subject to 
30.32 	the following co-payments:
30.33 	(i) $50 co-pay per emergency room visit;
30.34 	(ii) $3 co-pay per prescription drug; and
31.1 	(iii) $5 co-pay per nonpreventive visit.
31.2 	The services covered under this section may be provided by a physician, physician 
31.3 	ancillary, chiropractor, psychologist, or licensed independent clinical social worker if the 
31.4 	services are within the scope of practice of that health care professional.
31.5 	For purposes of this section, "a visit" means an episode of service which is required 
31.6 	because of a recipient's symptoms, diagnosis, or established illness, and which is delivered 
31.7 	in an ambulatory setting by any health care provider identified in this paragraph.
31.8 	Enrollees are responsible for all co-payments in this section.
31.9 	(b) Reimbursement to the providers shall be reduced by the amount of the 
31.10 	co-payment, except that reimbursement for prescription drugs shall not be reduced once a 
31.11 	recipient has reached the $20 per month maximum for prescription drug co-payments. 
31.12 	The provider collects the co-payment from the recipient. Providers may not deny services 
31.13 	to recipients who are unable to pay the co-payment, except as provided in paragraph (c).
31.14 	(c) If it is the routine business practice of a provider to refuse service to an individual 
31.15 	with uncollected debt, the provider may include uncollected co-payments under this 
31.16 	section. A provider must give advance notice to a recipient with uncollected debt before 
31.17 	services can be denied.
31.18 	(d) MinnesotaCare does not cover drugs that are coverable under Medicare Part D as 
31.19 	defined in the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, 
31.20 	Public Law 108-173, section 1860D-2(e), for individuals eligible for drug coverage as 
31.21 	defined in the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, 
31.22 	Public Law 108-173, section 1860D-1(a)(3)(A). For these individuals, MinnesotaCare 
31.23 	may cover drugs from the drug classes listed in United States Code, title 42, section 
31.24 	1396r-8(d)(2), subject to this subdivision and subdivisions 13a to 13g, except that drugs 
31.25 	listed in United States Code, title 42, section 1396r-8(d)(2)(E), are not covered.

31.26 	Sec. 25.  REPEALER.
 31.27 	Minnesota Statutes 2006, section 256B.0571, subdivision 8a, is repealed.