1.1 	CONFERENCE COMMITTEE REPORT ON S.F. No. 4699
1.2 	A bill for an act
1.3 	relating to state government; modifying provisions governing health care, health 
1.4 	insurance, health policy, emergency medical services, the Department of Health, 
1.5 	the Department of Human Services, MNsure, health care workforce, health-related 
1.6 	licensing boards, health care affordability and delivery, background studies, child 
1.7 	protection and welfare, child care licensing, behavioral health, economic assistance, 
1.8 	housing and homelessness, human services policy, the Minnesota Indian Family 
1.9 	Preservation Act, and the Department of Children, Youth, and Families; establishing 
1.10 	the Office of Emergency Medical Services; establishing the Minnesota African 
1.11 	American Family Preservation and Child Welfare Disproportionality Act; making 
1.12 	technical and conforming changes; requiring reports; imposing penalties; providing 
1.13 	appointments; making forecast adjustments; appropriating money;amending 
1.14 	Minnesota Statutes 2022, sections 16A.055, subdivision 1a, by adding a subdivision; 
1.15 	16A.103, by adding a subdivision; 62A.0411; 62A.15, subdivision 4, by adding a 
1.16 	subdivision; 62A.28, subdivision 2; 62D.02, subdivisions 4, 7; 62D.03, subdivision 
1.17 	1; 62D.05, subdivision 1; 62D.06, subdivision 1; 62D.14, subdivision 1; 62D.19; 
1.18 	62D.20, subdivision 1; 62D.22, subdivision 5; 62E.02, subdivision 3; 62J.49, 
1.19 	subdivision 1; 62J.61, subdivision 5; 62M.01, subdivision 3; 62Q.097, by adding 
1.20 	a subdivision; 62Q.14; 62V.05, subdivision 12; 62V.08; 62V.11, subdivision 4; 
1.21 	103I.621, subdivisions 1, 2; 121A.15, subdivision 3, by adding a subdivision; 
1.22 	144.05, subdivision 6, by adding a subdivision; 144.058; 144.0724, subdivisions 
1.23 	2, 3a, 4, 6, 7, 8, 9, 11; 144.1464, subdivisions 1, 2, 3; 144.1501, subdivision 5; 
1.24 	144.1911, subdivision 2; 144.212, by adding a subdivision; 144.216, subdivision 
1.25 	2, by adding subdivisions; 144.218, by adding a subdivision; 144.292, subdivision 
1.26 	6; 144.293, subdivisions 2, 4, 9, 10; 144.493, by adding a subdivision; 144.494, 
1.27 	subdivision 2; 144.551, subdivision 1; 144.555, subdivisions 1a, 1b, 2, by adding 
1.28 	subdivisions; 144.605, by adding a subdivision; 144.99, subdivision 3; 144A.10, 
1.29 	subdivisions 15, 16; 144A.471, by adding a subdivision; 144A.474, subdivision 
1.30 	13; 144A.61, subdivision 3a; 144A.70, subdivisions 3, 5, 6, 7; 144A.71, subdivision 
1.31 	2, by adding a subdivision; 144A.72, subdivision 1; 144A.73; 144E.001, subdivision 
1.32 	3a, by adding subdivisions; 144E.101, by adding a subdivision; 144E.16, 
1.33 	subdivisions 5, 7; 144E.19, subdivision 3; 144E.27, subdivisions 3, 5, 6; 144E.28, 
1.34 	subdivisions 3, 5, 6, 8; 144E.285, subdivisions 1, 2, 4, 6, by adding subdivisions; 
1.35 	144E.287; 144E.305, subdivision 3; 144G.08, subdivision 29; 144G.10, by adding 
1.36 	a subdivision; 144G.16, subdivision 6; 146B.03, subdivision 7a; 146B.10, 
1.37 	subdivisions 1, 3; 148.235, subdivision 10; 149A.02, subdivisions 3, 3b, 16, 23, 
1.38 	26a, 27, 35, 37c, by adding subdivisions; 149A.03; 149A.65; 149A.70, subdivisions 
1.39 	1, 2, 3, 5; 149A.71, subdivisions 2, 4; 149A.72, subdivisions 3, 9; 149A.73, 
1.40 	subdivision 1; 149A.74, subdivision 1; 149A.93, subdivision 3; 149A.94, 
1.41 	subdivisions 1, 3, 4; 149A.97, subdivision 2; 151.01, subdivisions 23, 27; 151.065, 
1.42 	by adding subdivisions; 151.066, subdivisions 1, 2, 3; 151.212, by adding a 
1.43 	subdivision; 151.37, by adding a subdivision; 151.74, subdivision 6; 152.22, 
2.1 	subdivision 14, by adding a subdivision; 152.25, subdivision 2; 152.27, subdivisions 
2.2 	2, 6, by adding a subdivision; 176.175, subdivision 2; 214.025; 214.04, subdivision 
2.3 	2a; 214.29; 214.31; 214.355; 243.166, subdivision 7, as amended; 245.096; 245.462, 
2.4 	subdivision 6; 245.4663, subdivision 2; 245A.04, subdivision 10, by adding a 
2.5 	subdivision; 245A.043, subdivisions 2, 4, by adding subdivisions; 245A.07, 
2.6 	subdivision 6; 245A.10, subdivisions 1, as amended, 2, as amended; 245A.14, 
2.7 	subdivision 17; 245A.144; 245A.175; 245A.52, subdivision 2, by adding a 
2.8 	subdivision; 245A.66, subdivision 2; 245C.05, subdivision 5; 245C.08, subdivision 
2.9 	4; 245C.10, subdivision 18; 245C.14, subdivision 1, by adding a subdivision; 
2.10 	245C.15, subdivisions 3, 4; 245C.22, subdivision 4; 245C.24, subdivisions 2, 5; 
2.11 	245C.30, by adding a subdivision; 245E.08; 245F.09, subdivision 2; 245F.14, by 
2.12 	adding a subdivision; 245F.17; 245G.07, subdivision 4; 245G.08, subdivisions 5, 
2.13 	6; 245G.10, by adding a subdivision; 245G.22, subdivisions 6, 7; 245H.01, by 
2.14 	adding subdivisions; 245H.08, subdivision 1; 245H.14, subdivisions 1, 4; 245I.02, 
2.15 	subdivisions 17, 19; 245I.10, subdivision 9; 245I.11, subdivision 1, by adding a 
2.16 	subdivision; 245I.20, subdivision 4; 245I.23, subdivision 14; 256.01, subdivision 
2.17 	41, by adding a subdivision; 256.029, as amended; 256.045, subdivisions 3b, as 
2.18 	amended, 5, as amended, 7, as amended; 256.0451, subdivisions 1, as amended, 
2.19 	22, 24; 256.046, subdivision 2, as amended; 256.9657, subdivision 8, by adding 
2.20 	a subdivision; 256.969, by adding subdivisions; 256B.056, subdivisions 1a, 10; 
2.21 	256B.0622, subdivisions 2a, 3a, 7a, 7d; 256B.0623, subdivision 5; 256B.0625, 
2.22 	subdivisions 12, 20, 39, by adding subdivisions; 256B.0757, subdivisions 4a, 4d, 
2.23 	by adding a subdivision; 256B.0943, subdivision 12; 256B.0947, subdivision 5; 
2.24 	256B.76, subdivision 6; 256B.795; 256I.04, subdivision 2f; 256J.08, subdivision 
2.25 	34a; 256J.28, subdivision 1; 256K.45, subdivision 2; 256N.22, subdivision 10; 
2.26 	256N.24, subdivision 10; 256N.26, subdivisions 12, 13, 15, 16, 18, 21, 22; 256P.05, 
2.27 	by adding a subdivision; 256R.02, subdivision 20; 259.20, subdivision 2; 259.37, 
2.28 	subdivision 2; 259.52, subdivisions 2, 4; 259.53, by adding a subdivision; 259.79, 
2.29 	subdivision 1; 259.83, subdivision 4; 260.755, subdivisions 2a, 5, 14, 17a, by 
2.30 	adding subdivisions; 260.775; 260.785, subdivisions 1, 3; 260.810, subdivision 3; 
2.31 	260C.007, subdivisions 6, 26b; 260C.141, by adding a subdivision; 260C.178, 
2.32 	subdivisions 1, as amended, 7; 260C.202; 260C.209, subdivision 1; 260C.212, 
2.33 	subdivisions 1, 2; 260C.301, subdivision 1, as amended; 260C.329, subdivisions 
2.34 	3, 8; 260C.4411, by adding a subdivision; 260C.515, subdivision 4; 260C.607, 
2.35 	subdivisions 1, 6; 260C.611; 260C.613, subdivision 1; 260C.615, subdivision 1; 
2.36 	260D.01; 260E.03, subdivision 23, as amended; 260E.30, subdivision 3, as 
2.37 	amended; 260E.33, subdivision 2, as amended; 317A.811, subdivisions 1, 2, 4; 
2.38 	393.07, subdivision 10a; 518.17, by adding a subdivision; 519.05; 524.3-801, as 
2.39 	amended; Minnesota Statutes 2023 Supplement, sections 13.46, subdivision 4, as 
2.40 	amended; 15A.0815, subdivision 2; 43A.08, subdivision 1a; 62J.84, subdivision 
2.41 	10; 62Q.46, subdivision 1; 62Q.473, by adding subdivisions; 62Q.522, subdivision 
2.42 	1; 119B.011, subdivision 15; 119B.16, subdivisions 1a, 1c; 119B.161, subdivision 
2.43 	2; 124D.142, subdivision 2, as amended; 142A.03, by adding a subdivision; 
2.44 	144.0526, subdivision 1; 144.1501, subdivisions 1, 2, 3, 4; 144.1505, subdivision 
2.45 	2; 144.2252, subdivision 2; 144.2253; 144.587, subdivision 4; 144A.4791, 
2.46 	subdivision 10; 144E.101, subdivisions 6, 7, as amended; 145.561, subdivision 4; 
2.47 	151.555, subdivisions 1, 4, 5, 6, 7, 8, 9, 11, 12; 151.74, subdivision 3; 152.126, 
2.48 	subdivision 6; 152.28, subdivision 1; 245.4889, subdivision 1; 245A.02, subdivision 
2.49 	2c; 245A.03, subdivisions 2, as amended, 7, as amended; 245A.043, subdivision 
2.50 	3; 245A.07, subdivision 1, as amended; 245A.11, subdivision 7; 245A.16, 
2.51 	subdivisions 1, as amended, 11; 245A.211, subdivision 4; 245A.242, subdivision 
2.52 	2; 245A.50, subdivisions 3, 4; 245A.66, subdivision 4, as amended; 245C.02, 
2.53 	subdivisions 6a, 13e; 245C.033, subdivision 3; 245C.08, subdivision 1; 245C.10, 
2.54 	subdivision 15; 245C.15, subdivisions 2, 4a; 245C.31, subdivision 1; 245G.22, 
2.55 	subdivisions 2, 17; 245H.06, subdivisions 1, 2; 245H.08, subdivisions 4, 5; 
2.56 	254B.04, subdivision 1a; 256.01, subdivision 12b; 256.043, subdivisions 3, 3a; 
2.57 	256.045, subdivision 3, as amended; 256.046, subdivision 3; 256.0471, subdivision 
2.58 	1, as amended; 256.969, subdivision 2b; 256B.0622, subdivisions 7b, 8; 256B.0625, 
3.1 	subdivisions 3a, 5m, 9, 13e, as amended, 13f, 13k, 16; 256B.064, subdivision 4; 
3.2 	256B.0671, subdivision 5; 256B.0701, subdivision 6; 256B.0947, subdivision 7; 
3.3 	256B.764; 256D.01, subdivision 1a; 256E.38, subdivision 4; 256I.05, subdivisions 
3.4 	1a, 11; 256L.03, subdivision 1; 256M.42, by adding a subdivision; 256P.06, 
3.5 	subdivision 3; 259.83, subdivisions 1, 1b, 3a; 260.014, by adding a subdivision; 
3.6 	260.755, subdivisions 1a, 3, 3a, 5b, 20, 22; 260.758, subdivisions 2, 4, 5; 260.761; 
3.7 	260.762; 260.763, subdivisions 1, 4, 5; 260.765, subdivisions 2, 3a, 4b; 260.771, 
3.8 	subdivisions 1a, 1b, 1c, 2b, 2d, 6, by adding a subdivision; 260.773, subdivisions 
3.9 	1, 2, 3, 4, 5, 10, 11; 260.774, subdivisions 1, 2, 3; 260.781, subdivision 1; 260.786, 
3.10 	subdivision 2; 260.795, subdivision 1; 342.01, subdivision 63; 342.52, subdivision 
3.11 	3; 342.53; 342.54, subdivision 2; 342.55, subdivision 2; 518A.42, subdivision 3; 
3.12 	Laws 1987, chapter 404, section 18, subdivision 1; Laws 2023, chapter 22, section 
3.13 	4, subdivision 2; Laws 2023, chapter 57, article 1, section 6; Laws 2023, chapter 
3.14 	70, article 1, section 35; article 11, section 13, subdivision 8; article 12, section 
3.15 	30, subdivisions 2, 3; article 14, section 42, subdivision 6; article 20, sections 2, 
3.16 	subdivisions 5, 22, 24, 29, 31; 3, subdivision 2; 12, as amended; 23; Laws 2024, 
3.17 	chapter 80, article 1, sections 38, subdivisions 1, 2, 5, 6, 7, 9; 96; article 2, sections 
3.18 	5, subdivision 21, by adding a subdivision; 6, subdivisions 2, 3, 3a, by adding a 
3.19 	subdivision; 7, subdivision 2; 10, subdivisions 1, 6; 16, subdivision 1, by adding 
3.20 	a subdivision; 30, subdivision 2; 31; 74; article 4, section 26; article 6, section 4; 
3.21 	article 7, section 4; proposing coding for new law in Minnesota Statutes, chapters 
3.22 	62D; 62J; 62Q; 137; 142A; 144; 144A; 144E; 145; 149A; 151; 214; 245C; 245H; 
3.23 	256B; 259; 260; 260D; 260E; 524; proposing coding for new law as Minnesota 
3.24 	Statutes, chapters 142B; 142F; 332C; repealing Minnesota Statutes 2022, sections 
3.25 	62A.041, subdivision 3; 144.218, subdivision 3; 144.497; 144E.001, subdivision 
3.26 	5; 144E.01; 144E.123, subdivision 5; 144E.27, subdivisions 1, 1a; 144E.50, 
3.27 	subdivision 3; 245A.065; 245C.125; 256.01, subdivisions 12, 12a; 256B.79, 
3.28 	subdivision 6; 256D.19, subdivisions 1, 2; 256D.20, subdivisions 1, 2, 3, 4; 
3.29 	256D.23, subdivisions 1, 2, 3; 256R.02, subdivision 46; 260.755, subdivision 13; 
3.30 	Minnesota Statutes 2023 Supplement, sections 62J.312, subdivision 6; 62Q.522, 
3.31 	subdivisions 3, 4; 144.0528, subdivision 5; 245C.08, subdivision 2; Laws 2023, 
3.32 	chapter 25, section 190, subdivision 10; Laws 2024, chapter 80, article 1, sections 
3.33 	38, subdivisions 3, 4, 11; 39; 43, subdivision 2; article 2, sections 1, subdivision 
3.34 	11; 3, subdivision 3; 4, subdivision 4; 6, subdivision 4; 10, subdivision 4; 33; 69; 
3.35 	article 7, sections 3; 9; Minnesota Rules, parts 9502.0425, subparts 5, 10; 
3.36 	9545.0805, subpart 1; 9545.0845; 9560.0232, subpart 5.
3.37 	May 19, 2024
3.38 	The Honorable Bobby Joe Champion
3.39 	President of the Senate
3.40 	The Honorable Melissa Hortman
3.41 	Speaker of the House of Representatives
3.42 	We, the undersigned conferees for S.F. No. 4699 report that we have agreed upon the 
3.43 	items in dispute and recommend as follows:
3.44 	That the House recede from its amendments and that S.F. No. 4699 be further amended 
3.45 	as follows:
3.46 	Delete everything after the enacting clause and insert:

4.1 	ARTICLE 1
4.2 	DEPARTMENT OF HUMAN SERVICES HEALTH CARE FINANCE

4.3 	Section 1. Minnesota Statutes 2023 Supplement, section 256.9631, is amended to read:
4.4 	256.9631 DIRECT PAYMENT SYSTEM ALTERNATIVE CARE DELIVERY 
4.5 	MODELS FOR MEDICAL ASSISTANCE AND MINNESOTACARE.
4.6 		Subdivision 1.Direction to the commissioner. (a) The commissioner, in order to deliver 
4.7 	services to eligible individuals, achieve better health outcomes, and reduce the cost of health 
4.8 	care for the state, shall develop an implementation plan plans for a direct payment system 
4.9 	to deliver services to eligible individuals in order to achieve better health outcomes and 
4.10 	reduce the cost of health care for the state. Under this system, at least three care delivery 
4.11 	models that:
4.12 	(1) are alternatives to the use of commercial managed care plans to deliver health care 
4.13 	to Minnesota health care program enrollees; and
4.14 	(2) do not shift financial risk to nongovernmental entities.
4.15 	(b) One of the alternative models must be a direct payment system under which eligible 
4.16 	individuals must receive services through the medical assistance fee-for-service system, 
4.17 	county-based purchasing plans, or and county-owned health maintenance organizations. At 
4.18 	least one additional model must include county-based purchasing plans and county-owned 
4.19 	health maintenance organizations in their design, and must allow these entities to deliver 
4.20 	care in geographic areas on a single plan basis, if:
4.21 	(1) these entities contract with all providers that agree to contract terms for network 
4.22 	participation; and
4.23 	(2) the commissioner of human services determines that an entity's provider network is 
4.24 	adequate to ensure enrollee access and choice.
4.25 	(c) Before determining the alternative models for which implementation plans will be 
4.26 	developed, the commissioner shall consult with the chairs and ranking minority members 
4.27 	of the legislative committees with jurisdiction over health care finance and policy.
4.28 	(d) The commissioner shall present an implementation plan plans for the direct payment 
4.29 	system selected models to the chairs and ranking minority members of the legislative 
4.30 	committees with jurisdiction over health care finance and policy by January 15, 2026. The 
4.31 	commissioner may contract for technical assistance in developing the implementation plan
4.32 	plans and conducting related studies and analyses.
5.1 	(b) For the purposes of the direct payment system, the commissioner shall make the 
5.2 	following assumptions:
5.3 	(1) health care providers are reimbursed directly for all medical assistance covered 
5.4 	services provided to eligible individuals, using the fee-for-service payment methods specified 
5.5 	in chapters 256, 256B, 256R, and 256S;
5.6 	(2) payments to a qualified hospital provider are equivalent to the payments that would 
5.7 	have been received based on managed care direct payment arrangements. If necessary, a 
5.8 	qualified hospital provider may use a county-owned health maintenance organization to 
5.9 	receive direct payments as described in section 256B.1973; and
5.10 	(3) county-based purchasing plans and county-owned health maintenance organizations 
5.11 	must be reimbursed at the capitation rate determined under sections 256B.69 and 256B.692.
5.12 		Subd. 2.Definitions. (a) For purposes of this section, the following terms have the 
5.13 	meanings given.
5.14 	(b) "Eligible individuals" means qualified all medical assistance enrollees, defined as 
5.15 	persons eligible for medical assistance as families and children and adults without children
5.16 	and MinnesotaCare enrollees.
5.17 	(c) "Minnesota health care programs" means the medical assistance and MinnesotaCare 
5.18 	programs.
5.19 	(c) (d) "Qualified hospital provider" means a nonstate government teaching hospital 
5.20 	with high medical assistance utilization and a level 1 trauma center, and all of the hospital's 
5.21 	owned or affiliated health care professionals, ambulance services, sites, and clinics.
5.22 		Subd. 3.Implementation plan plans. (a) The Each implementation plan must include:
5.23 	(1) a timeline for the development and recommended implementation date of the direct 
5.24 	payment system alternative model. In recommending a timeline, the commissioner must 
5.25 	consider:
5.26 	(i) timelines required by the existing contracts with managed care plans and county-based 
5.27 	purchasing plans to sunset existing delivery models;
5.28 	(ii) in counties that choose to operate a county-based purchasing plan under section 
5.29 	256B.692, timelines for any new procurements required for those counties to establish a 
5.30 	new county-based purchasing plan or participate in an existing county-based purchasing 
5.31 	plan;
6.1 	(iii) in counties that choose to operate a county-owned health maintenance organization 
6.2 	under section 256B.69, timelines for any new procurements required for those counties to 
6.3 	establish a new county-owned health maintenance organization or to continue serving 
6.4 	enrollees through an existing county-owned health maintenance organization; and
6.5 	(iv) a recommendation on whether the commissioner should contract with a third-party 
6.6 	administrator to administer the direct payment system alternative model, and the timeline 
6.7 	needed for procuring an administrator;
6.8 	(2) the procedures to be used to ensure continuity of care for enrollees who transition 
6.9 	from managed care to fee-for-service and any administrative resources needed to carry out 
6.10 	these procedures;
6.11 	(3) recommended quality measures for health care service delivery;
6.12 	(4) any changes to fee-for-service payment rates that the commissioner determines are 
6.13 	necessary to ensure provider access and high-quality care and to reduce health disparities;
6.14 	(5) recommendations on ensuring effective care coordination under the direct payment 
6.15 	system alternative model, especially for enrollees who:
6.16 	(i) are age 65 or older, blind, or have disabilities;
6.17 	(ii) have complex medical conditions, who;
6.18 	(iii) face socioeconomic barriers to receiving care, or who; or
6.19 	(iv) are from underserved populations that experience health disparities;
6.20 	(6) recommendations on whether the direct payment system should provide supplemental 
6.21 	payments payment arrangements for care coordination, including:
6.22 	(i) the provider types eligible for supplemental care coordination payments;
6.23 	(ii) procedures to coordinate supplemental care coordination payments with existing 
6.24 	supplemental or cost-based payment methods or to replace these existing methods; and
6.25 	(iii) procedures to align care coordination initiatives funded through supplemental 
6.26 	payments under this section the alternative model with existing care coordination initiatives;
6.27 	(7) recommendations on whether the direct payment system alternative model should 
6.28 	include funding to providers for outreach initiatives to patients who, because of mental 
6.29 	illness, homelessness, or other circumstances, are unlikely to obtain needed care and 
6.30 	treatment;
7.1 	(8) recommendations for a supplemental payment to qualified hospital providers to offset 
7.2 	any potential revenue losses resulting from the shift from managed care payments; and
7.3 	(9) recommendations on whether and how the direct payment system should be expanded 
7.4 	to deliver services and care coordination to medical assistance enrollees who are age 65 or 
7.5 	older, are blind, or have a disability and to persons enrolled in MinnesotaCare; and
7.6 	(10) (9) recommendations for statutory changes necessary to implement the direct 
7.7 	payment system alternative model.
7.8 	(b) In developing the each implementation plan, the commissioner shall:
7.9 	(1) calculate the projected cost of a direct payment system the alternative model relative 
7.10 	to the cost of the current system;
7.11 	(2) assess gaps in care coordination under the current medical assistance and 
7.12 	MinnesotaCare programs;
7.13 	(3) evaluate the effectiveness of approaches other states have taken to coordinate care 
7.14 	under a fee-for-service system, including the coordination of care provided to persons who 
7.15 	are age 65 or older, are blind, or have disabilities;
7.16 	(4) estimate the loss of revenue and cost savings from other payment enhancements 
7.17 	based on managed care plan directed payments and pass-throughs;
7.18 	(5) estimate cost trends under a direct payment system the alternative model for managed 
7.19 	care payments to county-based purchasing plans and county-owned health maintenance 
7.20 	organizations;
7.21 	(6) estimate the impact of a direct payment system the alternative model on other revenue, 
7.22 	including taxes, surcharges, or other federally approved in lieu of services and on other 
7.23 	arrangements allowed under managed care;
7.24 	(7) consider allowing eligible individuals to opt out of managed care as an alternative 
7.25 	approach;
7.26 	(8) assess the feasibility of a medical assistance outpatient prescription drug benefit 
7.27 	carve-out under section 256B.69, subdivision 6d, and in consultation with the commissioners 
7.28 	of commerce and health, assess the feasibility of including MinnesotaCare enrollees and 
7.29 	private sector enrollees of health plan companies in the drug benefit carve-out. The 
7.30 	assessment of feasibility must address and include recommendations related to the process 
7.31 	and terms by which the commissioner would contract with health plan companies to 
8.1 	administer prescription drug benefits and develop and manage a drug formulary, and the 
8.2 	impact of the drug-benefit carve-out on health care providers, including small pharmacies;
8.3 	(9) (8) consult with the commissioners of health and commerce and the contractor or 
8.4 	contractors analyzing the Minnesota Health Plan under section 19 and other health reform 
8.5 	models on plan design and assumptions; and
8.6 	(10) (9) conduct other analyses necessary to develop the implementation plan.

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

8.8 	Sec. 2. Minnesota Statutes 2022, section 256.9657, is amended by adding a subdivision 
8.9 	to read:
8.10 		Subd. 2a.Teaching hospital surcharge. (a) Each teaching hospital shall pay to the 
8.11 	medical assistance account a surcharge equal to 1.41 percent of its fiscal year 2021 net 
8.12 	patient revenue for inpatient services. The initial surcharge must not be collected more than 
8.13 	30 days before the commissioner makes the first of the payments required under section 
8.14 	256.969, subdivision 2g. Subsequent surcharge payments must be paid annually in the form 
8.15 	and manner specified by the commissioner. The surcharge must comply with all applicable 
8.16 	federal requirements and federal laws, including but not limited to Code of Federal 
8.17 	Regulations, title 42, section 433.68.
8.18 	(b) Revenue from the surcharge must be used by the commissioner only to pay the 
8.19 	nonfederal share of the medical assistance supplemental payments described in section 
8.20 	256.969, subdivision 2g, and must be used to supplement, and not supplant, medical 
8.21 	assistance reimbursement to teaching hospitals.
8.22 	(c) For purposes of this subdivision, "teaching hospital" means any Minnesota hospital 
8.23 	with a Centers for Medicare and Medicaid Services designation of "teaching hospital" as 
8.24 	reported on form CMS-2552-10, worksheet S-2, line 56, that is eligible for reimbursement 
8.25 	under section 256.969, subdivision 2g.
8.26 	(d) Notwithstanding paragraph (c), the following hospitals are exempt from paying the 
8.27 	surcharge under this section:
8.28 	(1) all hospitals in Minnesota designated as a children's hospital under Medicare, including 
8.29 	Children's Health Care, doing business as Children's Minnesota, and Gillette Children's 
8.30 	Specialty Healthcare, doing business as Gillette Children's;
8.31 	(2) teaching hospitals with three or fewer full-time equivalent trainees, based on a 
8.32 	Medicare cost report filed for the fiscal year ending in 2022;
9.1 	(3) federal Indian Health Service facilities; and
9.2 	(4) regional treatment centers.
9.3 	(e) The teaching hospital surcharge established under this subdivision must only be 
9.4 	assessed if the annual inpatient supplemental payments under section 256.969, subdivision 
9.5 	2g, are approved by the Centers for Medicare and Medicaid Services.
9.6 	(f) The commissioner must reduce the surcharge percentage in paragraph (a) such that 
9.7 	the aggregate amount collected from hospitals under this subdivision does not exceed the 
9.8 	total amount needed for the nonfederal share of the annual inpatient supplemental payments 
9.9 	authorized by section 256.969, subdivision 2g.
9.10 	(g) For purposes of this subdivision, net patient revenue for inpatient services must be 
9.11 	calculated by:
9.12 	(1) determining gross inpatient hospital facility charges from the hospital's audited 
9.13 	statements or, if not contained or segregated within the hospital's audited financial statements, 
9.14 	using detailed internal financial income statements or schedules; and
9.15 	(2) subtracting from gross inpatient hospital facility charges:
9.16 	(i) all professional fee charges, home health charges, skilled nursing facility charges, 
9.17 	hospice charges, end-stage renal disease charges, and other nonhospital charges; and
9.18 	(ii) applicable contractual allowances.
9.19 	(h) Teaching hospitals subject to the surcharge under this subdivision shall submit to 
9.20 	the commissioner, in the form and manner specified by the commissioner, all documentation 
9.21 	necessary to provide reconciliation of the net patient revenue calculation under paragraph 
9.22 	(b).
9.23 	(i) This subdivision is effective on the later of July 1, 2025, or 60 days after the end of 
9.24 	the first legislative regular session that begins following federal approval for all of the 
9.25 	following: (1) the amendment in this act adding section 256.9657, subdivision 2a; (2) the 
9.26 	amendment in this act to section 256.969, subdivision 2b; and (3) the amendment in this 
9.27 	act adding section 256.969, subdivision 2g. The commissioner of human services shall 
9.28 	notify the revisor of statutes when federal approval is obtained.
9.29 	(j) This subdivision is subject to the implementation requirements in section 9.
9.30 	(k) This subdivision expires June 30, 2030, or five years after federal approval is obtained, 
9.31 	whichever is later.

10.1 	Sec. 3. Minnesota Statutes 2023 Supplement, section 256.969, subdivision 2b, is amended 
10.2 	to read:
10.3 		Subd. 2b.Hospital payment rates. (a) For discharges occurring on or after November 
10.4 	1, 2014, hospital inpatient services for hospitals located in Minnesota shall be paid according 
10.5 	to the following:
10.6 	(1) critical access hospitals as defined by Medicare shall be paid using a cost-based 
10.7 	methodology;
10.8 	(2) long-term hospitals as defined by Medicare shall be paid on a per diem methodology 
10.9 	under subdivision 25;
10.10 	(3) rehabilitation hospitals or units of hospitals that are recognized as rehabilitation 
10.11 	distinct parts as defined by Medicare shall be paid according to the methodology under 
10.12 	subdivision 12; and
10.13 	(4) all other hospitals shall be paid on a diagnosis-related group (DRG) methodology.
10.14 	(b) For the period beginning January 1, 2011, through October 31, 2014, rates shall not 
10.15 	be rebased, except that a Minnesota long-term hospital shall be rebased effective January 
10.16 	1, 2011, based on its most recent Medicare cost report ending on or before September 1, 
10.17 	2008, with the provisions under subdivisions 9 and 23, based on the rates in effect on 
10.18 	December 31, 2010. For rate setting periods after November 1, 2014, in which the base 
10.19 	years are updated, a Minnesota long-term hospital's base year shall remain within the same 
10.20 	period as other hospitals.
10.21 	(c) Effective for discharges occurring on and after November 1, 2014, payment rates 
10.22 	for hospital inpatient services provided by hospitals located in Minnesota or the local trade 
10.23 	area, except for the hospitals paid under the methodologies described in paragraph (a), 
10.24 	clauses (2) and (3), shall be rebased, incorporating cost and payment methodologies in a 
10.25 	manner similar to Medicare. The base year or years for the rates effective November 1, 
10.26 	2014, shall be calendar year 2012. The rebasing under this paragraph shall be budget neutral, 
10.27 	ensuring that the total aggregate payments under the rebased system are equal to the total 
10.28 	aggregate payments that were made for the same number and types of services in the base 
10.29 	year. Separate budget neutrality calculations shall be determined for payments made to 
10.30 	critical access hospitals and payments made to hospitals paid under the DRG system. Only 
10.31 	the rate increases or decreases under subdivision 3a or 3c that applied to the hospitals being 
10.32 	rebased during the entire base period shall be incorporated into the budget neutrality 
10.33 	calculation.
11.1 	(d) For discharges occurring on or after November 1, 2014, through the next rebasing 
11.2 	that occurs, the rebased rates under paragraph (c) that apply to hospitals under paragraph 
11.3 	(a), clause (4), shall include adjustments to the projected rates that result in no greater than 
11.4 	a five percent increase or decrease from the base year payments for any hospital. Any 
11.5 	adjustments to the rates made by the commissioner under this paragraph and paragraph (e) 
11.6 	shall maintain budget neutrality as described in paragraph (c).
11.7 	(e) For discharges occurring on or after November 1, 2014, the commissioner may make 
11.8 	additional adjustments to the rebased rates, and when evaluating whether additional 
11.9 	adjustments should be made, the commissioner shall consider the impact of the rates on the 
11.10 	following:
11.11 	(1) pediatric services;
11.12 	(2) behavioral health services;
11.13 	(3) trauma services as defined by the National Uniform Billing Committee;
11.14 	(4) transplant services;
11.15 	(5) obstetric services, newborn services, and behavioral health services provided by 
11.16 	hospitals outside the seven-county metropolitan area;
11.17 	(6) outlier admissions;
11.18 	(7) low-volume providers; and
11.19 	(8) services provided by small rural hospitals that are not critical access hospitals.
11.20 	(f) Hospital payment rates established under paragraph (c) must incorporate the following:
11.21 	(1) for hospitals paid under the DRG methodology, the base year payment rate per 
11.22 	admission is standardized by the applicable Medicare wage index and adjusted by the 
11.23 	hospital's disproportionate population adjustment;
11.24 	(2) for critical access hospitals, payment rates for discharges between November 1, 2014, 
11.25 	and June 30, 2015, shall be set to the same rate of payment that applied for discharges on 
11.26 	October 31, 2014;
11.27 	(3) the cost and charge data used to establish hospital payment rates must only reflect 
11.28 	inpatient services covered by medical assistance; and
11.29 	(4) in determining hospital payment rates for discharges occurring on or after the rate 
11.30 	year beginning January 1, 2011, through December 31, 2012, the hospital payment rate per 
11.31 	discharge shall be based on the cost-finding methods and allowable costs of the Medicare 
12.1 	program in effect during the base year or years. In determining hospital payment rates for 
12.2 	discharges in subsequent base years, the per discharge rates shall be based on the cost-finding 
12.3 	methods and allowable costs of the Medicare program in effect during the base year or 
12.4 	years.
12.5 	(g) The commissioner shall validate the rates effective November 1, 2014, by applying 
12.6 	the rates established under paragraph (c), and any adjustments made to the rates under 
12.7 	paragraph (d) or (e), to hospital claims paid in calendar year 2013 to determine whether the 
12.8 	total aggregate payments for the same number and types of services under the rebased rates 
12.9 	are equal to the total aggregate payments made during calendar year 2013.
12.10 	(h) Effective for discharges occurring on or after July 1, 2017, and every two years 
12.11 	thereafter, payment rates under this section shall be rebased to reflect only those changes 
12.12 	in hospital costs between the existing base year or years and the next base year or years. In 
12.13 	any year that inpatient claims volume falls below the threshold required to ensure a 
12.14 	statistically valid sample of claims, the commissioner may combine claims data from two 
12.15 	consecutive years to serve as the base year. Years in which inpatient claims volume is 
12.16 	reduced or altered due to a pandemic or other public health emergency shall not be used as 
12.17 	a base year or part of a base year if the base year includes more than one year. Changes in 
12.18 	costs between base years shall be measured using the lower of the hospital cost index defined 
12.19 	in subdivision 1, paragraph (a), or the percentage change in the case mix adjusted cost per 
12.20 	claim. The commissioner shall establish the base year for each rebasing period considering 
12.21 	the most recent year or years for which filed Medicare cost reports are available, except 
12.22 	that the base years for the rebasing effective July 1, 2023, are calendar years 2018 and 2019. 
12.23 	The estimated change in the average payment per hospital discharge resulting from a 
12.24 	scheduled rebasing must be calculated and made available to the legislature by January 15 
12.25 	of each year in which rebasing is scheduled to occur, and must include by hospital the 
12.26 	differential in payment rates compared to the individual hospital's costs.
12.27 	(i) Effective for discharges occurring on or after July 1, 2015, inpatient payment rates 
12.28 	for critical access hospitals located in Minnesota or the local trade area shall be determined 
12.29 	using a new cost-based methodology. The commissioner shall establish within the 
12.30 	methodology tiers of payment designed to promote efficiency and cost-effectiveness. 
12.31 	Payment rates for hospitals under this paragraph shall be set at a level that does not exceed 
12.32 	the total cost for critical access hospitals as reflected in base year cost reports. Until the 
12.33 	next rebasing that occurs, the new methodology shall result in no greater than a five percent 
12.34 	decrease from the base year payments for any hospital, except a hospital that had payments 
12.35 	that were greater than 100 percent of the hospital's costs in the base year shall have their 
13.1 	rate set equal to 100 percent of costs in the base year. The rates paid for discharges on and 
13.2 	after July 1, 2016, covered under this paragraph shall be increased by the inflation factor 
13.3 	in subdivision 1, paragraph (a). The new cost-based rate shall be the final rate and shall not 
13.4 	be settled to actual incurred costs. Hospitals shall be assigned a payment tier based on the 
13.5 	following criteria:
13.6 	(1) hospitals that had payments at or below 80 percent of their costs in the base year 
13.7 	shall have a rate set that equals 85 percent of their base year costs;
13.8 	(2) hospitals that had payments that were above 80 percent, up to and including 90 
13.9 	percent of their costs in the base year shall have a rate set that equals 95 percent of their 
13.10 	base year costs; and
13.11 	(3) hospitals that had payments that were above 90 percent of their costs in the base year 
13.12 	shall have a rate set that equals 100 percent of their base year costs.
13.13 	(j) The commissioner may refine the payment tiers and criteria for critical access hospitals 
13.14 	to coincide with the next rebasing under paragraph (h). The factors used to develop the new 
13.15 	methodology may include, but are not limited to:
13.16 	(1) the ratio between the hospital's costs for treating medical assistance patients and the 
13.17 	hospital's charges to the medical assistance program;
13.18 	(2) the ratio between the hospital's costs for treating medical assistance patients and the 
13.19 	hospital's payments received from the medical assistance program for the care of medical 
13.20 	assistance patients;
13.21 	(3) the ratio between the hospital's charges to the medical assistance program and the 
13.22 	hospital's payments received from the medical assistance program for the care of medical 
13.23 	assistance patients;
13.24 	(4) the statewide average increases in the ratios identified in clauses (1), (2), and (3);
13.25 	(5) the proportion of that hospital's costs that are administrative and trends in 
13.26 	administrative costs; and
13.27 	(6) geographic location.
13.28 	(k) Subject to subdivision 2g, effective for discharges occurring on or after January 1, 
13.29 	2024, the rates paid to hospitals described in paragraph (a), clauses (2) to (4), must include 
13.30 	a rate factor specific to each hospital that qualifies for a medical education and research 
13.31 	cost distribution under section 62J.692, subdivision 4, paragraph (a).

14.1 	EFFECTIVE DATE. (a) This section is effective the later of July 1, 2025, or 60 days 
14.2 	after the end of the first legislative session that begins following federal approval of all of 
14.3 	the following:
14.4 	(1) the amendment in this act to add Minnesota Statutes, section 256.9657, subdivision 
14.5 	2a;
14.6 	(2) the amendments in this act to Minnesota Statutes, section 256.969, subdivision 2b; 
14.7 	and
14.8 	(3) the amendment in this act to add Minnesota Statutes, section 256.969, subdivision 
14.9 	2g.
14.10 	(b) The commissioner of human services shall notify the revisor of statutes when federal 
14.11 	approval is obtained.

14.12 	Sec. 4. Minnesota Statutes 2022, section 256.969, is amended by adding a subdivision to 
14.13 	read:
14.14 		Subd. 2g.Annual supplemental payment for graduate medical education. (a) The 
14.15 	commissioner and contracted managed care organizations shall annually pay an inpatient 
14.16 	supplemental payment to all eligible hospitals for graduate medical education. A hospital 
14.17 	must be an eligible hospital to receive an annual supplemental payment under this 
14.18 	subdivision. Payments under this subdivision must comply with all applicable federal 
14.19 	requirements and federal laws and meet the requirements of Code of Federal Regulations, 
14.20 	title 42, section 438.60.
14.21 	(b) For purposes of this subdivision, "eligible hospital" means a hospital that:
14.22 	(1) is located in Minnesota;
14.23 	(2) participates in Minnesota's medical assistance program;
14.24 	(3) has received fee-for-service medical assistance payments in the payment year; and
14.25 	(4) is either:
14.26 	(i) eligible to receive graduate medical education payments from the Medicare program 
14.27 	under Code of Federal Regulations, title 42, section 413.75; or
14.28 	(ii) a hospital in Minnesota designated as a children's hospital under Medicare, including 
14.29 	Children's Health Care, doing business as Children's Minnesota, and Gillette Children's 
14.30 	Specialty Healthcare, doing business as Gillette Children's.
14.31 	(c) The annual inpatient supplemental payment must be calculated as follows:
15.1 	(1) $425,000 per full-time equivalent trained for each of the first ten full-time equivalents 
15.2 	at a hospital;
15.3 	(2) $350,000 per full-time equivalent trained for each full-time equivalent between 11 
15.4 	and 20 full-time equivalents at a hospital;
15.5 	(3) $95,000 per full-time equivalent trained for each full-time equivalent between 21 
15.6 	and 30 full-time equivalents at a hospital;
15.7 	(4) $70,000 per full-time equivalent trained for each full-time equivalent between 31 
15.8 	and 400 full-time equivalents at a hospital; and
15.9 	(5) $50,000 per full-time equivalent trained for each full-time equivalent above 401 
15.10 	full-time equivalents at a hospital.
15.11 	(d) The data source for the full-time equivalent trained under paragraph (c) must be the 
15.12 	Medicare cost report for the fiscal year ending in calendar year 2022. The full-time equivalent 
15.13 	is calculated by adding the two values populated on lines 10 and 11 on worksheet E, part 
15.14 	A, of the Medicare cost report for that year, except that for eligible hospitals that are children's 
15.15 	hospitals, the full-time equivalent is calculated based on interns and residents, as determined 
15.16 	by adding form CMS-2552-10, worksheet E-4, lines 6, 10.01, and 15.01, or its equivalent, 
15.17 	for that year.
15.18 	(e) An eligible hospital must not accept any reimbursement under section 62J.692 if it 
15.19 	would result in payments in excess of eligible expenditures. The surcharge paid under section 
15.20 	256.9657, subdivision 2a, and the payment received under this section must be reported in 
15.21 	the application under section 62J.692.
15.22 	(f) The supplemental payments under this subdivision:
15.23 	(1) must not be included as public program revenue under section 62J.692; and
15.24 	(2) must be deemed permissible pass-through payments for graduate medical education 
15.25 	under Code of Federal Regulations, title 42, section 438.6(d), or when the state makes 
15.26 	payments directly to teaching hospitals for graduate medical education costs approved under 
15.27 	the state plan under Code of Federal Regulations, title 42, section 438.60.
15.28 	(g) The total aggregate state and federal supplemental payments for hospitals under this 
15.29 	subdivision must not exceed $203,000,000 per year. The commissioner may reduce the 
15.30 	amount paid for each full-time equivalent, as described in paragraph (c), on an equal basis 
15.31 	to limit the total cost of all supplemental payments to the total dollar amounts available.
16.1 	(h) This subdivision is effective the later of July 1, 2025, or 60 days after the end of the 
16.2 	first legislative regular session that begins following federal approval for all of the following: 
16.3 	(1) the amendment in this act adding section 256.9657, subdivision 2a; (2) the amendment 
16.4 	in this act to section 256.969, subdivision 2b; and (3) the amendment in this act to add 
16.5 	section 256.969, subdivision 2g. The commissioner of human services shall notify the revisor 
16.6 	of statutes when federal approval is obtained.
16.7 	(i) This subdivision is subject to the implementation requirements in section 9.
16.8 	(j) This subdivision expires June 30, 2030, or five years after federal approval is obtained, 
16.9 	whichever is later.

16.10 	Sec. 5. Minnesota Statutes 2022, section 256.969, is amended by adding a subdivision to 
16.11 	read:
16.12 		Subd. 32.Biological products for cell and gene therapy. (a) Effective July 1, 2025, 
16.13 	and upon necessary federal approval of documentation required to enter into a value-based 
16.14 	arrangement under section 256B.0625, subdivision 13k, the commissioner may provide 
16.15 	separate reimbursement to hospitals for biological products provided in the inpatient hospital 
16.16 	setting as part of cell or gene therapy to treat rare diseases, as defined in United States Code, 
16.17 	title 21, section 360bb, if the drug manufacturer enters into a value-based arrangement with 
16.18 	the commissioner.
16.19 	(b) The commissioner shall establish the separate reimbursement rate for biological 
16.20 	products provided under paragraph (a) based on the methodology used for drugs administered 
16.21 	in an outpatient setting under section 256B.0625, subdivision 13e, paragraph (e).

16.22 	EFFECTIVE DATE. This section is effective July 1, 2025.

16.23 	Sec. 6. Minnesota Statutes 2023 Supplement, section 256B.0625, subdivision 13e, as 
16.24 	amended by Laws 2024, chapter 85, section 66, is amended to read:
16.25 		Subd. 13e.Payment rates. (a) The basis for determining the amount of payment shall 
16.26 	be the lower of the ingredient costs of the drugs plus the professional dispensing fee; or the 
16.27 	usual and customary price charged to the public. The usual and customary price means the 
16.28 	lowest price charged by the provider to a patient who pays for the prescription by cash, 
16.29 	check, or charge account and includes prices the pharmacy charges to a patient enrolled in 
16.30 	a prescription savings club or prescription discount club administered by the pharmacy or 
16.31 	pharmacy chain. The amount of payment basis must be reduced to reflect all discount 
16.32 	amounts applied to the charge by any third-party provider/insurer agreement or contract for 
17.1 	submitted charges to medical assistance programs. The net submitted charge may not be 
17.2 	greater than the patient liability for the service. The professional dispensing fee shall be 
17.3 	$10.77 $11.55 for prescriptions filled with legend drugs meeting the definition of "covered 
17.4 	outpatient drugs" according to United States Code, title 42, section 1396r-8(k)(2). The 
17.5 	dispensing fee for intravenous solutions that must be compounded by the pharmacist shall 
17.6 	be $10.77 $11.55 per claim. The professional dispensing fee for prescriptions filled with 
17.7 	over-the-counter drugs meeting the definition of covered outpatient drugs shall be $10.77
17.8 	$11.55 for dispensed quantities equal to or greater than the number of units contained in 
17.9 	the manufacturer's original package. The professional dispensing fee shall be prorated based 
17.10 	on the percentage of the package dispensed when the pharmacy dispenses a quantity less 
17.11 	than the number of units contained in the manufacturer's original package. The pharmacy 
17.12 	dispensing fee for prescribed over-the-counter drugs not meeting the definition of covered 
17.13 	outpatient drugs shall be $3.65 for quantities equal to or greater than the number of units 
17.14 	contained in the manufacturer's original package and shall be prorated based on the 
17.15 	percentage of the package dispensed when the pharmacy dispenses a quantity less than the 
17.16 	number of units contained in the manufacturer's original package. The National Average 
17.17 	Drug Acquisition Cost (NADAC) shall be used to determine the ingredient cost of a drug. 
17.18 	For drugs for which a NADAC is not reported, the commissioner shall estimate the ingredient 
17.19 	cost at the wholesale acquisition cost minus two percent. The ingredient cost of a drug for 
17.20 	a provider participating in the federal 340B Drug Pricing Program shall be either the 340B 
17.21 	Drug Pricing Program ceiling price established by the Health Resources and Services 
17.22 	Administration or NADAC, whichever is lower. Wholesale acquisition cost is defined as 
17.23 	the manufacturer's list price for a drug or biological to wholesalers or direct purchasers in 
17.24 	the United States, not including prompt pay or other discounts, rebates, or reductions in 
17.25 	price, for the most recent month for which information is available, as reported in wholesale 
17.26 	price guides or other publications of drug or biological pricing data. The maximum allowable 
17.27 	cost of a multisource drug may be set by the commissioner and it shall be comparable to 
17.28 	the actual acquisition cost of the drug product and no higher than the NADAC of the generic 
17.29 	product. Establishment of the amount of payment for drugs shall not be subject to the 
17.30 	requirements of the Administrative Procedure Act.
17.31 	(b) Pharmacies dispensing prescriptions to residents of long-term care facilities using 
17.32 	an automated drug distribution system meeting the requirements of section 151.58, or a 
17.33 	packaging system meeting the packaging standards set forth in Minnesota Rules, part 
17.34 	6800.2700, that govern the return of unused drugs to the pharmacy for reuse, may employ 
17.35 	retrospective billing for prescription drugs dispensed to long-term care facility residents. A 
17.36 	retrospectively billing pharmacy must submit a claim only for the quantity of medication 
18.1 	used by the enrolled recipient during the defined billing period. A retrospectively billing 
18.2 	pharmacy must use a billing period not less than one calendar month or 30 days.
18.3 	(c) A pharmacy provider using packaging that meets the standards set forth in Minnesota 
18.4 	Rules, part 6800.2700, is required to credit the department for the actual acquisition cost 
18.5 	of all unused drugs that are eligible for reuse, unless the pharmacy is using retrospective 
18.6 	billing. The commissioner may permit the drug clozapine to be dispensed in a quantity that 
18.7 	is less than a 30-day supply.
18.8 	(d) If a pharmacy dispenses a multisource drug, the ingredient cost shall be the NADAC 
18.9 	of the generic product or the maximum allowable cost established by the commissioner 
18.10 	unless prior authorization for the brand name product has been granted according to the 
18.11 	criteria established by the Drug Formulary Committee as required by subdivision 13f, 
18.12 	paragraph (a), and the prescriber has indicated "dispense as written" on the prescription in 
18.13 	a manner consistent with section 151.21, subdivision 2.
18.14 	(e) The basis for determining the amount of payment for drugs administered in an 
18.15 	outpatient setting shall be the lower of the usual and customary cost submitted by the 
18.16 	provider, 106 percent of the average sales price as determined by the United States 
18.17 	Department of Health and Human Services pursuant to title XVIII, section 1847a of the 
18.18 	federal Social Security Act, the specialty pharmacy rate, or the maximum allowable cost 
18.19 	set by the commissioner. If average sales price is unavailable, the amount of payment must 
18.20 	be lower of the usual and customary cost submitted by the provider, the wholesale acquisition 
18.21 	cost, the specialty pharmacy rate, or the maximum allowable cost set by the commissioner. 
18.22 	The commissioner shall discount the payment rate for drugs obtained through the federal 
18.23 	340B Drug Pricing Program by 28.6 percent. The payment for drugs administered in an 
18.24 	outpatient setting shall be made to the administering facility or practitioner. A retail or 
18.25 	specialty pharmacy dispensing a drug for administration in an outpatient setting is not 
18.26 	eligible for direct reimbursement.
18.27 	(f) The commissioner may establish maximum allowable cost rates for specialty pharmacy 
18.28 	products that are lower than the ingredient cost formulas specified in paragraph (a). The 
18.29 	commissioner may require individuals enrolled in the health care programs administered 
18.30 	by the department to obtain specialty pharmacy products from providers with whom the 
18.31 	commissioner has negotiated lower reimbursement rates. Specialty pharmacy products are 
18.32 	defined as those used by a small number of recipients or recipients with complex and chronic 
18.33 	diseases that require expensive and challenging drug regimens. Examples of these conditions 
18.34 	include, but are not limited to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis C, 
18.35 	growth hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms of 
19.1 	cancer. Specialty pharmaceutical products include injectable and infusion therapies, 
19.2 	biotechnology drugs, antihemophilic factor products, high-cost therapies, and therapies that 
19.3 	require complex care. The commissioner shall consult with the Formulary Committee to 
19.4 	develop a list of specialty pharmacy products subject to maximum allowable cost 
19.5 	reimbursement. In consulting with the Formulary Committee in developing this list, the 
19.6 	commissioner shall take into consideration the population served by specialty pharmacy 
19.7 	products, the current delivery system and standard of care in the state, and access to care 
19.8 	issues. The commissioner shall have the discretion to adjust the maximum allowable cost 
19.9 	to prevent access to care issues.
19.10 	(g) Home infusion therapy services provided by home infusion therapy pharmacies must 
19.11 	be paid at rates according to subdivision 8d.
19.12 	(h) The commissioner shall contract with a vendor to conduct a cost of dispensing survey 
19.13 	for all pharmacies that are physically located in the state of Minnesota that dispense outpatient 
19.14 	drugs under medical assistance. The commissioner shall ensure that the vendor has prior 
19.15 	experience in conducting cost of dispensing surveys. Each pharmacy enrolled with the 
19.16 	department to dispense outpatient prescription drugs to fee-for-service members must 
19.17 	respond to the cost of dispensing survey. The commissioner may sanction a pharmacy under 
19.18 	section 256B.064 for failure to respond. The commissioner shall require the vendor to 
19.19 	measure a single statewide cost of dispensing for specialty prescription drugs and a single 
19.20 	statewide cost of dispensing for nonspecialty prescription drugs for all responding pharmacies 
19.21 	to measure the mean, mean weighted by total prescription volume, mean weighted by 
19.22 	medical assistance prescription volume, median, median weighted by total prescription 
19.23 	volume, and median weighted by total medical assistance prescription volume. The 
19.24 	commissioner shall post a copy of the final cost of dispensing survey report on the 
19.25 	department's website. The initial survey must be completed no later than January 1, 2021, 
19.26 	and repeated every three years. The commissioner shall provide a summary of the results 
19.27 	of each cost of dispensing survey and provide recommendations for any changes to the 
19.28 	dispensing fee to the chairs and ranking minority members of the legislative committees 
19.29 	with jurisdiction over medical assistance pharmacy reimbursement. Notwithstanding section 
19.30 	256.01, subdivision 42, this paragraph does not expire.
19.31 	(i) The commissioner shall increase the ingredient cost reimbursement calculated in 
19.32 	paragraphs (a) and (f) by 1.8 percent for prescription and nonprescription drugs subject to 
19.33 	the wholesale drug distributor tax under section 295.52.

19.34 	EFFECTIVE DATE. This section is effective October 1, 2024.

20.1 	Sec. 7. Minnesota Statutes 2023 Supplement, section 256B.0625, subdivision 13k, is 
20.2 	amended to read:
20.3 		Subd. 13k.Value-based purchasing arrangements. (a) The commissioner may enter 
20.4 	into a value-based purchasing arrangement under medical assistance or MinnesotaCare, by 
20.5 	written arrangement with a drug manufacturer based on agreed-upon metrics. The 
20.6 	commissioner may contract with a vendor to implement and administer the value-based 
20.7 	purchasing arrangement. A value-based purchasing arrangement may include but is not 
20.8 	limited to rebates, discounts, price reductions, risk sharing, reimbursements, guarantees, 
20.9 	shared savings payments, withholds, or bonuses. A value-based purchasing arrangement 
20.10 	must provide at least the same value or discount in the aggregate as would claiming the 
20.11 	mandatory federal drug rebate under the Federal Social Security Act, section 1927.
20.12 	(b) Nothing in this section shall be interpreted as requiring a drug manufacturer or the 
20.13 	commissioner to enter into an arrangement as described in paragraph (a).
20.14 	(c) Nothing in this section shall be interpreted as altering or modifying medical assistance 
20.15 	coverage requirements under the federal Social Security Act, section 1927.
20.16 	(d) If the commissioner determines that a state plan amendment is necessary before 
20.17 	implementing a value-based purchasing arrangement, the commissioner shall request the 
20.18 	amendment and may delay implementing this provision until the amendment is approved.
20.19 	(e) The commissioner may provide separate reimbursement to hospitals for drugs provided 
20.20 	in the inpatient hospital setting as part of a value-based purchasing arrangement. This 
20.21 	payment must be separate from the diagnostic related group reimbursement for the inpatient 
20.22 	admission or discharge associated with a stay during which the patient received a drug under 
20.23 	this section. For payments made under this section, the hospital must not be reimbursed for 
20.24 	the drug under the payment methodology in section 256.969. The commissioner shall 
20.25 	establish the separate reimbursement rate for drugs provided under this section based on 
20.26 	the methodology used for drugs administered in an outpatient setting under section 
20.27 	256B.0625, subdivision 13e, paragraph (e).

20.28 	EFFECTIVE DATE. This section is effective upon federal approval. The commissioner 
20.29 	of human services shall notify the revisor of statutes when federal approval is obtained.

20.30 	Sec. 8. Minnesota Statutes 2023 Supplement, section 256L.04, subdivision 10, is amended 
20.31 	to read:
20.32 		Subd. 10.Citizenship requirements. (a) Eligibility for MinnesotaCare is available to 
20.33 	citizens or nationals of the United States; lawfully present noncitizens as defined in Code 
21.1 	of Federal Regulations, title 8, section 103.12 title 45, section 155.20; and undocumented 
21.2 	noncitizens. For purposes of this subdivision, an undocumented noncitizen is an individual 
21.3 	who resides in the United States without the approval or acquiescence of the United States 
21.4 	Citizenship and Immigration Services. Families with children who are citizens or nationals 
21.5 	of the United States must cooperate in obtaining satisfactory documentary evidence of 
21.6 	citizenship or nationality according to the requirements of the federal Deficit Reduction 
21.7 	Act of 2005, Public Law 109-171.
21.8 	(b) Notwithstanding subdivisions 1 and 7, eligible persons include families and 
21.9 	individuals who are ineligible for medical assistance by reason of immigration status and 
21.10 	who have incomes equal to or less than 200 percent of federal poverty guidelines, except 
21.11 	that these persons may be eligible for emergency medical assistance under section 256B.06, 
21.12 	subdivision 4.

21.13 	EFFECTIVE DATE. This section is effective November 1, 2024.

21.14 	Sec. 9. IMPLEMENTATION OF TEACHING HOSPITAL SURCHARGE AND 
21.15 	GRADUATE MEDICAL EDUCATION SUPPLEMENTAL PAYMENT.
 21.16 	(a) The commissioner of human services shall submit to the Centers for Medicare and 
21.17 	Medicaid Services a request for federal approval to implement the teaching hospital surcharge 
21.18 	under Minnesota Statutes, section 256.9657, subdivision 2a, and the graduate medical 
21.19 	education supplemental payments under Minnesota Statutes, section 256.969, subdivisions 
21.20 	2b and 2g. At least 60 days before submitting the request for approval, the commissioner 
21.21 	of human services shall make available to the public the draft surcharge requirements, draft 
21.22 	supplemental payment rates, and an estimate of each nonexempt hospital's surcharge amount. 
21.23 	The commissioner shall provide at least 60 days for public comment.
21.24 	(b) During the design, and prior to submission, of the request for approval described in 
21.25 	paragraph (a), the commissioner must consult with representatives of eligible hospitals, as 
21.26 	defined in Minnesota Statutes, section 256.969, subdivision 2g.
21.27 	(c) If federal approval is received under paragraph (a), the commissioner shall provide 
21.28 	a 30-day public comment period on the federally approved terms and conditions for the 
21.29 	surcharge and supplemental payments. If, during the 30-day comment period, the 
21.30 	commissioner receives a documented, written statement of opposition from representatives 
21.31 	of one or more eligible hospitals, as defined in Minnesota Statutes, section 256.9657, 
21.32 	subdivision 2a, the commissioner shall publish the written statement and indefinitely suspend 
21.33 	implementation of both the teaching hospital surcharge under Minnesota Statutes, section 
22.1 	256.9657, subdivision 2a, and the supplemental payments under Minnesota Statutes, section 
22.2 	256.969, subdivisions 2b and 2g.
22.3 	(d) By December 15, 2024, the commissioner of health may make recommendations to 
22.4 	the legislature for program modifications and conforming amendments to Minnesota Statutes, 
22.5 	section 62J.692, that are necessary as a result of the amendments to Minnesota Statutes, 
22.6 	section 256.969, subdivisions 2b and 2g. In developing the recommendations under this 
22.7 	paragraph, the commissioner of health must consult with eligible hospitals, as defined in 
22.8 	Minnesota Statutes, section 256.969, subdivision 2g.

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

22.10 	Sec. 10. COUNTY-ADMINISTERED RURAL MEDICAL ASSISTANCE MODEL.
 22.11 		Subdivision 1.Model development. (a) The commissioner of human services, in 
22.12 	collaboration with the Association of Minnesota Counties and county-based purchasing 
22.13 	plans, shall develop a county-administered rural medical assistance (CARMA) model and 
22.14 	a detailed plan for implementing the CARMA model.
22.15 	(b) The CARMA model must be designed to achieve the following objectives:
22.16 	(1) provide a distinct county owned and administered alternative to the prepaid medical 
22.17 	assistance program;
22.18 	(2) facilitate greater integration of health care and social services to address social 
22.19 	determinants of health in rural communities, with the degree of integration of social services 
22.20 	varying with each county's needs and resources;
22.21 	(3) account for the smaller number of medical assistance enrollees and locally available 
22.22 	providers of behavioral health, oral health, specialty and tertiary care, nonemergency medical 
22.23 	transportation, and other health care services in rural communities; and
22.24 	(4) promote greater accountability for health outcomes, health equity, customer service, 
22.25 	community outreach, and cost of care.
22.26 		Subd. 2.County participation. The CARMA model must give each rural county the 
22.27 	option of applying to participate in the CARMA model as an alternative to participation in 
22.28 	the prepaid medical assistance program. The CARMA model must include a process for 
22.29 	the commissioner to determine whether and how a rural county can participate.
22.30 		Subd. 3.Report to the legislature. (a) The commissioner shall report recommendations 
22.31 	and an implementation plan for the CARMA model to the chairs and ranking minority 
22.32 	members of the legislative committees with jurisdiction over health care policy and finance 
23.1 	by January 15, 2025. The CARMA model and implementation plan must address the issues 
23.2 	and consider the recommendations identified in the document titled "Recommendations 
23.3 	Not Contingent on Outcome(s) of Current Litigation," attached to the September 13, 2022, 
23.4 	e-filing to the Second Judicial District Court (Correspondence for Judicial Approval Index 
23.5 	#102), that relates to the final contract decisions of the commissioner of human services 
23.6 	regarding South Country Health Alliance v. Minnesota Department of Human Services, No. 
23.7 	62-CV-22-907 (Ramsey Cnty. Dist. Ct. 2022).
23.8 	(b) The report must also identify the clarifications, approvals, and waivers that are needed 
23.9 	from the Centers for Medicare and Medicaid Services and include any draft legislation 
23.10 	necessary to implement the CARMA model.

23.11 	ARTICLE 2
23.12 	DEPARTMENT OF HUMAN SERVICES HEALTH CARE POLICY

23.13 	Section 1. Minnesota Statutes 2022, section 62M.01, subdivision 3, is amended to read:
23.14 		Subd. 3.Scope. (a) Nothing in this chapter applies to review of claims after submission 
23.15 	to determine eligibility for benefits under a health benefit plan. The appeal procedure 
23.16 	described in section 62M.06 applies to any complaint as defined under section 62Q.68, 
23.17 	subdivision 2, that requires a medical determination in its resolution.
23.18 	(b) Effective January 1, 2026, this chapter does not apply applies to managed care plans 
23.19 	or county-based purchasing plans when the plan is providing coverage to state public health 
23.20 	care program enrollees under chapter 256B or 256L.
23.21 	(c) Effective January 1, 2026, the following sections of this chapter apply to services 
23.22 	delivered under chapters 256B and 256L: 62M.02, subdivisions 1 to 5, 7 to 12, 13, 14 to 
23.23 	18, and 21; 62M.04; 62M.05, subdivisions 1 to 4; 62M.06, subdivisions 1 to 3; 62M.07; 
23.24 	62M.072; 62M.09; 62M.10; 62M.12; 62M.17, subdivision 2; and 62M.18.

23.25 	Sec. 2. Minnesota Statutes 2023 Supplement, section 256.0471, subdivision 1, as amended 
23.26 	by Laws 2024, chapter 80, article 1, section 76, is amended to read:
23.27 		Subdivision 1.Qualifying overpayment. Any overpayment for state-funded medical
23.28 	assistance under chapter 256B and state-funded MinnesotaCare under chapter 256L granted 
23.29 	pursuant to section 256.045, subdivision 10; chapter 256B for state-funded medical 
23.30 	assistance; and for assistance granted under chapters 256D, 256I, and 256K, and 256L for 
23.31 	state-funded MinnesotaCare except agency error claims, become a judgment by operation 
23.32 	of law 90 days after the notice of overpayment is personally served upon the recipient in a 
24.1 	manner that is sufficient under rule 4.03(a) of the Rules of Civil Procedure for district courts, 
24.2 	or by certified mail, return receipt requested. This judgment shall be entitled to full faith 
24.3 	and credit in this and any other state.

24.4 	EFFECTIVE DATE. This section is effective July 1, 2024.

24.5 	Sec. 3. Minnesota Statutes 2022, section 256.9657, subdivision 8, is amended to read:
24.6 		Subd. 8.Commissioner's duties. (a) Beginning October 1, 2023, the commissioner of 
24.7 	human services shall annually report to the chairs and ranking minority members of the 
24.8 	legislative committees with jurisdiction over health care policy and finance regarding the 
24.9 	provider surcharge program. The report shall include information on total billings, total 
24.10 	collections, and administrative expenditures for the previous fiscal year. This paragraph 
24.11 	expires January 1, 2032.
24.12 	(b) (a) The surcharge shall be adjusted by inflationary and caseload changes in future 
24.13 	bienniums to maintain reimbursement of health care providers in accordance with the 
24.14 	requirements of the state and federal laws governing the medical assistance program, 
24.15 	including the requirements of the Medicaid moratorium amendments of 1991 found in 
24.16 	Public Law No. 102-234.
24.17 	(c) (b) The commissioner shall request the Minnesota congressional delegation to support 
24.18 	a change in federal law that would prohibit federal disallowances for any state that makes 
24.19 	a good faith effort to comply with Public Law 102-234 by enacting conforming legislation 
24.20 	prior to the issuance of federal implementing regulations.

24.21 	Sec. 4. Minnesota Statutes 2022, section 256.969, is amended by adding a subdivision to 
24.22 	read:
24.23 		Subd. 2h.Alternate inpatient payment rate for a discharge. (a) Effective retroactively 
24.24 	from January 1, 2024, in any rate year in which a children's hospital discharge is included 
24.25 	in the federally required disproportionate share hospital payment audit, where the patient 
24.26 	discharged had resided in a children's hospital for over 20 years, the commissioner shall 
24.27 	compute an alternate inpatient rate for the children's hospital. The alternate payment rate 
24.28 	must be the rate computed under this section excluding the disproportionate share hospital 
24.29 	payment under subdivision 9, paragraph (d), clause (1), increased by an amount equal to 
24.30 	99 percent of what the disproportionate share hospital payment would have been under 
24.31 	subdivision 9, paragraph (d), clause (1), had the discharge been excluded.
25.1 	(b) In any rate year in which payment to a children's hospital is made using this alternate 
25.2 	payment rate, payments must not be made to the hospital under subdivisions 2e, 2f, and 9.

25.3 	EFFECTIVE DATE. This section is effective upon federal approval. The commissioner 
25.4 	of human services shall notify the revisor of statutes when federal approval is obtained.

25.5 	Sec. 5. Minnesota Statutes 2022, section 256B.056, subdivision 1a, is amended to read:
25.6 		Subd. 1a.Income and assets generally. (a)(1) Unless specifically required by state law 
25.7 	or rule or federal law or regulation, the methodologies used in counting income and assets 
25.8 	to determine eligibility for medical assistance for persons whose eligibility category is based 
25.9 	on blindness, disability, or age of 65 or more years, the methodologies for the Supplemental 
25.10 	Security Income program shall be used, except as provided under in clause (2) and
25.11 	subdivision 3, paragraph (a), clause (6).
25.12 	(2) State tax credits, rebates, and refunds must not be counted as income. State tax credits, 
25.13 	rebates, and refunds must not be counted as assets for a period of 12 months after the month 
25.14 	of receipt.
25.15 	(2) (3) Increases in benefits under title II of the Social Security Act shall not be counted 
25.16 	as income for purposes of this subdivision until July 1 of each year. Effective upon federal 
25.17 	approval, for children eligible under section 256B.055, subdivision 12, or for home and 
25.18 	community-based waiver services whose eligibility for medical assistance is determined 
25.19 	without regard to parental income, child support payments, including any payments made 
25.20 	by an obligor in satisfaction of or in addition to a temporary or permanent order for child 
25.21 	support, and Social Security payments are not counted as income.
25.22 	(b)(1) The modified adjusted gross income methodology as defined in United States 
25.23 	Code, title 42, section 1396a(e)(14), shall be used for eligibility categories based on:
25.24 	(i) children under age 19 and their parents and relative caretakers as defined in section 
25.25 	256B.055, subdivision 3a;
25.26 	(ii) children ages 19 to 20 as defined in section 256B.055, subdivision 16;
25.27 	(iii) pregnant women as defined in section 256B.055, subdivision 6;
25.28 	(iv) infants as defined in sections 256B.055, subdivision 10, and 256B.057, subdivision 
25.29 	1; and
25.30 	(v) adults without children as defined in section 256B.055, subdivision 15.
25.31 	For these purposes, a "methodology" does not include an asset or income standard, or 
25.32 	accounting method, or method of determining effective dates.
26.1 	(2) For individuals whose income eligibility is determined using the modified adjusted 
26.2 	gross income methodology in clause (1):
26.3 	(i) the commissioner shall subtract from the individual's modified adjusted gross income 
26.4 	an amount equivalent to five percent of the federal poverty guidelines; and
26.5 	(ii) the individual's current monthly income and household size is used to determine 
26.6 	eligibility for the 12-month eligibility period. If an individual's income is expected to vary 
26.7 	month to month, eligibility is determined based on the income predicted for the 12-month 
26.8 	eligibility period.

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

26.10 	Sec. 6. Minnesota Statutes 2022, section 256B.056, subdivision 10, is amended to read:
26.11 		Subd. 10.Eligibility verification. (a) The commissioner shall require women who are 
26.12 	applying for the continuation of medical assistance coverage following the end of the 
26.13 	12-month postpartum period to update their income and asset information and to submit 
26.14 	any required income or asset verification.
26.15 	(b) The commissioner shall determine the eligibility of private-sector health care coverage 
26.16 	for infants less than one year of age eligible under section 256B.055, subdivision 10, or 
26.17 	256B.057, subdivision 1, paragraph (c), and shall pay for private-sector coverage if this is 
26.18 	determined to be cost-effective.
26.19 	(c) The commissioner shall verify assets and income for all applicants, and for all 
26.20 	recipients upon renewal.
26.21 	(d) The commissioner shall utilize information obtained through the electronic service 
26.22 	established by the secretary of the United States Department of Health and Human Services 
26.23 	and other available electronic data sources in Code of Federal Regulations, title 42, sections 
26.24 	435.940 to 435.956, to verify eligibility requirements. The commissioner shall establish 
26.25 	standards to define when information obtained electronically is reasonably compatible with 
26.26 	information provided by applicants and enrollees, including use of self-attestation, to 
26.27 	accomplish real-time eligibility determinations and maintain program integrity.
26.28 	(e) Each person applying for or receiving medical assistance under section 256B.055, 
26.29 	subdivision 7, and any other person whose resources are required by law to be disclosed to 
26.30 	determine the applicant's or recipient's eligibility must authorize the commissioner to obtain 
26.31 	information from financial institutions to identify unreported accounts verify assets as 
26.32 	required in section 256.01, subdivision 18f. If a person refuses or revokes the authorization, 
26.33 	the commissioner may determine that the applicant or recipient is ineligible for medical 
27.1 	assistance. For purposes of this paragraph, an authorization to identify unreported accounts
27.2 	verify assets meets the requirements of the Right to Financial Privacy Act, United States 
27.3 	Code, title 12, chapter 35, and need not be furnished to the financial institution.
27.4 	(f) County and tribal agencies shall comply with the standards established by the 
27.5 	commissioner for appropriate use of the asset verification system specified in section 256.01, 
27.6 	subdivision 18f.

27.7 	Sec. 7. Minnesota Statutes 2023 Supplement, section 256B.0622, subdivision 8, is amended 
27.8 	to read:
27.9 		Subd. 8.Medical assistance payment for assertive community treatment and 
27.10 	intensive residential treatment services. (a) Payment for intensive residential treatment 
27.11 	services and assertive community treatment in this section shall be based on one daily rate 
27.12 	per provider inclusive of the following services received by an eligible client in a given 
27.13 	calendar day: all rehabilitative services under this section, staff travel time to provide 
27.14 	rehabilitative services under this section, and nonresidential crisis stabilization services 
27.15 	under section 256B.0624.
27.16 	(b) Except as indicated in paragraph (c), payment will not be made to more than one 
27.17 	entity for each client for services provided under this section on a given day. If services 
27.18 	under this section are provided by a team that includes staff from more than one entity, the 
27.19 	team must determine how to distribute the payment among the members.
27.20 	(c) The commissioner shall determine one rate for each provider that will bill medical 
27.21 	assistance for residential services under this section and one rate for each assertive community 
27.22 	treatment provider. If a single entity provides both services, one rate is established for the 
27.23 	entity's residential services and another rate for the entity's nonresidential services under 
27.24 	this section. A provider is not eligible for payment under this section without authorization 
27.25 	from the commissioner. The commissioner shall develop rates using the following criteria:
27.26 	(1) the provider's cost for services shall include direct services costs, other program 
27.27 	costs, and other costs determined as follows:
27.28 	(i) the direct services costs must be determined using actual costs of salaries, benefits, 
27.29 	payroll taxes, and training of direct service staff and service-related transportation;
27.30 	(ii) other program costs not included in item (i) must be determined as a specified 
27.31 	percentage of the direct services costs as determined by item (i). The percentage used shall 
27.32 	be determined by the commissioner based upon the average of percentages that represent 
28.1 	the relationship of other program costs to direct services costs among the entities that provide 
28.2 	similar services;
28.3 	(iii) physical plant costs calculated based on the percentage of space within the program 
28.4 	that is entirely devoted to treatment and programming. This does not include administrative 
28.5 	or residential space;
28.6 	(iv) assertive community treatment physical plant costs must be reimbursed as part of 
28.7 	the costs described in item (ii); and
28.8 	(v) subject to federal approval, up to an additional five percent of the total rate may be 
28.9 	added to the program rate as a quality incentive based upon the entity meeting performance 
28.10 	criteria specified by the commissioner;
28.11 	(2) actual cost is defined as costs which are allowable, allocable, and reasonable, and 
28.12 	consistent with federal reimbursement requirements under Code of Federal Regulations, 
28.13 	title 48, chapter 1, part 31, relating to for-profit entities, and Office of Management and 
28.14 	Budget Circular Number A-122, relating to nonprofit entities;
28.15 	(3) the number of service units;
28.16 	(4) the degree to which clients will receive services other than services under this section; 
28.17 	and
28.18 	(5) the costs of other services that will be separately reimbursed.
28.19 	(d) The rate for intensive residential treatment services and assertive community treatment 
28.20 	must exclude the medical assistance room and board rate, as defined in section 256B.056, 
28.21 	subdivision 5d, and services not covered under this section, such as partial hospitalization, 
28.22 	home care, and inpatient services.
28.23 	(e) Physician services that are not separately billed may be included in the rate to the 
28.24 	extent that a psychiatrist, or other health care professional providing physician services 
28.25 	within their scope of practice, is a member of the intensive residential treatment services 
28.26 	treatment team. Physician services, whether billed separately or included in the rate, may 
28.27 	be delivered by telehealth. For purposes of this paragraph, "telehealth" has the meaning 
28.28 	given to "mental health telehealth" in section 256B.0625, subdivision 46, when telehealth 
28.29 	is used to provide intensive residential treatment services.
28.30 	(f) When services under this section are provided by an assertive community treatment 
28.31 	provider, case management functions must be an integral part of the team.
29.1 	(g) The rate for a provider must not exceed the rate charged by that provider for the 
29.2 	same service to other payors.
29.3 	(h) The rates for existing programs must be established prospectively based upon the 
29.4 	expenditures and utilization over a prior 12-month period using the criteria established in 
29.5 	paragraph (c). The rates for new programs must be established based upon estimated 
29.6 	expenditures and estimated utilization using the criteria established in paragraph (c).
29.7 	(i) Effective for the rate years beginning on and after January 1, 2024, rates for assertive 
29.8 	community treatment, adult residential crisis stabilization services, and intensive residential 
29.9 	treatment services must be annually adjusted for inflation using the Centers for Medicare 
29.10 	and Medicaid Services Medicare Economic Index, as forecasted in the fourth third quarter 
29.11 	of the calendar year before the rate year. The inflation adjustment must be based on the 
29.12 	12-month period from the midpoint of the previous rate year to the midpoint of the rate year 
29.13 	for which the rate is being determined.
29.14 	(j) Entities who discontinue providing services must be subject to a settle-up process 
29.15 	whereby actual costs and reimbursement for the previous 12 months are compared. In the 
29.16 	event that the entity was paid more than the entity's actual costs plus any applicable 
29.17 	performance-related funding due the provider, the excess payment must be reimbursed to 
29.18 	the department. If a provider's revenue is less than actual allowed costs due to lower 
29.19 	utilization than projected, the commissioner may reimburse the provider to recover its actual 
29.20 	allowable costs. The resulting adjustments by the commissioner must be proportional to the 
29.21 	percent of total units of service reimbursed by the commissioner and must reflect a difference 
29.22 	of greater than five percent.
29.23 	(k) A provider may request of the commissioner a review of any rate-setting decision 
29.24 	made under this subdivision.

29.25 	Sec. 8. Minnesota Statutes 2023 Supplement, section 256B.0625, subdivision 9, is amended 
29.26 	to read:
29.27 		Subd. 9.Dental services. (a) Medical assistance covers medically necessary dental 
29.28 	services.
29.29 	(b) The following guidelines apply to dental services:
29.30 	(1) posterior fillings are paid at the amalgam rate;
29.31 	(2) application of sealants are covered once every five years per permanent molar; and
29.32 	(3) application of fluoride varnish is covered once every six months.
30.1 	(c) In addition to the services specified in paragraph (b) (a), medical assistance covers 
30.2 	the following services:
30.3 	(1) house calls or extended care facility calls for on-site delivery of covered services;
30.4 	(2) behavioral management when additional staff time is required to accommodate 
30.5 	behavioral challenges and sedation is not used;
30.6 	(3) oral or IV sedation, if the covered dental service cannot be performed safely without 
30.7 	it or would otherwise require the service to be performed under general anesthesia in a 
30.8 	hospital or surgical center; and
30.9 	(4) prophylaxis, in accordance with an appropriate individualized treatment plan, but 
30.10 	no more than four times per year.
30.11 	(d) The commissioner shall not require prior authorization for the services included in 
30.12 	paragraph (c), clauses (1) to (3), and shall prohibit managed care and county-based purchasing 
30.13 	plans from requiring prior authorization for the services included in paragraph (c), clauses 
30.14 	(1) to (3), when provided under sections 256B.69, 256B.692, and 256L.12.

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

30.16 	Sec. 9. Minnesota Statutes 2023 Supplement, section 256B.0625, subdivision 13e, as 
30.17 	amended by Laws 2024, chapter 85, section 66, is amended to read:
30.18 		Subd. 13e.Payment rates. (a) The basis for determining the amount of payment shall 
30.19 	be the lower of the ingredient costs of the drugs plus the professional dispensing fee; or the 
30.20 	usual and customary price charged to the public. The usual and customary price means the 
30.21 	lowest price charged by the provider to a patient who pays for the prescription by cash, 
30.22 	check, or charge account and includes prices the pharmacy charges to a patient enrolled in 
30.23 	a prescription savings club or prescription discount club administered by the pharmacy or 
30.24 	pharmacy chain, unless the prescription savings club or prescription discount club is one 
30.25 	in which an individual pays a recurring monthly access fee for unlimited access to a defined 
30.26 	list of drugs for which the pharmacy does not bill the member or a payer on a 
30.27 	per-standard-transaction basis. The amount of payment basis must be reduced to reflect all 
30.28 	discount amounts applied to the charge by any third-party provider/insurer agreement or 
30.29 	contract for submitted charges to medical assistance programs. The net submitted charge 
30.30 	may not be greater than the patient liability for the service. The professional dispensing fee 
30.31 	shall be $10.77 for prescriptions filled with legend drugs meeting the definition of "covered 
30.32 	outpatient drugs" according to United States Code, title 42, section 1396r-8(k)(2). The 
30.33 	dispensing fee for intravenous solutions that must be compounded by the pharmacist shall 
31.1 	be $10.77 per claim. The professional dispensing fee for prescriptions filled with 
31.2 	over-the-counter drugs meeting the definition of covered outpatient drugs shall be $10.77 
31.3 	for dispensed quantities equal to or greater than the number of units contained in the 
31.4 	manufacturer's original package. The professional dispensing fee shall be prorated based 
31.5 	on the percentage of the package dispensed when the pharmacy dispenses a quantity less 
31.6 	than the number of units contained in the manufacturer's original package. The pharmacy 
31.7 	dispensing fee for prescribed over-the-counter drugs not meeting the definition of covered 
31.8 	outpatient drugs shall be $3.65 for quantities equal to or greater than the number of units 
31.9 	contained in the manufacturer's original package and shall be prorated based on the 
31.10 	percentage of the package dispensed when the pharmacy dispenses a quantity less than the 
31.11 	number of units contained in the manufacturer's original package. The National Average 
31.12 	Drug Acquisition Cost (NADAC) shall be used to determine the ingredient cost of a drug. 
31.13 	For drugs for which a NADAC is not reported, the commissioner shall estimate the ingredient 
31.14 	cost at the wholesale acquisition cost minus two percent. The ingredient cost of a drug for 
31.15 	a provider participating in the federal 340B Drug Pricing Program shall be either the 340B 
31.16 	Drug Pricing Program ceiling price established by the Health Resources and Services 
31.17 	Administration or NADAC, whichever is lower. Wholesale acquisition cost is defined as 
31.18 	the manufacturer's list price for a drug or biological to wholesalers or direct purchasers in 
31.19 	the United States, not including prompt pay or other discounts, rebates, or reductions in 
31.20 	price, for the most recent month for which information is available, as reported in wholesale 
31.21 	price guides or other publications of drug or biological pricing data. The maximum allowable 
31.22 	cost of a multisource drug may be set by the commissioner and it shall be comparable to 
31.23 	the actual acquisition cost of the drug product and no higher than the NADAC of the generic 
31.24 	product. Establishment of the amount of payment for drugs shall not be subject to the 
31.25 	requirements of the Administrative Procedure Act.
31.26 	(b) Pharmacies dispensing prescriptions to residents of long-term care facilities using 
31.27 	an automated drug distribution system meeting the requirements of section 151.58, or a 
31.28 	packaging system meeting the packaging standards set forth in Minnesota Rules, part 
31.29 	6800.2700, that govern the return of unused drugs to the pharmacy for reuse, may employ 
31.30 	retrospective billing for prescription drugs dispensed to long-term care facility residents. A 
31.31 	retrospectively billing pharmacy must submit a claim only for the quantity of medication 
31.32 	used by the enrolled recipient during the defined billing period. A retrospectively billing 
31.33 	pharmacy must use a billing period not less than one calendar month or 30 days.
31.34 	(c) A pharmacy provider using packaging that meets the standards set forth in Minnesota 
31.35 	Rules, part 6800.2700, is required to credit the department for the actual acquisition cost 
32.1 	of all unused drugs that are eligible for reuse, unless the pharmacy is using retrospective 
32.2 	billing. The commissioner may permit the drug clozapine to be dispensed in a quantity that 
32.3 	is less than a 30-day supply.
32.4 	(d) If a pharmacy dispenses a multisource drug, the ingredient cost shall be the NADAC 
32.5 	of the generic product or the maximum allowable cost established by the commissioner 
32.6 	unless prior authorization for the brand name product has been granted according to the 
32.7 	criteria established by the Drug Formulary Committee as required by subdivision 13f, 
32.8 	paragraph (a), and the prescriber has indicated "dispense as written" on the prescription in 
32.9 	a manner consistent with section 151.21, subdivision 2.
32.10 	(e) The basis for determining the amount of payment for drugs administered in an 
32.11 	outpatient setting shall be the lower of the usual and customary cost submitted by the 
32.12 	provider, 106 percent of the average sales price as determined by the United States 
32.13 	Department of Health and Human Services pursuant to title XVIII, section 1847a of the 
32.14 	federal Social Security Act, the specialty pharmacy rate, or the maximum allowable cost 
32.15 	set by the commissioner. If average sales price is unavailable, the amount of payment must 
32.16 	be lower of the usual and customary cost submitted by the provider, the wholesale acquisition 
32.17 	cost, the specialty pharmacy rate, or the maximum allowable cost set by the commissioner. 
32.18 	The commissioner shall discount the payment rate for drugs obtained through the federal 
32.19 	340B Drug Pricing Program by 28.6 percent. The payment for drugs administered in an 
32.20 	outpatient setting shall be made to the administering facility or practitioner. A retail or 
32.21 	specialty pharmacy dispensing a drug for administration in an outpatient setting is not 
32.22 	eligible for direct reimbursement.
32.23 	(f) The commissioner may establish maximum allowable cost rates for specialty pharmacy 
32.24 	products that are lower than the ingredient cost formulas specified in paragraph (a). The 
32.25 	commissioner may require individuals enrolled in the health care programs administered 
32.26 	by the department to obtain specialty pharmacy products from providers with whom the 
32.27 	commissioner has negotiated lower reimbursement rates. Specialty pharmacy products are 
32.28 	defined as those used by a small number of recipients or recipients with complex and chronic 
32.29 	diseases that require expensive and challenging drug regimens. Examples of these conditions 
32.30 	include, but are not limited to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis C, 
32.31 	growth hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms of 
32.32 	cancer. Specialty pharmaceutical products include injectable and infusion therapies, 
32.33 	biotechnology drugs, antihemophilic factor products, high-cost therapies, and therapies that 
32.34 	require complex care. The commissioner shall consult with the Formulary Committee to 
32.35 	develop a list of specialty pharmacy products subject to maximum allowable cost 
33.1 	reimbursement. In consulting with the Formulary Committee in developing this list, the 
33.2 	commissioner shall take into consideration the population served by specialty pharmacy 
33.3 	products, the current delivery system and standard of care in the state, and access to care 
33.4 	issues. The commissioner shall have the discretion to adjust the maximum allowable cost 
33.5 	to prevent access to care issues.
33.6 	(g) Home infusion therapy services provided by home infusion therapy pharmacies must 
33.7 	be paid at rates according to subdivision 8d.
33.8 	(h) The commissioner shall contract with a vendor to conduct a cost of dispensing survey 
33.9 	for all pharmacies that are physically located in the state of Minnesota that dispense outpatient 
33.10 	drugs under medical assistance. The commissioner shall ensure that the vendor has prior 
33.11 	experience in conducting cost of dispensing surveys. Each pharmacy enrolled with the 
33.12 	department to dispense outpatient prescription drugs to fee-for-service members must 
33.13 	respond to the cost of dispensing survey. The commissioner may sanction a pharmacy under 
33.14 	section 256B.064 for failure to respond. The commissioner shall require the vendor to 
33.15 	measure a single statewide cost of dispensing for specialty prescription drugs and a single 
33.16 	statewide cost of dispensing for nonspecialty prescription drugs for all responding pharmacies 
33.17 	to measure the mean, mean weighted by total prescription volume, mean weighted by 
33.18 	medical assistance prescription volume, median, median weighted by total prescription 
33.19 	volume, and median weighted by total medical assistance prescription volume. The 
33.20 	commissioner shall post a copy of the final cost of dispensing survey report on the 
33.21 	department's website. The initial survey must be completed no later than January 1, 2021, 
33.22 	and repeated every three years. The commissioner shall provide a summary of the results 
33.23 	of each cost of dispensing survey and provide recommendations for any changes to the 
33.24 	dispensing fee to the chairs and ranking minority members of the legislative committees 
33.25 	with jurisdiction over medical assistance pharmacy reimbursement. Notwithstanding section 
33.26 	256.01, subdivision 42, this paragraph does not expire.
33.27 	(i) The commissioner shall increase the ingredient cost reimbursement calculated in 
33.28 	paragraphs (a) and (f) by 1.8 percent for prescription and nonprescription drugs subject to 
33.29 	the wholesale drug distributor tax under section 295.52.

33.30 	Sec. 10. Minnesota Statutes 2022, section 256B.0625, is amended by adding a subdivision 
33.31 	to read:
33.32 		Subd. 25c.Applicability of utilization review provisions. Effective January 1, 2026, 
33.33 	the following provisions of chapter 62M apply to the commissioner when delivering services 
33.34 	under chapters 256B and 256L: 62M.02, subdivisions 1 to 5, 7 to 12, 13, 14 to 18, and 21; 
34.1 	62M.04; 62M.05, subdivisions 1 to 4; 62M.06, subdivisions 1 to 3; 62M.07; 62M.072; 
34.2 	62M.09; 62M.10; 62M.12; 62M.17, subdivision 2; and 62M.18.

34.3 	Sec. 11. Minnesota Statutes 2023 Supplement, section 256B.0701, subdivision 6, is 
34.4 	amended to read:
34.5 		Subd. 6.Recuperative care facility rate. (a) The recuperative care facility rate is for 
34.6 	facility costs and must be paid from state money in an amount equal to the medical assistance 
34.7 	room and board MSA equivalent rate as defined in section 256I.03, subdivision 11a, at the 
34.8 	time the recuperative care services were provided. The eligibility standards in chapter 256I
34.9 	do not apply to the recuperative care facility rate. The recuperative care facility rate is only 
34.10 	paid when the recuperative care services rate is paid to a provider. Providers may opt to 
34.11 	only receive the recuperative care services rate.
34.12 	(b) Before a recipient is discharged from a recuperative care setting, the provider must 
34.13 	ensure that the recipient's medical condition is stabilized or that the recipient is being 
34.14 	discharged to a setting that is able to meet that recipient's needs.

34.15 	Sec. 12. Minnesota Statutes 2023 Supplement, section 256B.0947, subdivision 7, is 
34.16 	amended to read:
34.17 		Subd. 7.Medical assistance payment and rate setting. (a) Payment for services in this 
34.18 	section must be based on one daily encounter rate per provider inclusive of the following 
34.19 	services received by an eligible client in a given calendar day: all rehabilitative services, 
34.20 	supports, and ancillary activities under this section, staff travel time to provide rehabilitative 
34.21 	services under this section, and crisis response services under section 256B.0624.
34.22 	(b) Payment must not be made to more than one entity for each client for services 
34.23 	provided under this section on a given day. If services under this section are provided by a 
34.24 	team that includes staff from more than one entity, the team shall determine how to distribute 
34.25 	the payment among the members.
34.26 	(c) The commissioner shall establish regional cost-based rates for entities that will bill 
34.27 	medical assistance for nonresidential intensive rehabilitative mental health services. In 
34.28 	developing these rates, the commissioner shall consider:
34.29 	(1) the cost for similar services in the health care trade area;
34.30 	(2) actual costs incurred by entities providing the services;
34.31 	(3) the intensity and frequency of services to be provided to each client;
35.1 	(4) the degree to which clients will receive services other than services under this section; 
35.2 	and
35.3 	(5) the costs of other services that will be separately reimbursed.
35.4 	(d) The rate for a provider must not exceed the rate charged by that provider for the 
35.5 	same service to other payers.
35.6 	(e) Effective for the rate years beginning on and after January 1, 2024, rates must be 
35.7 	annually adjusted for inflation using the Centers for Medicare and Medicaid Services 
35.8 	Medicare Economic Index, as forecasted in the fourth third quarter of the calendar year 
35.9 	before the rate year. The inflation adjustment must be based on the 12-month period from 
35.10 	the midpoint of the previous rate year to the midpoint of the rate year for which the rate is 
35.11 	being determined.

35.12 	Sec. 13. Minnesota Statutes 2023 Supplement, section 256B.764, is amended to read:
35.13 	256B.764 REIMBURSEMENT FOR FAMILY PLANNING SERVICES.
35.14 	(a) Effective for services rendered on or after July 1, 2007, payment rates for family 
35.15 	planning services shall be increased by 25 percent over the rates in effect June 30, 2007, 
35.16 	when these services are provided by a community clinic as defined in section 145.9268, 
35.17 	subdivision 1.
35.18 	(b) Effective for services rendered on or after July 1, 2013, payment rates for family 
35.19 	planning services shall be increased by 20 percent over the rates in effect June 30, 2013, 
35.20 	when these services are provided by a community clinic as defined in section 145.9268, 
35.21 	subdivision 1. The commissioner shall adjust capitation rates to managed care and 
35.22 	county-based purchasing plans to reflect this increase, and shall require plans to pass on the 
35.23 	full amount of the rate increase to eligible community clinics, in the form of higher payment 
35.24 	rates for family planning services.
35.25 	(c) Effective for services provided on or after January 1, 2024, payment rates for family 
35.26 	planning, when such services are provided by an eligible community clinic as defined in 
35.27 	section 145.9268, subdivision 1, and abortion services shall be increased by 20 percent. 
35.28 	This increase does not apply to federally qualified health centers, rural health centers, or 
35.29 	Indian health services.

36.1 	Sec. 14. Minnesota Statutes 2023 Supplement, section 256L.03, subdivision 1, is amended 
36.2 	to read:
36.3 		Subdivision 1.Covered health services. (a) "Covered health services" means the health 
36.4 	services reimbursed under chapter 256B, with the exception of special education services, 
36.5 	home care nursing services, adult dental care services other than services covered under 
36.6 	section 256B.0625, subdivision 9, orthodontic services, nonemergency medical transportation 
36.7 	services, personal care assistance and case management services, community first services 
36.8 	and supports under section 256B.85, behavioral health home services under section 
36.9 	256B.0757, housing stabilization services under section 256B.051, and nursing home or 
36.10 	intermediate care facilities services.
36.11 	(b) Covered health services shall be expanded as provided in this section.
36.12 	(c) For the purposes of covered health services under this section, "child" means an 
36.13 	individual younger than 19 years of age.

36.14 	Sec. 15. Minnesota Statutes 2022, section 524.3-801, as amended by Laws 2024, chapter 
36.15 	79, article 9, section 20, is amended to read:
36.16 	524.3-801 NOTICE TO CREDITORS.
36.17 	(a) Unless notice has already been given under this section, upon appointment of a 
36.18 	general personal representative in informal proceedings or upon the filing of a petition for 
36.19 	formal appointment of a general personal representative, notice thereof, in the form prescribed 
36.20 	by court rule, shall be given under the direction of the court administrator by publication 
36.21 	once a week for two successive weeks in a legal newspaper in the county wherein the 
36.22 	proceedings are pending giving the name and address of the general personal representative 
36.23 	and notifying creditors of the estate to present their claims within four months after the date 
36.24 	of the court administrator's notice which is subsequently published or be forever barred, 
36.25 	unless they are entitled to further service of notice under paragraph (b) or (c).
36.26 	(b) The personal representative shall, within three months after the date of the first 
36.27 	publication of the notice, serve a copy of the notice upon each then known and identified 
36.28 	creditor in the manner provided in paragraph (c). If the decedent or a predeceased spouse 
36.29 	of the decedent received assistance for which a claim could be filed under section 246.53, 
36.30 	256B.15, 256D.16, or 261.04, notice to the commissioner of human services or direct care 
36.31 	and treatment executive board, as applicable, must be given under paragraph (d) instead of 
36.32 	under this paragraph or paragraph (c). A creditor is "known" if: (i) the personal representative 
36.33 	knows that the creditor has asserted a claim that arose during the decedent's life against 
37.1 	either the decedent or the decedent's estate; (ii) the creditor has asserted a claim that arose 
37.2 	during the decedent's life and the fact is clearly disclosed in accessible financial records 
37.3 	known and available to the personal representative; or (iii) the claim of the creditor would 
37.4 	be revealed by a reasonably diligent search for creditors of the decedent in accessible 
37.5 	financial records known and available to the personal representative. Under this section, a 
37.6 	creditor is "identified" if the personal representative's knowledge of the name and address 
37.7 	of the creditor will permit service of notice to be made under paragraph (c).
37.8 	(c) Unless the claim has already been presented to the personal representative or paid, 
37.9 	the personal representative shall serve a copy of the notice required by paragraph (b) upon 
37.10 	each creditor of the decedent who is then known to the personal representative and identified 
37.11 	either by delivery of a copy of the required notice to the creditor, or by mailing a copy of 
37.12 	the notice to the creditor by certified, registered, or ordinary first class mail addressed to 
37.13 	the creditor at the creditor's office or place of residence.
37.14 	(d)(1) Effective for decedents dying on or after July 1, 1997, if the decedent or a 
37.15 	predeceased spouse of the decedent received assistance for which a claim could be filed 
37.16 	under section 246.53, 256B.15, 256D.16, or 261.04, the personal representative or the 
37.17 	attorney for the personal representative shall serve the commissioner or executive board, 
37.18 	as applicable, with notice in the manner prescribed in paragraph (c), or electronically in a 
37.19 	manner prescribed by the commissioner or executive board, as soon as practicable after the 
37.20 	appointment of the personal representative. The notice must state the decedent's full name, 
37.21 	date of birth, and Social Security number and, to the extent then known after making a 
37.22 	reasonably diligent inquiry, the full name, date of birth, and Social Security number for 
37.23 	each of the decedent's predeceased spouses. The notice may also contain a statement that, 
37.24 	after making a reasonably diligent inquiry, the personal representative has determined that 
37.25 	the decedent did not have any predeceased spouses or that the personal representative has 
37.26 	been unable to determine one or more of the previous items of information for a predeceased 
37.27 	spouse of the decedent. A copy of the notice to creditors must be attached to and be a part 
37.28 	of the notice to the commissioner or executive board.
37.29 	(2) Notwithstanding a will or other instrument or law to the contrary, except as allowed 
37.30 	in this paragraph, no property subject to administration by the estate may be distributed by 
37.31 	the estate or the personal representative until 70 days after the date the notice is served on 
37.32 	the commissioner or executive board as provided in paragraph (c), unless the local agency 
37.33 	consents as provided for in clause (6). This restriction on distribution does not apply to the 
37.34 	personal representative's sale of real or personal property, but does apply to the net proceeds 
37.35 	the estate receives from these sales. The personal representative, or any person with personal 
38.1 	knowledge of the facts, may provide an affidavit containing the description of any real or 
38.2 	personal property affected by this paragraph and stating facts showing compliance with this 
38.3 	paragraph. If the affidavit describes real property, it may be filed or recorded in the office 
38.4 	of the county recorder or registrar of titles for the county where the real property is located. 
38.5 	This paragraph does not apply to proceedings under sections 524.3-1203 and 525.31, or 
38.6 	when a duly authorized agent of a county is acting as the personal representative of the 
38.7 	estate.
38.8 	(3) At any time before an order or decree is entered under section 524.3-1001 or 
38.9 	524.3-1002, or a closing statement is filed under section 524.3-1003, the personal 
38.10 	representative or the attorney for the personal representative may serve an amended notice 
38.11 	on the commissioner or executive board to add variations or other names of the decedent 
38.12 	or a predeceased spouse named in the notice, the name of a predeceased spouse omitted 
38.13 	from the notice, to add or correct the date of birth or Social Security number of a decedent 
38.14 	or predeceased spouse named in the notice, or to correct any other deficiency in a prior 
38.15 	notice. The amended notice must state the decedent's name, date of birth, and Social Security 
38.16 	number, the case name, case number, and district court in which the estate is pending, and 
38.17 	the date the notice being amended was served on the commissioner or executive board. If 
38.18 	the amendment adds the name of a predeceased spouse omitted from the notice, it must also 
38.19 	state that spouse's full name, date of birth, and Social Security number. The amended notice 
38.20 	must be served on the commissioner or executive board in the same manner as the original 
38.21 	notice. Upon service, the amended notice relates back to and is effective from the date the 
38.22 	notice it amends was served, and the time for filing claims arising under section 246.53, 
38.23 	256B.15, 256D.16 or 261.04 is extended by 60 days from the date of service of the amended 
38.24 	notice. Claims filed during the 60-day period are undischarged and unbarred claims, may 
38.25 	be prosecuted by the entities entitled to file those claims in accordance with section 
38.26 	524.3-1004, and the limitations in section 524.3-1006 do not apply. The personal 
38.27 	representative or any person with personal knowledge of the facts may provide and file or 
38.28 	record an affidavit in the same manner as provided for in clause (1).
38.29 	(4) Within one year after the date an order or decree is entered under section 524.3-1001
38.30 	or 524.3-1002 or a closing statement is filed under section 524.3-1003, any person who has 
38.31 	an interest in property that was subject to administration by the estate may serve an amended 
38.32 	notice on the commissioner or executive board to add variations or other names of the 
38.33 	decedent or a predeceased spouse named in the notice, the name of a predeceased spouse 
38.34 	omitted from the notice, to add or correct the date of birth or Social Security number of a 
38.35 	decedent or predeceased spouse named in the notice, or to correct any other deficiency in 
39.1 	a prior notice. The amended notice must be served on the commissioner or executive board 
39.2 	in the same manner as the original notice and must contain the information required for 
39.3 	amendments under clause (3). If the amendment adds the name of a predeceased spouse 
39.4 	omitted from the notice, it must also state that spouse's full name, date of birth, and Social 
39.5 	Security number. Upon service, the amended notice relates back to and is effective from 
39.6 	the date the notice it amends was served. If the amended notice adds the name of an omitted 
39.7 	predeceased spouse or adds or corrects the Social Security number or date of birth of the 
39.8 	decedent or a predeceased spouse already named in the notice, then, notwithstanding any 
39.9 	other laws to the contrary, claims against the decedent's estate on account of those persons 
39.10 	resulting from the amendment and arising under section 246.53, 256B.15, 256D.16, or 
39.11 	261.04 are undischarged and unbarred claims, may be prosecuted by the entities entitled to 
39.12 	file those claims in accordance with section 524.3-1004, and the limitations in section 
39.13 	524.3-1006 do not apply. The person filing the amendment or any other person with personal 
39.14 	knowledge of the facts may provide and file or record an affidavit describing affected real 
39.15 	or personal property in the same manner as clause (1).
39.16 	(5) After one year from the date an order or decree is entered under section 524.3-1001
39.17 	or 524.3-1002, or a closing statement is filed under section 524.3-1003, no error, omission, 
39.18 	or defect of any kind in the notice to the commissioner or executive board required under 
39.19 	this paragraph or in the process of service of the notice on the commissioner or executive 
39.20 	board, or the failure to serve the commissioner or executive board with notice as required 
39.21 	by this paragraph, makes any distribution of property by a personal representative void or 
39.22 	voidable. The distributee's title to the distributed property shall be free of any claims based 
39.23 	upon a failure to comply with this paragraph.
39.24 	(6) The local agency may consent to a personal representative's request to distribute 
39.25 	property subject to administration by the estate to distributees during the 70-day period after 
39.26 	service of notice on the commissioner or executive board. The local agency may grant or 
39.27 	deny the request in whole or in part and may attach conditions to its consent as it deems 
39.28 	appropriate. When the local agency consents to a distribution, it shall give the estate a written 
39.29 	certificate evidencing its consent to the early distribution of assets at no cost. The certificate 
39.30 	must include the name, case number, and district court in which the estate is pending, the 
39.31 	name of the local agency, describe the specific real or personal property to which the consent 
39.32 	applies, state that the local agency consents to the distribution of the specific property 
39.33 	described in the consent during the 70-day period following service of the notice on the 
39.34 	commissioner or executive board, state that the consent is unconditional or list all of the 
39.35 	terms and conditions of the consent, be dated, and may include other contents as may be 
40.1 	appropriate. The certificate must be signed by the director of the local agency or the director's 
40.2 	designees and is effective as of the date it is dated unless it provides otherwise. The signature 
40.3 	of the director or the director's designee does not require any acknowledgment. The certificate 
40.4 	shall be prima facie evidence of the facts it states, may be attached to or combined with a 
40.5 	deed or any other instrument of conveyance and, when so attached or combined, shall 
40.6 	constitute a single instrument. If the certificate describes real property, it shall be accepted 
40.7 	for recording or filing by the county recorder or registrar of titles in the county in which the 
40.8 	property is located. If the certificate describes real property and is not attached to or combined 
40.9 	with a deed or other instrument of conveyance, it shall be accepted for recording or filing 
40.10 	by the county recorder or registrar of titles in the county in which the property is located. 
40.11 	The certificate constitutes a waiver of the 70-day period provided for in clause (2) with 
40.12 	respect to the property it describes and is prima facie evidence of service of notice on the 
40.13 	commissioner or executive board. The certificate is not a waiver or relinquishment of any 
40.14 	claims arising under section 246.53, 256B.15, 256D.16, or 261.04, and does not otherwise 
40.15 	constitute a waiver of any of the personal representative's duties under this paragraph. 
40.16 	Distributees who receive property pursuant to a consent to an early distribution shall remain 
40.17 	liable to creditors of the estate as provided for by law.
40.18 	(7) All affidavits provided for under this paragraph:
40.19 	(i) shall be provided by persons who have personal knowledge of the facts stated in the 
40.20 	affidavit;
40.21 	(ii) may be filed or recorded in the office of the county recorder or registrar of titles in 
40.22 	the county in which the real property they describe is located for the purpose of establishing 
40.23 	compliance with the requirements of this paragraph; and
40.24 	(iii) are prima facie evidence of the facts stated in the affidavit.
40.25 	(8) This paragraph applies to the estates of decedents dying on or after July 1, 1997. 
40.26 	Clause (5) also applies with respect to all notices served on the commissioner of human 
40.27 	services before July 1, 1997, under Laws 1996, chapter 451, article 2, section 55. All notices 
40.28 	served on the commissioner before July 1, 1997, pursuant to Laws 1996, chapter 451, article 
40.29 	2, section 55, shall be deemed to be legally sufficient for the purposes for which they were 
40.30 	intended, notwithstanding any errors, omissions or other defects.

41.1 	Sec. 16. DIRECTION TO COMMISSIONER; REIMBURSEMENT FOR 
41.2 	EXTRACORPOREAL MEMBRANE OXYGENATION CANNULATION AS AN 
41.3 	OUTPATIENT SERVICE.
 41.4 	The commissioner of human services, in consultation with providers and hospitals, shall 
41.5 	determine the feasibility of an outpatient reimbursement mechanism for medical assistance 
41.6 	coverage of extracorporeal membrane oxygenation (ECMO) cannulation performed outside 
41.7 	an inpatient hospital setting or in a self-contained mobile ECMO unit. If an outpatient 
41.8 	reimbursement mechanism is feasible, then the commissioner of human services shall 
41.9 	develop a recommended payment mechanism. By January 15, 2025, the commissioner of 
41.10 	human services shall submit a recommendation and the required legislative language to the 
41.11 	chairs and ranking minority members of the legislative committees with jurisdiction over 
41.12 	health care finance. If such a payment mechanism is infeasible, the commissioner of human 
41.13 	services shall submit an explanation as to why it is infeasible.

41.14 	ARTICLE 3
41.15 	HEALTH CARE

41.16 	Section 1. Minnesota Statutes 2022, section 62V.05, subdivision 12, is amended to read:
41.17 		Subd. 12.Reports on interagency agreements and intra-agency transfers. The 
41.18 	MNsure Board shall provide quarterly reports to the chairs and ranking minority members 
41.19 	of the legislative committees with jurisdiction over health and human services policy and 
41.20 	finance on: legislative reports on interagency agreements and intra-agency transfers according 
41.21 	to section 15.0395.
41.22 	(1) interagency agreements or service-level agreements and any renewals or extensions 
41.23 	of existing interagency or service-level agreements with a state department under section 
41.24 	15.01, state agency under section 15.012, or the Department of Information Technology 
41.25 	Services, with a value of more than $100,000, or related agreements with the same department 
41.26 	or agency with a cumulative value of more than $100,000; and
41.27 	(2) transfers of appropriations of more than $100,000 between accounts within or between 
41.28 	agencies.
41.29 	The report must include the statutory citation authorizing the agreement, transfer or dollar 
41.30 	amount, purpose, and effective date of the agreement, the duration of the agreement, and a 
41.31 	copy of the agreement.

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

42.1 	Sec. 2. Minnesota Statutes 2022, section 62V.08, is amended to read:
42.2 	62V.08 REPORTS.
42.3 	(a) MNsure shall submit a report to the legislature by January 15, 2015 March 31, 2025, 
42.4 	and each January 15 March 31 thereafter, on: (1) the performance of MNsure operations; 
42.5 	(2) meeting MNsure responsibilities; (3) an accounting of MNsure budget activities; (4) 
42.6 	practices and procedures that have been implemented to ensure compliance with data 
42.7 	practices laws, and a description of any violations of data practices laws or procedures; and 
42.8 	(5) the effectiveness of the outreach and implementation activities of MNsure in reducing 
42.9 	the rate of uninsurance.
42.10 	(b) MNsure must publish its administrative and operational costs on a website to educate 
42.11 	consumers on those costs. The information published must include: (1) the amount of 
42.12 	premiums and federal premium subsidies collected; (2) the amount and source of revenue 
42.13 	received under section 62V.05, subdivision 1, paragraph (b), clause (3); (3) the amount and 
42.14 	source of any other fees collected for purposes of supporting operations; and (4) any misuse 
42.15 	of funds as identified in accordance with section 3.975. The website must be updated at 
42.16 	least annually.

42.17 	Sec. 3. Minnesota Statutes 2022, section 62V.11, subdivision 4, is amended to read:
42.18 		Subd. 4.Review of costs. The board shall submit for review the annual budget of MNsure 
42.19 	for the next fiscal year by March 15 31 of each year, beginning March 15, 2014 31, 2025.

42.20 	Sec. 4. Minnesota Statutes 2023 Supplement, section 151.74, subdivision 3, is amended 
42.21 	to read:
42.22 		Subd. 3.Access to urgent-need insulin. (a) MNsure shall develop an application form 
42.23 	to be used by an individual who is in urgent need of insulin. The application must ask the 
42.24 	individual to attest to the eligibility requirements described in subdivision 2. The form shall 
42.25 	be accessible through MNsure's website. MNsure shall also make the form available to 
42.26 	pharmacies and health care providers who prescribe or dispense insulin, hospital emergency 
42.27 	departments, urgent care clinics, and community health clinics. By submitting a completed, 
42.28 	signed, and dated application to a pharmacy, the individual attests that the information 
42.29 	contained in the application is correct.
42.30 	(b) If the individual is in urgent need of insulin, the individual may present a completed, 
42.31 	signed, and dated application form to a pharmacy. The individual must also:
42.32 	(1) have a valid insulin prescription; and
43.1 	(2) present the pharmacist with identification indicating Minnesota residency in the form 
43.2 	of a valid Minnesota identification card, driver's license or permit, individual taxpayer 
43.3 	identification number, or Tribal identification card as defined in section 171.072, paragraph 
43.4 	(b). If the individual in urgent need of insulin is under the age of 18, the individual's parent 
43.5 	or legal guardian must provide the pharmacist with proof of residency.
43.6 	(c) Upon receipt of a completed and signed application, the pharmacist shall dispense 
43.7 	the prescribed insulin in an amount that will provide the individual with a 30-day supply. 
43.8 	The pharmacy must notify the health care practitioner who issued the prescription order no 
43.9 	later than 72 hours after the insulin is dispensed.
43.10 	(d) The pharmacy may submit to the manufacturer of the dispensed insulin product or 
43.11 	to the manufacturer's vendor a claim for payment that is in accordance with the National 
43.12 	Council for Prescription Drug Program standards for electronic claims processing, unless 
43.13 	the manufacturer agrees to send to the pharmacy a replacement supply of the same insulin 
43.14 	as dispensed in the amount dispensed. If the pharmacy submits an electronic claim to the 
43.15 	manufacturer or the manufacturer's vendor, the manufacturer or vendor shall reimburse the 
43.16 	pharmacy in an amount that covers the pharmacy's acquisition cost.
43.17 	(e) The pharmacy may collect an insulin co-payment from the individual to cover the 
43.18 	pharmacy's costs of processing and dispensing in an amount not to exceed $35 for the 30-day 
43.19 	supply of insulin dispensed.
43.20 	(f) The pharmacy shall also provide each eligible individual with the information sheet 
43.21 	described in subdivision 7 and a list of trained navigators provided by the Board of Pharmacy 
43.22 	for the individual to contact if the individual is in need of accessing needs to access ongoing 
43.23 	insulin coverage options, including assistance in:
43.24 	(1) applying for medical assistance or MinnesotaCare;
43.25 	(2) applying for a qualified health plan offered through MNsure, subject to open and 
43.26 	special enrollment periods;
43.27 	(3) accessing information on providers who participate in prescription drug discount 
43.28 	programs, including providers who are authorized to participate in the 340B program under 
43.29 	section 340b of the federal Public Health Services Act, United States Code, title 42, section 
43.30 	256b; and
43.31 	(4) accessing insulin manufacturers' patient assistance programs, co-payment assistance 
43.32 	programs, and other foundation-based programs.
44.1 	(g) The pharmacist shall retain a copy of the application form submitted by the individual 
44.2 	to the pharmacy for reporting and auditing purposes.
44.3 	(h) A manufacturer may submit to the commissioner of administration a request for 
44.4 	reimbursement in an amount not to exceed $35 for each 30-day supply of insulin the 
44.5 	manufacturer provides under paragraph (d). The commissioner of administration shall 
44.6 	determine the manner and format for submitting and processing requests for reimbursement. 
44.7 	After receiving a reimbursement request, the commissioner of administration shall reimburse 
44.8 	the manufacturer in an amount not to exceed $35 for each 30-day supply of insulin the 
44.9 	manufacturer provided under paragraph (d).

44.10 	EFFECTIVE DATE. This section is effective December 1, 2024.

44.11 	Sec. 5. Minnesota Statutes 2022, section 151.74, subdivision 6, is amended to read:
44.12 		Subd. 6.Continuing safety net program; process. (a) The individual shall submit to 
44.13 	a pharmacy the statement of eligibility provided by the manufacturer under subdivision 5, 
44.14 	paragraph (b). Upon receipt of an individual's eligibility status, the pharmacy shall submit 
44.15 	an order containing the name of the insulin product and the daily dosage amount as contained 
44.16 	in a valid prescription to the product's manufacturer.
44.17 	(b) The pharmacy must include with the order to the manufacturer the following 
44.18 	information:
44.19 	(1) the pharmacy's name and shipping address;
44.20 	(2) the pharmacy's office telephone number, fax number, email address, and contact 
44.21 	name; and
44.22 	(3) any specific days or times when deliveries are not accepted by the pharmacy.
44.23 	(c) Upon receipt of an order from a pharmacy and the information described in paragraph 
44.24 	(b), the manufacturer shall send to the pharmacy a 90-day supply of insulin as ordered, 
44.25 	unless a lesser amount is requested in the order, at no charge to the individual or pharmacy.
44.26 	(d) Except as authorized under paragraph (e), the pharmacy shall provide the insulin to 
44.27 	the individual at no charge to the individual. The pharmacy shall not provide insulin received 
44.28 	from the manufacturer to any individual other than the individual associated with the specific 
44.29 	order. The pharmacy shall not seek reimbursement for the insulin received from the 
44.30 	manufacturer or from any third-party payer.
45.1 	(e) The pharmacy may collect a co-payment from the individual to cover the pharmacy's 
45.2 	costs for processing and dispensing in an amount not to exceed $50 for each 90-day supply 
45.3 	if the insulin is sent to the pharmacy.
45.4 	(f) The pharmacy may submit to a manufacturer a reorder for an individual if the 
45.5 	individual's eligibility statement has not expired. Upon receipt of a reorder from a pharmacy, 
45.6 	the manufacturer must send to the pharmacy an additional 90-day supply of the product, 
45.7 	unless a lesser amount is requested, at no charge to the individual or pharmacy if the 
45.8 	individual's eligibility statement has not expired.
45.9 	(g) Notwithstanding paragraph (c), a manufacturer may send the insulin as ordered 
45.10 	directly to the individual if the manufacturer provides a mail order service option.
45.11 	(h) A manufacturer may submit to the commissioner of administration a request for 
45.12 	reimbursement in an amount not to exceed $105 for each 90-day supply of insulin the 
45.13 	manufacturer provides under paragraphs (c) and (f). The commissioner of administration 
45.14 	shall determine the manner and format for submitting and processing requests for 
45.15 	reimbursement. After receiving a reimbursement request, the commissioner of administration 
45.16 	shall reimburse the manufacturer in an amount not to exceed $105 for each 90-day supply 
45.17 	of insulin the manufacturer provided under paragraphs (c) and (f). If the manufacturer 
45.18 	provides less than a 90-day supply of insulin under paragraphs (c) and (f), the manufacturer 
45.19 	may submit a request for reimbursement not to exceed $35 for each 30-day supply of insulin 
45.20 	provided.

45.21 	EFFECTIVE DATE. This section is effective December 1, 2024.

45.22 	Sec. 6. [151.741] INSULIN MANUFACTURER REGISTRATION FEE.
45.23 		Subdivision 1.Definitions. (a) For purposes of this section, the following terms have 
45.24 	the meanings given.
45.25 	(b) "Board" means the Minnesota Board of Pharmacy under section 151.02.
45.26 	(c) "Manufacturer" means a manufacturer licensed under section 151.252 and engaged 
45.27 	in the manufacturing of prescription insulin.
45.28 		Subd. 2.Assessment of registration fee. (a) The board shall assess each manufacturer 
45.29 	an annual registration fee of $100,000, except as provided in paragraph (b). The board shall 
45.30 	notify each manufacturer of this requirement beginning November 1, 2024, and each 
45.31 	November 1 thereafter.
46.1 	(b) A manufacturer may request an exemption from the annual registration fee. The 
46.2 	board shall exempt a manufacturer from the annual registration fee if the manufacturer can 
46.3 	demonstrate to the board, in the form and manner specified by the board, that gross revenue 
46.4 	from sales of prescription insulin produced by that manufacturer and sold or delivered within 
46.5 	or into Minnesota was less than five percent of the total gross revenue from sales of 
46.6 	prescription insulin produced by all manufacturers and sold or delivered within or into 
46.7 	Minnesota in the previous calendar year.
46.8 		Subd. 3.Payment of the registration fee; deposit of fee. (a) Each manufacturer must 
46.9 	pay the registration fee by March 1, 2025, and by each March 1 thereafter. In the event of 
46.10 	a change in ownership of the manufacturer, the new owner must pay the registration fee 
46.11 	that the original owner would have been assessed had the original owner retained ownership. 
46.12 	The board may assess a late fee of ten percent per month or any portion of a month that the 
46.13 	registration fee is paid after the due date.
46.14 	(b) The registration fee, including any late fees, must be deposited in the insulin safety 
46.15 	net program account.
46.16 		Subd. 4.Insulin safety net program account. The insulin safety net program account 
46.17 	is established in the special revenue fund in the state treasury. Money in the account is 
46.18 	appropriated each fiscal year to:
46.19 	(1) the MNsure board in an amount sufficient to carry out assigned duties under section 
46.20 	151.74, subdivision 7; and
46.21 	(2) the Board of Pharmacy in an amount sufficient to cover costs incurred by the board 
46.22 	in assessing and collecting the registration fee under this section and in administering the 
46.23 	insulin safety net program under section 151.74.
46.24 		Subd. 5.Insulin repayment account; annual transfer from health care access fund. (a) 
46.25 	The insulin repayment account is established in the special revenue fund in the state treasury. 
46.26 	Money in the account is appropriated each fiscal year to the commissioner of administration 
46.27 	to reimburse manufacturers for insulin dispensed under the insulin safety net program in 
46.28 	section 151.74, in accordance with section 151.74, subdivisions 3, paragraph (h), and 6, 
46.29 	paragraph (h), and to cover costs incurred by the commissioner in providing these 
46.30 	reimbursement payments.
46.31 	(b) By June 30, 2025, and each June 30 thereafter, the commissioner of administration 
46.32 	shall certify to the commissioner of management and budget the total amount expended in 
46.33 	the prior fiscal year for:
47.1 	(1) reimbursement to manufacturers for insulin dispensed under the insulin safety net 
47.2 	program in section 151.74, in accordance with section 151.74, subdivisions 3, paragraph 
47.3 	(h), and 6, paragraph (h); and
47.4 	(2) costs incurred by the commissioner of administration in providing the reimbursement 
47.5 	payments described in clause (1).
47.6 	(c) The commissioner of management and budget shall transfer from the health care 
47.7 	access fund to the special revenue fund, beginning July 1, 2025, and each July 1 thereafter, 
47.8 	an amount equal to the amount to which the commissioner of administration certified 
47.9 	pursuant to paragraph (b).
47.10 		Subd. 6.Contingent transfer by commissioner. If subdivisions 2 and 3, or the 
47.11 	application of subdivisions 2 and 3 to any person or circumstance, are held invalid for any 
47.12 	reason in a court of competent jurisdiction, the invalidity of subdivisions 2 and 3 does not 
47.13 	affect other provisions of this act, and the commissioner of management and budget shall 
47.14 	annually transfer from the health care access fund to the insulin safety net program account 
47.15 	an amount sufficient to implement subdivision 4.

47.16 	EFFECTIVE DATE. This section is effective July 1, 2024.

47.17 	Sec. 7. Laws 2020, chapter 73, section 8, is amended to read:
47.18 	Sec. 8. APPROPRIATIONS.
 47.19 	(a) $297,000 is appropriated in fiscal year 2020 from the health care access fund to the 
47.20 	Board of Directors of MNsure to train navigators to assist individuals and provide 
47.21 	compensation as required for the insulin safety net program under Minnesota Statutes, 
47.22 	section 151.74, subdivision 7. Of this appropriation, $108,000 is for implementing the 
47.23 	training requirements for navigators and $189,000 is for application assistance bonus 
47.24 	payments. This is a onetime appropriation and is available until December 31, 2024 June 
47.25 	30, 2027.
47.26 	(b) $250,000 is appropriated in fiscal year 2020 from the health care access fund to the 
47.27 	Board of Directors of MNsure for a public awareness campaign for the insulin safety net 
47.28 	program established under Minnesota Statutes, section 151.74. This is a onetime appropriation 
47.29 	and is available until December 31, 2024.
47.30 	(c) $76,000 is appropriated in fiscal year 2021 from the health care access fund to the 
47.31 	Board of Pharmacy to implement Minnesota Statutes, section 151.74. The base for this 
48.1 	appropriation is $76,000 in fiscal year 2022; $76,000 in fiscal year 2023; $76,000 in fiscal 
48.2 	year 2024; $38,000 in fiscal year 2025; and $0 in fiscal year 2026.
48.3 	(d) $136,000 in fiscal year 2021 is appropriated from the health care access fund to the 
48.4 	commissioner of health to implement the survey to assess program satisfaction in Minnesota 
48.5 	Statutes, section 151.74, subdivision 12. The base for this appropriation is $80,000 in fiscal 
48.6 	year 2022 and $0 in fiscal year 2023. This is a onetime appropriation.

48.7 	Sec. 8. REPEALER; SUNSET FOR THE LONG-TERM SAFETY NET INSULIN 
48.8 	PROGRAM.
 48.9 	Minnesota Statutes 2022, section 151.74, subdivision 16, is repealed.

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

48.11 	ARTICLE 4
48.12 	HEALTH INSURANCE

48.13 	Section 1. Minnesota Statutes 2022, section 43A.24, is amended by adding a subdivision 
48.14 	to read:
48.15 		Subd. 4.For-profit health maintenance organizations prohibited.  The commissioner 
48.16 	must ensure that state paid hospital, medical, and dental benefits are not provided to eligible 
48.17 	employees by a health maintenance organization which is not a nonprofit corporation 
48.18 	organized under chapter 317A or a local governmental unit, as defined in section 62D.02.

48.19 	EFFECTIVE DATE. This section is effective January 1, 2025.

48.20 	Sec. 2. Minnesota Statutes 2022, section 62A.0411, is amended to read:
48.21 	62A.0411 MATERNITY CARE.
48.22 		Subdivision 1.Minimum inpatient care. Every health plan as defined in section 62Q.01, 
48.23 	subdivision 3, that provides maternity benefits must, consistent with other coinsurance, 
48.24 	co-payment, deductible, and related contract terms, provide coverage of a minimum of 48 
48.25 	hours of inpatient care following a vaginal delivery and a minimum of 96 hours of inpatient 
48.26 	care following a caesarean section for a mother and her newborn. The health plan shall not 
48.27 	provide any compensation or other nonmedical remuneration to encourage a mother and 
48.28 	newborn to leave inpatient care before the duration minimums specified in this section.
48.29 		Subd. 1a.Medical facility transfer. (a) If a health care provider acting within the 
48.30 	provider's scope of practice recommends that either the mother or newborn be transferred 
48.31 	to a different medical facility, every health plan must provide the coverage required under 
49.1 	subdivision 1 for the mother, newborn, and newborn siblings at both medical facilities. The 
49.2 	coverage required under this subdivision includes but is not limited to expenses related to 
49.3 	transferring all individuals from one medical facility to a different medical facility.
49.4 	(b) The coverage required under this subdivision must be provided without cost sharing, 
49.5 	including but not limited to deductible, co-pay, or coinsurance. The coverage required under 
49.6 	this paragraph must be provided without any limitation that is not generally applicable to 
49.7 	other coverages under the plan.
49.8 	(c) Notwithstanding paragraph (b), a health plan that is a high-deductible health plan in 
49.9 	conjunction with a health savings account must include cost-sharing for the coverage required 
49.10 	under this subdivision at the minimum level necessary to preserve the enrollee's ability to 
49.11 	make tax-exempt contributions and withdrawals from the health savings account as provided 
49.12 	in section 223 of the Internal Revenue Code of 1986.
49.13 		Subd. 2.Minimum postdelivery outpatient care. (a) The health plan must also provide 
49.14 	coverage for postdelivery outpatient care to a mother and her newborn if the duration of 
49.15 	inpatient care is less than the minimums provided in this section.
49.16 	(b) Postdelivery care consists of a minimum of one home visit by a registered nurse. 
49.17 	Services provided by the registered nurse include, but are not limited to, parent education, 
49.18 	assistance and training in breast and bottle feeding, and conducting any necessary and 
49.19 	appropriate clinical tests. The home visit must be conducted within four days following the 
49.20 	discharge of the mother and her child.
49.21 		Subd. 3.Health plan defined. For purposes of this section, "health plan" has the meaning 
49.22 	given in section 62Q.01, subdivision 3, and county-based purchasing plans.

49.23 	EFFECTIVE DATE. This section is effective January 1, 2025, and applies to all policies, 
49.24 	plans, certificates, and contracts offered, issued, or renewed on or after that date.

49.25 	Sec. 3. Minnesota Statutes 2022, section 62A.15, is amended by adding a subdivision to 
49.26 	read:
49.27 		Subd. 3d.Pharmacist. All benefits provided by a policy or contract referred to in 
49.28 	subdivision 1 relating to expenses incurred for medical treatment or services provided by 
49.29 	a licensed physician must include services provided by a licensed pharmacist, according to 
49.30 	the requirements of section 151.01, to the extent a licensed pharmacist's services are within 
49.31 	the pharmacist's scope of practice.

49.32 	EFFECTIVE DATE. This section is effective January 1, 2025, and applies to policies 
49.33 	or contracts offered, issued, or renewed on or after that date.

50.1 	Sec. 4. Minnesota Statutes 2022, section 62A.15, subdivision 4, is amended to read:
50.2 		Subd. 4.Denial of benefits. (a) No carrier referred to in subdivision 1 may, in the 
50.3 	payment of claims to employees in this state, deny benefits payable for services covered by 
50.4 	the policy or contract if the services are lawfully performed by a licensed chiropractor, a 
50.5 	licensed optometrist, a registered nurse meeting the requirements of subdivision 3a, a licensed 
50.6 	physician assistant, or a licensed acupuncture practitioner, or a licensed pharmacist.
50.7 	(b) When carriers referred to in subdivision 1 make claim determinations concerning 
50.8 	the appropriateness, quality, or utilization of chiropractic health care for Minnesotans, any 
50.9 	of these determinations that are made by health care professionals must be made by, or 
50.10 	under the direction of, or subject to the review of licensed doctors of chiropractic.
50.11 	(c) When a carrier referred to in subdivision 1 makes a denial of payment claim 
50.12 	determination concerning the appropriateness, quality, or utilization of acupuncture services 
50.13 	for individuals in this state performed by a licensed acupuncture practitioner, a denial of 
50.14 	payment claim determination that is made by a health professional must be made by, under 
50.15 	the direction of, or subject to the review of a licensed acupuncture practitioner.

50.16 	EFFECTIVE DATE. This section is effective January 1, 2025, and applies to policies 
50.17 	or contracts offered, issued, or renewed on or after that date.

50.18 	Sec. 5. Minnesota Statutes 2022, section 62A.28, subdivision 2, is amended to read:
50.19 		Subd. 2.Required coverage. (a) Every policy, plan, certificate, or contract referred to 
50.20 	in subdivision 1 issued or renewed after August 1, 1987, must provide coverage for scalp 
50.21 	hair prostheses, including all equipment and accessories necessary for regular use of scalp 
50.22 	hair prostheses, worn for hair loss suffered as a result of a health condition, including but 
50.23 	not limited to alopecia areata or the treatment for cancer, unless there is a clinical basis for 
50.24 	limitation.
50.25 	(b) The coverage required by this section is subject to the co-payment, coinsurance, 
50.26 	deductible, and other enrollee cost-sharing requirements that apply to similar types of items 
50.27 	under the policy, plan, certificate, or contract and may be limited to one prosthesis per 
50.28 	benefit year.
50.29 	(c) The coverage required by this section for scalp hair prostheses is limited to $1,000 
50.30 	per benefit year.
50.31 	(d) A scalp hair prosthesis must be prescribed by a doctor to be covered under this 
50.32 	section.

51.1 	EFFECTIVE DATE. This section is effective January 1, 2025, and applies to all policies, 
51.2 	plans, certificates, and contracts offered, issued, or renewed on or after that date.

51.3 	Sec. 6. [62A.3098] RAPID WHOLE GENOME SEQUENCING; COVERAGE.
51.4 		Subdivision 1.Definition. For purposes of this section, "rapid whole genome sequencing" 
51.5 	or "rWGS" means an investigation of the entire human genome, including coding and 
51.6 	noncoding regions and mitochondrial deoxyribonucleic acid, to identify disease-causing 
51.7 	genetic changes that returns the final results in 14 days. Rapid whole genome sequencing 
51.8 	includes patient-only whole genome sequencing and duo and trio whole genome sequencing 
51.9 	of the patient and the patient's biological parent or parents.
51.10 		Subd. 2.Required coverage. A health plan that provides coverage to Minnesota residents 
51.11 	must cover rWGS testing if the enrollee:
51.12 	(1) is 21 years of age or younger;
51.13 	(2) has a complex or acute illness of unknown etiology that is not confirmed to have 
51.14 	been caused by an environmental exposure, toxic ingestion, an infection with a normal 
51.15 	response to therapy, or trauma; and
51.16 	(3) is receiving inpatient hospital services in an intensive care unit or a neonatal or high 
51.17 	acuity pediatric care unit.
51.18 		Subd. 3.Coverage criteria. Coverage may be based on the following medical necessity 
51.19 	criteria:
51.20 	(1) the enrollee has symptoms that suggest a broad differential diagnosis that would 
51.21 	require an evaluation by multiple genetic tests if rWGS testing is not performed;
51.22 	(2) timely identification of a molecular diagnosis is necessary in order to guide clinical 
51.23 	decision making, and the rWGS testing may aid in guiding the treatment or management 
51.24 	of the enrollee's condition; and
51.25 	(3) the enrollee's complex or acute illness of unknown etiology includes at least one of 
51.26 	the following conditions:
51.27 	(i) congenital anomalies involving at least two organ systems, or complex or multiple 
51.28 	congenital anomalies in one organ system;
51.29 	(ii) specific organ malformations that are highly suggestive of a genetic etiology;
51.30 	(iii) abnormal laboratory tests or abnormal chemistry profiles suggesting the presence 
51.31 	of a genetic disease, complex metabolic disorder, or inborn error of metabolism;
52.1 	(iv) refractory or severe hypoglycemia or hyperglycemia;
52.2 	(v) abnormal response to therapy related to an underlying medical condition affecting 
52.3 	vital organs or bodily systems;
52.4 	(vi) severe muscle weakness, rigidity, or spasticity;
52.5 	(vii) refractory seizures;
52.6 	(viii) a high-risk stratification on evaluation for a brief resolved unexplained event with 
52.7 	any of the following features:
52.8 	(A) a recurrent event without respiratory infection;
52.9 	(B) a recurrent seizure-like event; or
52.10 	(C) a recurrent cardiopulmonary resuscitation;
52.11 	(ix) abnormal cardiac diagnostic testing results that are suggestive of possible 
52.12 	channelopathies, arrhythmias, cardiomyopathies, myocarditis, or structural heart disease;
52.13 	(x) abnormal diagnostic imaging studies that are suggestive of underlying genetic 
52.14 	condition;
52.15 	(xi) abnormal physiologic function studies that are suggestive of an underlying genetic 
52.16 	etiology; or
52.17 	(xii) family genetic history related to the patient's condition.
52.18 		Subd. 4.Cost sharing. Coverage provided in this section is subject to the enrollee's 
52.19 	health plan cost-sharing requirements, including any deductibles, co-payments, or coinsurance 
52.20 	requirements that apply to diagnostic testing services.
52.21 		Subd. 5.Payment for services provided. If the enrollee's health plan uses a capitated 
52.22 	or bundled payment arrangement to reimburse a provider for services provided in an inpatient 
52.23 	setting, reimbursement for services covered under this section must be paid separately and 
52.24 	in addition to any reimbursement otherwise payable to the provider under the capitated or 
52.25 	bundled payment arrangement, unless the health carrier and the provider have negotiated 
52.26 	an increased capitated or bundled payment rate that includes the services covered under this 
52.27 	section.
52.28 		Subd. 6.Genetic data. Genetic data generated as a result of performing rWGS and 
52.29 	covered under this section: (1) must be used for the primary purpose of assisting the ordering 
52.30 	provider and treating care team to diagnose and treat the patient; (2) is protected health 
52.31 	information as set forth under the Health Insurance Portability and Accountability Act 
53.1 	(HIPAA), the Health Information Technology for Economic and Clinical Health Act, and 
53.2 	any promulgated regulations, including but not limited to Code of Federal Regulations, title 
53.3 	45, parts 160 and 164, subparts A and E; and (3) is a protected health record under sections 
53.4 	144.291 to 144.298.
53.5 		Subd. 7.Reimbursement. (a) The commissioner of commerce must reimburse health 
53.6 	carriers for coverage under this section. Reimbursement is available only for coverage that 
53.7 	would not have been provided by the health plan without the requirements of this section. 
53.8 	Treatments and services covered by the health plan as of January 1, 2024, are ineligible for 
53.9 	payments under this subdivision by the commissioner of commerce.
53.10 	(b) Health carriers must report to the commissioner of commerce quantified costs 
53.11 	attributable to the additional benefit under this section in a format developed by the 
53.12 	commissioner. A health plan's coverage as of January 1, 2024, must be used by the health 
53.13 	carrier as the basis for determining whether coverage would not have been provided by the 
53.14 	health plan for purposes of this subdivision.
53.15 	(c) The commissioner of commerce must evaluate submissions and make payments to 
53.16 	health carriers as provided in Code of Federal Regulations, title 45, section 155.170.
53.17 		Subd. 8.Appropriation. Each fiscal year, an amount necessary to make payments to 
53.18 	health carriers to defray the cost of providing coverage under this section is appropriated 
53.19 	to the commissioner of commerce.

53.20 	EFFECTIVE DATE. This section is effective January 1, 2025, and applies to a health 
53.21 	plan offered, issued, or sold on or after that date.

53.22 	Sec. 7. [62A.59] COVERAGE OF SERVICE; PRIOR AUTHORIZATION.
53.23 		Subdivision 1.Service for which prior authorization not required. A health carrier 
53.24 	must not retrospectively deny or limit coverage of a health care service for which prior 
53.25 	authorization was not required by the health carrier, unless there is evidence that the health 
53.26 	care service was provided based on fraud or misinformation.
53.27 		Subd. 2.Service for which prior authorization required but not obtained. A health 
53.28 	carrier must not deny or limit coverage of a health care service which the enrollee has already 
53.29 	received solely on the basis of lack of prior authorization if the service would otherwise 
53.30 	have been covered had the prior authorization been obtained.

53.31 	EFFECTIVE DATE. This section is effective January 1, 2026, and applies to health 
53.32 	plans offered, sold, issued, or renewed on or after that date.

54.1 	Sec. 8. [62C.045] APPLICATION OF OTHER LAW.
54.2 	Sections 145D.30 to 145D.37 apply to service plan corporations operating under this 
54.3 	chapter.

54.4 	EFFECTIVE DATE. This section is effective July 1, 2025.

54.5 	Sec. 9. Minnesota Statutes 2022, section 62D.02, subdivision 7, is amended to read:
54.6 		Subd. 7.Comprehensive health maintenance services. "Comprehensive health 
54.7 	maintenance services" means a set of comprehensive health services which the enrollees 
54.8 	might reasonably require to be maintained in good health including as a minimum, but not 
54.9 	limited to, emergency care, emergency ground ambulance transportation services, inpatient 
54.10 	hospital and physician care, outpatient health services and preventive health services. 
54.11 	Elective, induced abortion, except as medically necessary to prevent the death of the mother, 
54.12 	whether performed in a hospital, other abortion facility or the office of a physician, shall 
54.13 	not be mandatory for any health maintenance organization.

54.14 	EFFECTIVE DATE. This section is effective January 1, 2025, and applies to health 
54.15 	plans offered, sold, issued, or renewed on or after that date.

54.16 	Sec. 10. Minnesota Statutes 2022, section 62D.04, subdivision 5, is amended to read:
54.17 		Subd. 5.Participation; government programs. Health maintenance organizations that 
54.18 	are a nonprofit corporation organized under chapter 317A or a local governmental unit shall, 
54.19 	as a condition of receiving and retaining a certificate of authority, participate in the medical 
54.20 	assistance and MinnesotaCare programs. A health maintenance organization governed by 
54.21 	this subdivision is required to submit proposals in good faith that meet the requirements of 
54.22 	the request for proposal provided that the requirements can be reasonably met by a health 
54.23 	maintenance organization to serve individuals eligible for the above programs in a geographic 
54.24 	region of the state if, at the time of publication of a request for proposal, the percentage of 
54.25 	recipients in the public programs in the region who are enrolled in the health maintenance 
54.26 	organization is less than the health maintenance organization's percentage of the total number 
54.27 	of individuals enrolled in health maintenance organizations in the same region. Geographic 
54.28 	regions shall be defined by the commissioner of human services in the request for proposals.

54.29 	EFFECTIVE DATE. This section is effective January 1, 2025.

55.1 	Sec. 11. [62D.1071] COVERAGE OF LICENSED PHARMACIST SERVICES.
55.2 		Subdivision 1.Pharmacist. All benefits provided by a health maintenance contract 
55.3 	relating to expenses incurred for medical treatment or services provided by a licensed 
55.4 	physician must include services provided by a licensed pharmacist to the extent a licensed 
55.5 	pharmacist's services are within the pharmacist's scope of practice.
55.6 		Subd. 2.Denial of benefits. When paying claims for enrollees in Minnesota, a health 
55.7 	maintenance organization must not deny payment for medical services covered by an 
55.8 	enrollee's health maintenance contract if the services are lawfully performed by a licensed 
55.9 	pharmacist.
55.10 		Subd. 3.Exemptions. (a) This section does not apply to or affect the coverage or 
55.11 	reimbursement for medication therapy management services under section 62Q.676 or 
55.12 	256B.0625, subdivisions 5, 13h, and 28a.
55.13 	(b) This section does not apply to managed care organizations or county-based purchasing 
55.14 	plans when the plan provides coverage to public health care program enrollees under chapter 
55.15 	256B or 256L.

55.16 	EFFECTIVE DATE. This section is effective January 1, 2025, and applies to health 
55.17 	plans offered, issued, or renewed on or after that date.

55.18 	Sec. 12. Minnesota Statutes 2022, section 62D.12, subdivision 19, is amended to read:
55.19 		Subd. 19.Coverage of service. A health maintenance organization may not deny or 
55.20 	limit coverage of a service which the enrollee has already received solely on the basis of 
55.21 	lack of prior authorization or second opinion, to the extent that the service would otherwise 
55.22 	have been covered under the member's contract by the health maintenance organization had 
55.23 	prior authorization or second opinion been obtained. This subdivision expires December 
55.24 	31, 2025, for health plans offered, sold, issued, or renewed on or after that date.

55.25 	Sec. 13. Minnesota Statutes 2022, section 62D.20, subdivision 1, is amended to read:
55.26 		Subdivision 1.Rulemaking. The commissioner of health may, pursuant to chapter 14, 
55.27 	promulgate such reasonable rules as are necessary or proper to carry out the provisions of 
55.28 	sections 62D.01 to 62D.30. Included among such rules shall be those which provide minimum 
55.29 	requirements for the provision of comprehensive health maintenance services, as defined 
55.30 	in section 62D.02, subdivision 7, and reasonable exclusions therefrom. Nothing in such 
55.31 	rules shall force or require a health maintenance organization to provide elective, induced 
55.32 	abortions, except as medically necessary to prevent the death of the mother, whether 
56.1 	performed in a hospital, other abortion facility, or the office of a physician; the rules shall 
56.2 	provide every health maintenance organization the option of excluding or including elective, 
56.3 	induced abortions, except as medically necessary to prevent the death of the mother, as part 
56.4 	of its comprehensive health maintenance services.

56.5 	EFFECTIVE DATE. This section is effective January 1, 2025, and applies to health 
56.6 	plans offered, sold, issued, or renewed on or after that date.

56.7 	Sec. 14. Minnesota Statutes 2022, section 62D.22, subdivision 5, is amended to read:
56.8 		Subd. 5.Other state law. Except as otherwise provided in sections 62A.01 to 62A.42
56.9 	and 62D.01 to 62D.30, and except as they eliminate elective, induced abortions, wherever 
56.10 	performed, from health or maternity benefits, provisions of the insurance laws and provisions 
56.11 	of nonprofit health service plan corporation laws shall not be applicable to any health 
56.12 	maintenance organization granted a certificate of authority under sections 62D.01 to 62D.30.

56.13 	EFFECTIVE DATE. This section is effective January 1, 2025, and applies to health 
56.14 	plans offered, sold, issued, or renewed on or after that date.

56.15 	Sec. 15. Minnesota Statutes 2022, section 62D.22, is amended by adding a subdivision to 
56.16 	read:
56.17 		Subd. 5a.Application of other law. Effective July 1, 2025, sections 145D.30 to 145D.37 
56.18 	apply to nonprofit health maintenance organizations operating under this chapter.

56.19 	Sec. 16. [62D.221] OVERSIGHT OF TRANSACTIONS.
56.20 		Subdivision 1.Insurance provisions applicable to health maintenance 
56.21 	organizations. Health maintenance organizations are subject to sections 60A.135, 60A.136, 
56.22 	60A.137, 60A.16, 60A.161, 60D.17, 60D.18, and 60D.20 and must comply with the 
56.23 	provisions of these sections applicable to insurers. In applying these sections to health 
56.24 	maintenance organizations, "commissioner" means the commissioner of health. Health 
56.25 	maintenance organizations are subject to Minnesota Rules, chapter 2720, as applicable to 
56.26 	sections 60D.17, 60D.18, and 60D.20, and must comply with the provisions of chapter 2720 
56.27 	applicable to insurers, unless the commissioner of health adopts rules to implement this 
56.28 	subdivision.
56.29 		Subd. 2.Statement. In addition to the conditions in section 60D.17, subdivision 1, 
56.30 	subjecting a health maintenance organization to filing requirements, no person other than 
56.31 	the issuer shall acquire all or substantially all of the assets of a domestic nonprofit health 
56.32 	maintenance organization through any means unless at the time the offer, request, or 
57.1 	invitation is made or the agreement is entered into the person has filed with the commissioner 
57.2 	and has sent to the health maintenance organization a statement containing the information 
57.3 	required in section 60D.17 and the offer, request, invitation, agreement, or acquisition has 
57.4 	been approved by the commissioner of health in the manner prescribed in section 60D.17.

57.5 	Sec. 17. Minnesota Statutes 2022, section 62M.02, subdivision 1a, is amended to read:
57.6 		Subd. 1a.Adverse determination. "Adverse determination" means a decision by a 
57.7 	utilization review organization relating to an admission, extension of stay, or health care 
57.8 	service that is partially or wholly adverse to the enrollee, including:
57.9 	(1) a decision to deny an admission, extension of stay, or health care service on the basis 
57.10 	that it is not medically necessary; or
57.11 	(2) an authorization for a health care service that is less intensive than the health care 
57.12 	service specified in the original request for authorization.

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

57.14 	Sec. 18. Minnesota Statutes 2022, section 62M.02, subdivision 5, is amended to read:
57.15 		Subd. 5.Authorization. "Authorization" means a determination by a utilization review 
57.16 	organization that an admission, extension of stay, or other health care service has been 
57.17 	reviewed and that, based on the information provided, it satisfies the utilization review 
57.18 	requirements of the applicable health benefit plan and the health plan company or 
57.19 	commissioner will then pay for the covered benefit, provided the preexisting limitation 
57.20 	provisions, the general exclusion provisions, and any deductible, co-payment, coinsurance, 
57.21 	or other policy requirements have been met.

57.22 	Sec. 19. Minnesota Statutes 2022, section 62M.02, is amended by adding a subdivision 
57.23 	to read:
57.24 		Subd. 8a.Commissioner. "Commissioner" means, effective January 1, 2026, for the 
57.25 	sections specified in section 62M.01, subdivision 3, paragraph (c), the commissioner of 
57.26 	human services, unless otherwise specified.

57.27 	Sec. 20. Minnesota Statutes 2022, section 62M.02, subdivision 11, is amended to read:
57.28 		Subd. 11.Enrollee. "Enrollee" means:
57.29 	(1) an individual covered by a health benefit plan and includes an insured policyholder, 
57.30 	subscriber, contract holder, member, covered person, or certificate holder; or
58.1 	(2) effective January 1, 2026, for the sections specified in section 62M.01, subdivision 
58.2 	3, paragraph (c), a recipient receiving coverage through fee-for-service under chapters 256B 
58.3 	and 256L.

58.4 	Sec. 21. Minnesota Statutes 2022, section 62M.02, subdivision 12, is amended to read:
58.5 		Subd. 12.Health benefit plan. (a) "Health benefit plan" means:
58.6 	(1) a policy, contract, or certificate issued by a health plan company for the coverage of 
58.7 	medical, dental, or hospital benefits; or
58.8 	(2) effective January 1, 2026, for the sections specified in section 62M.01, subdivision 
58.9 	3, paragraph (c), coverage of medical, dental, or hospital benefits through fee-for-service 
58.10 	under chapters 256B and 256L, as specified by the commissioner on the agency's public 
58.11 	website or through other forms of recipient and provider guidance.
58.12 	(b) A health benefit plan does not include coverage that is:
58.13 	(1) limited to disability or income protection coverage;
58.14 	(2) automobile medical payment coverage;
58.15 	(3) supplemental to liability insurance;
58.16 	(4) designed solely to provide payments on a per diem, fixed indemnity, or nonexpense 
58.17 	incurred basis;
58.18 	(5) credit accident and health insurance issued under chapter 62B;
58.19 	(6) blanket accident and sickness insurance as defined in section 62A.11;
58.20 	(7) accident only coverage issued by a licensed and tested insurance agent; or
58.21 	(8) workers' compensation.

58.22 	Sec. 22. Minnesota Statutes 2022, section 62M.02, subdivision 21, is amended to read:
58.23 		Subd. 21.Utilization review organization. "Utilization review organization" means an 
58.24 	entity including but not limited to an insurance company licensed under chapter 60A to 
58.25 	offer, sell, or issue a policy of accident and sickness insurance as defined in section 62A.01; 
58.26 	a prepaid limited health service organization issued a certificate of authority and operating 
58.27 	under sections 62A.451 to 62A.4528; a health service plan licensed under chapter 62C; a 
58.28 	health maintenance organization licensed under chapter 62D; a community integrated service 
58.29 	network licensed under chapter 62N; an accountable provider network operating under 
58.30 	chapter 62T; a fraternal benefit society operating under chapter 64B; a joint self-insurance 
59.1 	employee health plan operating under chapter 62H; a multiple employer welfare arrangement, 
59.2 	as defined in section 3 of the Employee Retirement Income Security Act of 1974 (ERISA), 
59.3 	United States Code, title 29, section 1103, as amended; a third-party administrator licensed 
59.4 	under section 60A.23, subdivision 8, which conducts utilization review and authorizes or 
59.5 	makes adverse determinations regarding an admission, extension of stay, or other health 
59.6 	care services for a Minnesota resident; effective January 1, 2026, for the sections specified 
59.7 	in section 62M.01, subdivision 3, paragraph (c), the commissioner of human services for 
59.8 	purposes of delivering services through fee-for-service under chapters 256B and 256L; any 
59.9 	other entity that provides, offers, or administers hospital, outpatient, medical, prescription 
59.10 	drug, or other health benefits to individuals treated by a health professional under a policy, 
59.11 	plan, or contract; or any entity performing utilization review that is affiliated with, under 
59.12 	contract with, or conducting utilization review on behalf of, a business entity in this state. 
59.13 	Utilization review organization does not include a clinic or health care system acting pursuant 
59.14 	to a written delegation agreement with an otherwise regulated utilization review organization 
59.15 	that contracts with the clinic or health care system. The regulated utilization review 
59.16 	organization is accountable for the delegated utilization review activities of the clinic or 
59.17 	health care system.

59.18 	Sec. 23. Minnesota Statutes 2022, section 62M.04, subdivision 1, is amended to read:
59.19 		Subdivision 1.Responsibility for obtaining authorization. A health benefit plan that 
59.20 	includes utilization review requirements must specify the process for notifying the utilization 
59.21 	review organization in a timely manner and obtaining authorization for health care services. 
59.22 	Each health plan company must provide a clear and concise description of this process to 
59.23 	an enrollee as part of the policy, subscriber contract, or certificate of coverage. Effective 
59.24 	January 1, 2026, the commissioner must provide a clear and concise description of this 
59.25 	process to fee-for-service recipients receiving services under chapters 256B and 256L, 
59.26 	through the agency's public website or through other forms of recipient guidance. In addition 
59.27 	to the enrollee, the utilization review organization must allow any provider or provider's 
59.28 	designee, or responsible patient representative, including a family member, to fulfill the 
59.29 	obligations under the health benefit plan.
59.30 	A claims administrator that contracts directly with providers for the provision of health 
59.31 	care services to enrollees may, through contract, require the provider to notify the review 
59.32 	organization in a timely manner and obtain authorization for health care services.

60.1 	Sec. 24. Minnesota Statutes 2022, section 62M.05, subdivision 3a, is amended to read:
60.2 		Subd. 3a.Standard review determination. (a) Notwithstanding subdivision 3b, a 
60.3 	standard review determination on all requests for utilization review must be communicated 
60.4 	to the provider and enrollee in accordance with this subdivision within five business days 
60.5 	after receiving the request if the request is received electronically, or within six business 
60.6 	days if received through nonelectronic means, provided that all information reasonably 
60.7 	necessary to make a determination on the request has been made available to the utilization 
60.8 	review organization. Effective January 1, 2022, A standard review determination on all 
60.9 	requests for utilization review must be communicated to the provider and enrollee in 
60.10 	accordance with this subdivision within five business days after receiving the request, 
60.11 	regardless of how the request was received, provided that all information reasonably 
60.12 	necessary to make a determination on the request has been made available to the utilization 
60.13 	review organization.
60.14 	(b) When a determination is made to authorize, notification must be provided promptly 
60.15 	by telephone to the provider. The utilization review organization shall send written 
60.16 	notification to the provider or shall maintain an audit trail of the determination and telephone 
60.17 	notification. For purposes of this subdivision, "audit trail" includes documentation of the 
60.18 	telephone notification, including the date; the name of the person spoken to; the enrollee; 
60.19 	the service, procedure, or admission authorized; and the date of the service, procedure, or 
60.20 	admission. If the utilization review organization indicates authorization by use of a number, 
60.21 	the number must be called the "authorization number." For purposes of this subdivision, 
60.22 	notification may also be made by facsimile to a verified number or by electronic mail to a 
60.23 	secure electronic mailbox. These electronic forms of notification satisfy the "audit trail" 
60.24 	requirement of this paragraph.
60.25 	(c) When an adverse determination is made, notification must be provided within the 
60.26 	time periods specified in paragraph (a) by telephone, by facsimile to a verified number, or 
60.27 	by electronic mail to a secure electronic mailbox to the attending health care professional 
60.28 	and hospital or physician office as applicable. Written notification must also be sent to the 
60.29 	hospital or physician office as applicable and attending health care professional if notification 
60.30 	occurred by telephone. For purposes of this subdivision, notification may be made by 
60.31 	facsimile to a verified number or by electronic mail to a secure electronic mailbox. Written 
60.32 	notification must be sent to the enrollee and may be sent by United States mail, facsimile 
60.33 	to a verified number, or by electronic mail to a secure mailbox. The written notification 
60.34 	must include all reasons relied on by the utilization review organization for the determination 
60.35 	and the process for initiating an appeal of the determination. Upon request, the utilization 
61.1 	review organization shall provide the provider or enrollee with the criteria used to determine 
61.2 	the necessity, appropriateness, and efficacy of the health care service and identify the 
61.3 	database, professional treatment parameter, or other basis for the criteria. Reasons for an 
61.4 	adverse determination may include, among other things, the lack of adequate information 
61.5 	to authorize after a reasonable attempt has been made to contact the provider or enrollee.
61.6 	(d) When an adverse determination is made, the written notification must inform the 
61.7 	enrollee and the attending health care professional of the right to submit an appeal to the 
61.8 	internal appeal process described in section 62M.06 and the procedure for initiating the 
61.9 	internal appeal. The written notice shall be provided in a culturally and linguistically 
61.10 	appropriate manner consistent with the provisions of the Affordable Care Act as defined 
61.11 	under section 62A.011, subdivision 1a.

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

61.13 	Sec. 25. Minnesota Statutes 2022, section 62M.07, subdivision 2, is amended to read:
61.14 		Subd. 2.Prior authorization of emergency certain services prohibited.  No utilization 
61.15 	review organization, health plan company, or claims administrator may conduct or require 
61.16 	prior authorization of:
61.17 	(1) emergency confinement or an emergency service. The enrollee or the enrollee's 
61.18 	authorized representative may be required to notify the health plan company, claims 
61.19 	administrator, or utilization review organization as soon as reasonably possible after the 
61.20 	beginning of the emergency confinement or emergency service.;
61.21 	(2) outpatient mental health treatment or outpatient substance use disorder treatment, 
61.22 	except for treatment which is a medication. Prior authorizations required for medications 
61.23 	used for outpatient mental health treatment or outpatient substance use disorder treatment 
61.24 	must be processed according to section 62M.05, subdivision 3b, for initial determinations, 
61.25 	and according to section 62M.06, subdivision 2, for appeals;
61.26 	(3) antineoplastic cancer treatment that is consistent with guidelines of the National 
61.27 	Comprehensive Cancer Network, except for treatment which is a medication. Prior 
61.28 	authorizations required for medications used for antineoplastic cancer treatment must be 
61.29 	processed according to section 62M.05, subdivision 3b, for initial determinations, and 
61.30 	according to section 62M.06, subdivision 2, for appeals;
61.31 	(4) services that currently have a rating of A or B from the United States Preventive 
61.32 	Services Task Force, immunizations recommended by the Advisory Committee on 
61.33 	Immunization Practices of the Centers for Disease Control and Prevention, or preventive 
62.1 	services and screenings provided to women as described in Code of Federal Regulations, 
62.2 	title 45, section 147.130;
62.3 	(5) pediatric hospice services provided by a hospice provider licensed under sections 
62.4 	144A.75 to 144A.755; and
62.5 	(6) treatment delivered through a neonatal abstinence program operated by pediatric 
62.6 	pain or palliative care subspecialists.
62.7 	Clauses (2) to (6) are effective January 1, 2026, and apply to health benefit plans offered, 
62.8 	sold, issued, or renewed on or after that date.

62.9 	Sec. 26. Minnesota Statutes 2022, section 62M.07, subdivision 4, is amended to read:
62.10 		Subd. 4.Submission of prior authorization requests. (a) If prior authorization for a 
62.11 	health care service is required, the utilization review organization, health plan company, or 
62.12 	claim administrator must allow providers to submit requests for prior authorization of the 
62.13 	health care services without unreasonable delay by telephone, facsimile, or voice mail or 
62.14 	through an electronic mechanism 24 hours a day, seven days a week. This subdivision does 
62.15 	not apply to dental service covered under MinnesotaCare or medical assistance.
62.16 	(b) Effective January 1, 2027, for health benefit plans offered, sold, issued, or renewed 
62.17 	on or after that date, utilization review organizations, health plan companies, and claims 
62.18 	administrators must have and maintain a prior authorization application programming 
62.19 	interface (API) that automates the prior authorization process for health care services, 
62.20 	excluding prescription drugs and medications. The API must allow providers to determine 
62.21 	whether a prior authorization is required for health care services, identify prior authorization 
62.22 	information and documentation requirements, and facilitate the exchange of prior 
62.23 	authorization requests and determinations from provider electronic health records or practice 
62.24 	management systems. The API must use the Health Level Seven (HL7) Fast Healthcare 
62.25 	Interoperability Resources (FHIR) standard in accordance with Code of Federal Regulations, 
62.26 	title 45, section 170.215(a)(1), and the most recent standards and guidance adopted by the 
62.27 	United States Department of Health and Human Services to implement that section. Prior 
62.28 	authorization submission requests for prescription drugs and medications must comply with 
62.29 	the requirements of section 62J.497.

63.1 	Sec. 27. Minnesota Statutes 2022, section 62M.07, is amended by adding a subdivision 
63.2 	to read:
63.3 		Subd. 5.Treatment of a chronic condition. This subdivision is effective January 1, 
63.4 	2026, and applies to health benefit plans offered, sold, issued, or renewed on or after that 
63.5 	date. An authorization for treatment of a chronic health condition does not expire unless 
63.6 	the standard of treatment for that health condition changes. A chronic health condition is a 
63.7 	condition that is expected to last one year or more and:
63.8 	(1) requires ongoing medical attention to effectively manage the condition or prevent 
63.9 	an adverse health event; or
63.10 	(2) limits one or more activities of daily living.

63.11 	Sec. 28. Minnesota Statutes 2022, section 62M.10, subdivision 7, is amended to read:
63.12 		Subd. 7.Availability of criteria. (a) For utilization review determinations other than 
63.13 	prior authorization, a utilization review organization shall, upon request, provide to an 
63.14 	enrollee, a provider, and the commissioner of commerce the criteria used to determine the 
63.15 	medical necessity, appropriateness, and efficacy of a procedure or service and identify the 
63.16 	database, professional treatment guideline, or other basis for the criteria.
63.17 	(b) For prior authorization determinations, a utilization review organization must submit 
63.18 	the organization's current prior authorization requirements and restrictions, including written, 
63.19 	evidence-based, clinical criteria used to make an authorization or adverse determination, to 
63.20 	all health plan companies for which the organization performs utilization review. A health 
63.21 	plan company must post on its public website the prior authorization requirements and 
63.22 	restrictions of any utilization review organization that performs utilization review for the 
63.23 	health plan company. These prior authorization requirements and restrictions must be detailed 
63.24 	and written in language that is easily understandable to providers. This paragraph does not 
63.25 	apply to the commissioner of human services when delivering services through fee-for-service 
63.26 	under chapters 256B and 256L.
63.27 	(c) Effective January 1, 2026, the commissioner of human services must post on the 
63.28 	department's public website the prior authorization requirements and restrictions, including 
63.29 	written, evidence-based, clinical criteria used to make an authorization or adverse 
63.30 	determination, that apply to prior authorization determinations for fee-for-service under 
63.31 	chapters 256B and 256L. These prior authorization requirements and restrictions must be 
63.32 	detailed and written in language that is easily understandable to providers.

64.1 	Sec. 29. Minnesota Statutes 2022, section 62M.10, subdivision 8, is amended to read:
64.2 		Subd. 8.Notice; new prior authorization requirements or restrictions; change to 
64.3 	existing requirement or restriction. (a) Before a utilization review organization may 
64.4 	implement a new prior authorization requirement or restriction or amend an existing prior 
64.5 	authorization requirement or restriction, the utilization review organization must submit the 
64.6 	new or amended requirement or restriction to all health plan companies for which the 
64.7 	organization performs utilization review. A health plan company must post on its website 
64.8 	the new or amended requirement or restriction. This paragraph does not apply to the 
64.9 	commissioner of human services when delivering services through fee-for-service under 
64.10 	chapters 256B and 256L.
64.11 	(b) At least 45 days before a new prior authorization requirement or restriction or an 
64.12 	amended existing prior authorization requirement or restriction is implemented, the utilization 
64.13 	review organization, health plan company, or claims administrator must provide written or 
64.14 	electronic notice of the new or amended requirement or restriction to all Minnesota-based, 
64.15 	in-network attending health care professionals who are subject to the prior authorization 
64.16 	requirements and restrictions. This paragraph does not apply to the commissioner of human 
64.17 	services when delivering services through fee-for-service under chapters 256B and 256L.
64.18 	(c) Effective January 1, 2026, before the commissioner of human services may implement 
64.19 	a new prior authorization requirement or restriction or amend an existing prior authorization 
64.20 	requirement or restriction, the commissioner, at least 45 days before the new or amended 
64.21 	requirement or restriction takes effect, must provide written or electronic notice of the new 
64.22 	or amended requirement or restriction, to all health care professionals participating as 
64.23 	fee-for-service providers under chapters 256B and 256L who are subject to the prior 
64.24 	authorization requirements and restrictions.

64.25 	Sec. 30. Minnesota Statutes 2022, section 62M.17, subdivision 2, is amended to read:
64.26 		Subd. 2.Effect of change in prior authorization clinical criteria. (a) If, during a plan 
64.27 	year, a utilization review organization changes coverage terms for a health care service or 
64.28 	the clinical criteria used to conduct prior authorizations for a health care service, the change 
64.29 	in coverage terms or change in clinical criteria shall not apply until the next plan year for 
64.30 	any enrollee who received prior authorization for a health care service using the coverage 
64.31 	terms or clinical criteria in effect before the effective date of the change.
64.32 	(b) Paragraph (a) does not apply if a utilization review organization changes coverage 
64.33 	terms for a drug or device that has been deemed unsafe by the United States Food and Drug 
64.34 	Administration (FDA); that has been withdrawn by either the FDA or the product 
65.1 	manufacturer; or when an independent source of research, clinical guidelines, or 
65.2 	evidence-based standards has issued drug- or device-specific warnings or recommended 
65.3 	changes in drug or device usage.
65.4 	(c) Paragraph (a) does not apply if a utilization review organization changes coverage 
65.5 	terms for a service or the clinical criteria used to conduct prior authorizations for a service 
65.6 	when an independent source of research, clinical guidelines, or evidence-based standards 
65.7 	has recommended changes in usage of the service for reasons related to patient harm. This 
65.8 	paragraph expires December 31, 2025, for health benefit plans offered, sold, issued, or 
65.9 	renewed on or after that date.
65.10 	(d) Effective January 1, 2026, and applicable to health benefit plans offered, sold, issued, 
65.11 	or renewed on or after that date, paragraph (a) does not apply if a utilization review 
65.12 	organization changes coverage terms for a service or the clinical criteria used to conduct 
65.13 	prior authorizations for a service when an independent source of research, clinical guidelines, 
65.14 	or evidence-based standards has recommended changes in usage of the service for reasons 
65.15 	related to previously unknown and imminent patient harm.
65.16 	(d) (e) Paragraph (a) does not apply if a utilization review organization removes a brand 
65.17 	name drug from its formulary or places a brand name drug in a benefit category that increases 
65.18 	the enrollee's cost, provided the utilization review organization (1) adds to its formulary a 
65.19 	generic or multisource brand name drug rated as therapeutically equivalent according to 
65.20 	the FDA Orange Book, or a biologic drug rated as interchangeable according to the FDA 
65.21 	Purple Book, at a lower cost to the enrollee, and (2) provides at least a 60-day notice to 
65.22 	prescribers, pharmacists, and affected enrollees.

65.23 	Sec. 31. [62M.19] ANNUAL REPORT TO COMMISSIONER OF HEALTH; PRIOR 
65.24 	AUTHORIZATIONS.
65.25 	On or before September 1 each year, each utilization review organization must report 
65.26 	to the commissioner of health, in a form and manner specified by the commissioner, 
65.27 	information on prior authorization requests for the previous calendar year. The report 
65.28 	submitted under this subdivision must include the following data:
65.29 	(1) the total number of prior authorization requests received;
65.30 	(2) the number of prior authorization requests for which an authorization was issued;
65.31 	(3) the number of prior authorization requests for which an adverse determination was 
65.32 	issued;
65.33 	(4) the number of adverse determinations reversed on appeal;
66.1 	(5) the 25 codes with the highest number of prior authorization requests and the 
66.2 	percentage of authorizations for each of these codes;
66.3 	(6) the 25 codes with the highest percentage of prior authorization requests for which 
66.4 	an authorization was issued and the total number of the requests;
66.5 	(7) the 25 codes with the highest percentage of prior authorization requests for which 
66.6 	an adverse determination was issued but which was reversed on appeal and the total number 
66.7 	of the requests;
66.8 	(8) the 25 codes with the highest percentage of prior authorization requests for which 
66.9 	an adverse determination was issued and the total number of the requests; and
66.10 	(9) the reasons an adverse determination to a prior authorization request was issued, 
66.11 	expressed as a percentage of all adverse determinations. The reasons listed may include but 
66.12 	are not limited to:
66.13 	(i) the patient did not meet prior authorization criteria;
66.14 	(ii) incomplete information was submitted by the provider to the utilization review 
66.15 	organization;
66.16 	(iii) the treatment program changed; and
66.17 	(iv) the patient is no longer covered by the health benefit plan.

66.18 	Sec. 32. Minnesota Statutes 2022, section 62Q.097, is amended by adding a subdivision 
66.19 	to read:
66.20 		Subd. 3.Prohibited application questions. An application for provider credentialing 
66.21 	must not:
66.22 	(1) require the provider to disclose past health conditions;
66.23 	(2) require the provider to disclose current health conditions, if the provider is being 
66.24 	treated so that the condition does not affect the provider's ability to practice medicine; or
66.25 	(3) require the disclosure of any health conditions that would not affect the provider's 
66.26 	ability to practice medicine in a competent, safe, and ethical manner.

66.27 	EFFECTIVE DATE. This section applies to applications for provider credentialing 
66.28 	submitted to a health plan company on or after January 1, 2025.

67.1 	Sec. 33. Minnesota Statutes 2022, section 62Q.14, is amended to read:
67.2 	62Q.14 RESTRICTIONS ON ENROLLEE SERVICES.
67.3 	No health plan company may restrict the choice of an enrollee as to where the enrollee 
67.4 	receives services related to:
67.5 	(1) the voluntary planning of the conception and bearing of children, provided that this 
67.6 	clause does not refer to abortion services;
67.7 	(2) the diagnosis of infertility;
67.8 	(3) the testing and treatment of a sexually transmitted disease; and
67.9 	(4) the testing for AIDS or other HIV-related conditions.

67.10 	EFFECTIVE DATE. This section is effective January 1, 2025, and applies to health 
67.11 	plans offered, sold, issued, or renewed on or after that date.

67.12 	Sec. 34. Minnesota Statutes 2022, section 62Q.19, subdivision 3, is amended to read:
67.13 		Subd. 3.Health plan company affiliation. A health plan company must offer a provider 
67.14 	contract to any all designated essential community provider providers located within the 
67.15 	area served by the health plan company. A health plan company must include all essential 
67.16 	community providers that have accepted a contract in each of the company's provider 
67.17 	networks. A health plan company shall not restrict enrollee access to services designated 
67.18 	to be provided by the essential community provider for the population that the essential 
67.19 	community provider is certified to serve. A health plan company may also make other 
67.20 	providers available for these services. A health plan company may require an essential 
67.21 	community provider to meet all data requirements, utilization review, and quality assurance 
67.22 	requirements on the same basis as other health plan providers.

67.23 	EFFECTIVE DATE. This section is effective January 1, 2025, and applies to health 
67.24 	plans offered, issued, or renewed on or after that date.

67.25 	Sec. 35. Minnesota Statutes 2022, section 62Q.19, is amended by adding a subdivision to 
67.26 	read:
67.27 		Subd. 4a.Contract payment rates; private. An essential community provider and a 
67.28 	health plan company may negotiate the payment rate for covered services provided by the 
67.29 	essential community provider. This rate must be at least the same rate per unit of service 
67.30 	as is paid by the health plan company to the essential community provider under the provider 
67.31 	contract between the two with the highest number of enrollees receiving health care services 
68.1 	from the provider or, if there is no provider contract between the health plan company and 
68.2 	the essential community provider, the rate must be at least the same rate per unit of service 
68.3 	as is paid to other plan providers for the same or similar services. The provider contract 
68.4 	used to set the rate under this subdivision must be in relation to an individual, small group, 
68.5 	or large group health plan. This subdivision applies only to provider contracts in relation 
68.6 	to individual, small employer, and large group health plans.

68.7 	Sec. 36. Minnesota Statutes 2022, section 62Q.19, subdivision 5, is amended to read:
68.8 		Subd. 5.Contract payment rates; public. An essential community provider and a 
68.9 	health plan company may negotiate the payment rate for covered services provided by the 
68.10 	essential community provider. This rate must be at least the same rate per unit of service 
68.11 	as is paid to other health plan providers for the same or similar services. This subdivision 
68.12 	applies only to provider contracts in relation to health plans offered through the State 
68.13 	Employee Group Insurance Program, medical assistance, and MinnesotaCare.

68.14 	Sec. 37. Minnesota Statutes 2023 Supplement, section 62Q.473, is amended by adding a 
68.15 	subdivision to read:
68.16 		Subd. 3.Reimbursement. (a) The commissioner of commerce must reimburse health 
68.17 	plan companies for coverage under this section. Reimbursement is available only for coverage 
68.18 	that would not have been provided by the health plan without the requirements of this 
68.19 	section. Treatments and services covered by the health plan as of January 1, 2023, are 
68.20 	ineligible for payment under this subdivision by the commissioner of commerce.
68.21 	(b) Health plan companies must report to the commissioner of commerce quantified 
68.22 	costs attributable to the additional benefit under this section in a format developed by the 
68.23 	commissioner. A health plan's coverage as of January 1, 2023, must be used by the health 
68.24 	plan company as the basis for determining whether coverage would not have been provided 
68.25 	by the health plan for purposes of this subdivision.
68.26 	(c) The commissioner of commerce must evaluate submissions and make payments to 
68.27 	health plan companies as provided in Code of Federal Regulations, title 45, section 155.170.

68.28 	EFFECTIVE DATE. This section is effective January 1, 2025, and applies to health 
68.29 	plans offered, issued, or renewed on or after that date.

69.1 	Sec. 38. Minnesota Statutes 2023 Supplement, section 62Q.473, is amended by adding a 
69.2 	subdivision to read:
69.3 		Subd. 4.Appropriation. Each fiscal year, an amount necessary to make payments to 
69.4 	health plan companies to defray the cost of providing coverage under this section is 
69.5 	appropriated to the commissioner of commerce.

69.6 	EFFECTIVE DATE. This section is effective January 1, 2025, and applies to health 
69.7 	plans offered, issued, or renewed on or after that date.

69.8 	Sec. 39. [62Q.524] COVERAGE OF ABORTIONS AND ABORTION-RELATED 
69.9 	SERVICES.
69.10 		Subdivision 1.Definition. For purposes of this section, "abortion" means any medical 
69.11 	treatment intended to induce the termination of a pregnancy with a purpose other than 
69.12 	producing a live birth.
69.13 		Subd. 2.Required coverage. (a) A health plan must provide coverage for abortions and 
69.14 	abortion-related services, including preabortion services and follow-up services.
69.15 	(b) A health plan must not impose on the coverage under this section any co-payment, 
69.16 	coinsurance, deductible, or other enrollee cost-sharing that is greater than the cost-sharing 
69.17 	that applies to similar services covered under the health plan.
69.18 	(c) A health plan must not impose any limitation on the coverage under this section, 
69.19 	including but not limited to any utilization review, prior authorization, referral requirements, 
69.20 	restrictions, or delays, that is not generally applicable to other coverages under the plan.
69.21 		Subd. 3.Exclusion. This section does not apply to managed care organizations or 
69.22 	county-based purchasing plans when the plan provides coverage to public health care 
69.23 	program enrollees under chapter 256B or 256L.
69.24 		Subd. 4.Reimbursement. (a) The commissioner of commerce must reimburse health 
69.25 	plan companies for coverage under this section. Reimbursement is available only for coverage 
69.26 	that would not have been provided by the health plan without the requirements of this 
69.27 	section. Treatments and services covered by the health plan as of January 1, 2024, are 
69.28 	ineligible for payment under this subdivision by the commissioner of commerce.
69.29 	(b) Health plan companies must report to the commissioner of commerce quantified 
69.30 	costs attributable to the additional benefit under this section in a format developed by the 
69.31 	commissioner. A health plan's coverage as of January 1, 2024, must be used by the health 
70.1 	plan company as the basis for determining whether coverage would not have been provided 
70.2 	by the health plan for purposes of this subdivision.
70.3 	(c) The commissioner of commerce must evaluate submissions and make payments to 
70.4 	health plan companies as provided in Code of Federal Regulations, title 45, section 155.170.
70.5 		Subd. 5.Appropriation. Each fiscal year, an amount necessary to make payments to 
70.6 	health plan companies to defray the cost of providing coverage under this section is 
70.7 	appropriated to the commissioner of commerce.

70.8 	EFFECTIVE DATE. This section is effective January 1, 2025, and applies to health 
70.9 	plans offered, sold, issued, or renewed on or after that date.

70.10 	Sec. 40. [62Q.531] AMINO ACID-BASED FORMULA COVERAGE.
70.11 		Subdivision 1.Definition. (a) For purposes of this section, the following term has the 
70.12 	meaning given.
70.13 	(b) "Formula" means an amino acid-based elemental formula.
70.14 		Subd. 2.Required coverage. A health plan company must provide coverage for formula 
70.15 	when formula is medically necessary.
70.16 		Subd. 3.Covered conditions. Conditions for which formula is medically necessary 
70.17 	include but are not limited to:
70.18 	(1) cystic fibrosis;
70.19 	(2) amino acid, organic acid, and fatty acid metabolic and malabsorption disorders;
70.20 	(3) IgE mediated allergies to food proteins;
70.21 	(4) food protein-induced enterocolitis syndrome;
70.22 	(5) eosinophilic esophagitis;
70.23 	(6) eosinophilic gastroenteritis;
70.24 	(7) eosinophilic colitis; and
70.25 	(8) mast cell activation syndrome.

70.26 	EFFECTIVE DATE. This section is effective January 1, 2025, and applies to health 
70.27 	plans offered, issued, or sold on or after that date.

71.1 	Sec. 41. [62Q.665] COVERAGE FOR ORTHOTIC AND PROSTHETIC DEVICES.
71.2 		Subdivision 1.Definitions. (a) For the purposes of this section, the following terms have 
71.3 	the meanings given.
71.4 	(b) "Accredited facility" means any entity that is accredited to provide comprehensive 
71.5 	orthotic or prosthetic devices or services by a Centers for Medicare and Medicaid Services 
71.6 	approved accrediting agency.
71.7 	(c) "Orthosis" means:
71.8 	(1) an external medical device that is:
71.9 	(i) custom-fabricated or custom-fitted to a specific patient based on the patient's unique 
71.10 	physical condition;
71.11 	(ii) applied to a part of the body to correct a deformity, provide support and protection, 
71.12 	restrict motion, improve function, or relieve symptoms of a disease, syndrome, injury, or 
71.13 	postoperative condition; and
71.14 	(iii) deemed medically necessary by a prescribing physician or licensed health care 
71.15 	provider who has authority in Minnesota to prescribe orthotic and prosthetic devices, supplies, 
71.16 	and services; and
71.17 	(2) any provision, repair, or replacement of a device that is furnished or performed by:
71.18 	(i) an accredited facility in comprehensive orthotic services; or
71.19 	(ii) a health care provider licensed in Minnesota and operating within the provider's 
71.20 	scope of practice which allows the provider to provide orthotic or prosthetic devices, supplies, 
71.21 	or services.
71.22 	(d) "Orthotics" means:
71.23 	(1) the science and practice of evaluating, measuring, designing, fabricating, assembling, 
71.24 	fitting, adjusting, or servicing and providing the initial training necessary to accomplish the 
71.25 	fitting of an orthotic device for the support, correction, or alleviation of a neuromuscular 
71.26 	or musculoskeletal dysfunction, disease, injury, or deformity;
71.27 	(2) evaluation, treatment, and consultation related to an orthotic device;
71.28 	(3) basic observation of gait and postural analysis;
71.29 	(4) assessing and designing orthosis to maximize function and provide support and 
71.30 	alignment necessary to prevent or correct a deformity or to improve the safety and efficiency 
71.31 	of mobility and locomotion;
72.1 	(5) continuing patient care to assess the effect of an orthotic device on the patient's 
72.2 	tissues; and
72.3 	(6) proper fit and function of the orthotic device by periodic evaluation.
72.4 	(e) "Prosthesis" means:
72.5 	(1) an external medical device that is:
72.6 	(i) used to replace or restore a missing limb, appendage, or other external human body 
72.7 	part; and
72.8 	(ii) deemed medically necessary by a prescribing physician or licensed health care 
72.9 	provider who has authority in Minnesota to prescribe orthotic and prosthetic devices, supplies, 
72.10 	and services; and
72.11 	(2) any provision, repair, or replacement of a device that is furnished or performed by:
72.12 	(i) an accredited facility in comprehensive prosthetic services; or
72.13 	(ii) a health care provider licensed in Minnesota and operating within the provider's 
72.14 	scope of practice which allows the provider to provide orthotic or prosthetic devices, supplies, 
72.15 	or services.
72.16 	(f) "Prosthetics" means:
72.17 	(1) the science and practice of evaluating, measuring, designing, fabricating, assembling, 
72.18 	fitting, aligning, adjusting, or servicing, as well as providing the initial training necessary 
72.19 	to accomplish the fitting of, a prosthesis through the replacement of external parts of a 
72.20 	human body lost due to amputation or congenital deformities or absences;
72.21 	(2) the generation of an image, form, or mold that replicates the patient's body segment 
72.22 	and that requires rectification of dimensions, contours, and volumes for use in the design 
72.23 	and fabrication of a socket to accept a residual anatomic limb to, in turn, create an artificial 
72.24 	appendage that is designed either to support body weight or to improve or restore function 
72.25 	or anatomical appearance, or both;
72.26 	(3) observational gait analysis and clinical assessment of the requirements necessary to 
72.27 	refine and mechanically fix the relative position of various parts of the prosthesis to maximize 
72.28 	function, stability, and safety of the patient;
72.29 	(4) providing and continuing patient care in order to assess the prosthetic device's effect 
72.30 	on the patient's tissues; and
72.31 	(5) assuring proper fit and function of the prosthetic device by periodic evaluation.
73.1 		Subd. 2.Coverage. (a) A health plan must provide coverage for orthotic and prosthetic 
73.2 	devices, supplies, and services, including repair and replacement, at least equal to the 
73.3 	coverage provided under federal law for health insurance for the aged and disabled under 
73.4 	sections 1832, 1833, and 1834 of the Social Security Act, United States Code, title 42, 
73.5 	sections 1395k, 1395l, and 1395m, but only to the extent consistent with this section.
73.6 	(b) A health plan must not subject orthotic and prosthetic benefits to separate financial 
73.7 	requirements that apply only with respect to those benefits. A health plan may impose 
73.8 	co-payment and coinsurance amounts on those benefits, except that any financial 
73.9 	requirements that apply to such benefits must not be more restrictive than the financial 
73.10 	requirements that apply to the health plan's medical and surgical benefits, including those 
73.11 	for internal restorative devices.
73.12 	(c) A health plan may limit the benefits for, or alter the financial requirements for, 
73.13 	out-of-network coverage of prosthetic and orthotic devices, except that the restrictions and 
73.14 	requirements that apply to those benefits must not be more restrictive than the financial 
73.15 	requirements that apply to the out-of-network coverage for the health plan's medical and 
73.16 	surgical benefits.
73.17 	(d) A health plan must cover orthoses and prostheses when furnished under an order by 
73.18 	a prescribing physician or licensed health care prescriber who has authority in Minnesota 
73.19 	to prescribe orthoses and prostheses, and that coverage for orthotic and prosthetic devices, 
73.20 	supplies, accessories, and services must include those devices or device systems, supplies, 
73.21 	accessories, and services that are customized to the covered individual's needs.
73.22 	(e) A health plan must cover orthoses and prostheses determined by the enrollee's provider 
73.23 	to be the most appropriate model that meets the medical needs of the enrollee for purposes 
73.24 	of performing physical activities, as applicable, including but not limited to running, biking, 
73.25 	and swimming, and maximizing the enrollee's limb function.
73.26 	(f) A health plan must cover orthoses and prostheses for showering or bathing.
73.27 		Subd. 3.Prior authorization. A health plan may require prior authorization for orthotic 
73.28 	and prosthetic devices, supplies, and services in the same manner and to the same extent as 
73.29 	prior authorization is required for any other covered benefit.
73.30 		Subd. 4.Reimbursement. (a) The commissioner of commerce must reimburse health 
73.31 	plan companies for coverage under this section. Reimbursement is available only for coverage 
73.32 	that would not have been provided by the health plan without the requirements of this 
73.33 	section. Treatments and services covered by the health plan as of January 1, 2024, are 
73.34 	ineligible for payment under this subdivision by the commissioner of commerce.
74.1 	(b) Health plan companies must report to the commissioner of commerce quantified 
74.2 	costs attributable to the additional benefit under this section in a format developed by the 
74.3 	commissioner. A health plan's coverage as of January 1, 2024, must be used by the health 
74.4 	plan company as the basis for determining whether coverage would not have been provided 
74.5 	by the health plan for purposes of this subdivision.
74.6 	(c) The commissioner of commerce must evaluate submissions and make payments to 
74.7 	health plan companies as provided in Code of Federal Regulations, title 45, section 155.170.
74.8 		Subd. 5.Appropriation. Each fiscal year, an amount necessary to make payments to 
74.9 	health plan companies to defray the cost of providing coverage under this section is 
74.10 	appropriated to the commissioner of commerce.

74.11 	EFFECTIVE DATE. This section is effective January 1, 2025, and applies to all health 
74.12 	plans offered, issued, or renewed on or after that date.

74.13 	Sec. 42. [62Q.6651] MEDICAL NECESSITY AND NONDISCRIMINATION 
74.14 	STANDARDS FOR COVERAGE OF PROSTHETICS OR ORTHOTICS.
74.15 	(a) When performing a utilization review for a request for coverage of prosthetic or 
74.16 	orthotic benefits, a health plan company shall apply the most recent version of evidence-based 
74.17 	treatment and fit criteria as recognized by relevant clinical specialists.
74.18 	(b) A health plan company shall render utilization review determinations in a 
74.19 	nondiscriminatory manner and shall not deny coverage for habilitative or rehabilitative 
74.20 	benefits, including prosthetics or orthotics, solely on the basis of an enrollee's actual or 
74.21 	perceived disability.
74.22 	(c) A health plan company shall not deny a prosthetic or orthotic benefit for an individual 
74.23 	with limb loss or absence that would otherwise be covered for a nondisabled person seeking 
74.24 	medical or surgical intervention to restore or maintain the ability to perform the same 
74.25 	physical activity.
74.26 	(d) A health plan offered, issued, or renewed in Minnesota that offers coverage for 
74.27 	prosthetics and custom orthotic devices shall include language describing an enrollee's rights 
74.28 	pursuant to paragraphs (b) and (c) in its evidence of coverage and any benefit denial letters.
74.29 	(e) A health plan that provides coverage for prosthetic or orthotic services shall ensure 
74.30 	access to medically necessary clinical care and to prosthetic and custom orthotic devices 
74.31 	and technology from not less than two distinct prosthetic and custom orthotic providers in 
74.32 	the plan's provider network located in Minnesota. In the event that medically necessary 
74.33 	covered orthotics and prosthetics are not available from an in-network provider, the health 
75.1 	plan company shall provide processes to refer a member to an out-of-network provider and 
75.2 	shall fully reimburse the out-of-network provider at a mutually agreed upon rate less member 
75.3 	cost sharing determined on an in-network basis.
75.4 	(f) If coverage for prosthetic or custom orthotic devices is provided, payment shall be 
75.5 	made for the replacement of a prosthetic or custom orthotic device or for the replacement 
75.6 	of any part of the devices, without regard to continuous use or useful lifetime restrictions, 
75.7 	if an ordering health care provider determines that the provision of a replacement device, 
75.8 	or a replacement part of a device, is necessary because:
75.9 	(1) of a change in the physiological condition of the patient;
75.10 	(2) of an irreparable change in the condition of the device or in a part of the device; or
75.11 	(3) the condition of the device, or the part of the device, requires repairs and the cost of 
75.12 	the repairs would be more than 60 percent of the cost of a replacement device or of the part 
75.13 	being replaced.
75.14 	(g) Confirmation from a prescribing health care provider may be required if the prosthetic 
75.15 	or custom orthotic device or part being replaced is less than three years old.

75.16 	EFFECTIVE DATE. This section is effective January 1, 2025, and applies to all health 
75.17 	plans offered, issued, or renewed on or after that date.

75.18 	Sec. 43. [62Q.666] INTERMITTENT CATHETERS.
75.19 		Subdivision 1.Required coverage. A health plan must provide coverage for intermittent 
75.20 	urinary catheters and insertion supplies if intermittent catheterization is recommended by 
75.21 	the enrollee's health care provider. At least 180 intermittent catheters per month with insertion 
75.22 	supplies must be covered unless a lesser amount is prescribed by the enrollee's health care 
75.23 	provider. A health plan providing coverage under the medical assistance program may be 
75.24 	required to provide coverage for more than 180 intermittent catheters per month with 
75.25 	insertion supplies.
75.26 		Subd. 2.Cost-sharing requirements. A health plan is prohibited from imposing a 
75.27 	deductible, co-payment, coinsurance, or other restriction on intermittent catheters and 
75.28 	insertion supplies that the health plan does not apply to durable medical equipment in general.

75.29 	EFFECTIVE DATE. This section is effective for any health plan issued or renewed 
75.30 	on or after January 1, 2025.

76.1 	Sec. 44. [62Q.679] RELIGIOUS OBJECTIONS.
76.2 		Subdivision 1.Definitions. (a) The definitions in this subdivision apply to this section.
76.3 	(b) "Closely held for-profit entity" means an entity that is not a nonprofit entity, has 
76.4 	more than 50 percent of the value of its ownership interest owned directly or indirectly by 
76.5 	five or fewer owners, and has no publicly traded ownership interest. For purposes of this 
76.6 	paragraph:
76.7 	(1) ownership interests owned by a corporation, partnership, limited liability company, 
76.8 	estate, trust, or similar entity are considered owned by that entity's shareholders, partners, 
76.9 	members, or beneficiaries in proportion to their interest held in the corporation, partnership, 
76.10 	limited liability company, estate, trust, or similar entity;
76.11 	(2) ownership interests owned by a nonprofit entity are considered owned by a single 
76.12 	owner;
76.13 	(3) ownership interests owned by all individuals in a family are considered held by a 
76.14 	single owner. For purposes of this clause, "family" means brothers and sisters, including 
76.15 	half-brothers and half-sisters, a spouse, ancestors, and lineal descendants; and
76.16 	(4) if an individual or entity holds an option, warrant, or similar right to purchase an 
76.17 	ownership interest, the individual or entity is considered to be the owner of those ownership 
76.18 	interests.
76.19 	(c) "Eligible organization" means an organization that opposes covering some or all 
76.20 	health benefits under section 62Q.522, 62Q.524, or 62Q.585 on account of religious 
76.21 	objections and that is:
76.22 	(1) organized as a nonprofit entity and holds itself out to be religious; or
76.23 	(2) organized and operates as a closely held for-profit entity, and the organization's 
76.24 	owners or highest governing body has adopted, under the organization's applicable rules of 
76.25 	governance and consistent with state law, a resolution or similar action establishing that the 
76.26 	organization objects to covering some or all health benefits under section 62Q.522, 62Q.524, 
76.27 	or 62Q.585 on account of the owners' sincerely held religious beliefs.
76.28 	(d) "Exempt organization" means an organization that is organized and operates as a 
76.29 	nonprofit entity and meets the requirements of section 6033(a)(3)(A)(i) or (iii) of the Internal 
76.30 	Revenue Code of 1986, as amended.
76.31 		Subd. 2.Exemption. (a) An exempt organization is not required to provide coverage 
76.32 	under section 62Q.522, 62Q.524, or 62Q.585 if the exempt organization has religious 
77.1 	objections to the coverage. An exempt organization that chooses to not provide coverage 
77.2 	pursuant to this paragraph must notify employees as part of the hiring process and must 
77.3 	notify all employees at least 30 days before:
77.4 	(1) an employee enrolls in the health plan; or
77.5 	(2) the effective date of the health plan, whichever occurs first.
77.6 	(b) If the exempt organization provides partial coverage under section 62Q.522, 62Q.524, 
77.7 	or 62Q.585, the notice required under paragraph (a) must provide a list of the portions of 
77.8 	such coverage which the organization refuses to cover.
77.9 		Subd. 3.Accommodation for eligible organizations. (a) A health plan established or 
77.10 	maintained by an eligible organization complies with the coverage requirements of section 
77.11 	62Q.522, 62Q.524, or 62Q.585, with respect to the health benefits identified in the notice 
77.12 	under this paragraph, if the eligible organization provides notice to any health plan company 
77.13 	with which the eligible organization contracts that it is an eligible organization and that the 
77.14 	eligible organization has a religious objection to coverage for all or a subset of the health 
77.15 	benefits under section 62Q.522, 62Q.524, or 62Q.585.
77.16 	(b) The notice from an eligible organization to a health plan company under paragraph 
77.17 	(a) must include: (1) the name of the eligible organization; (2) a statement that it objects to 
77.18 	coverage for some or all of the health benefits under section 62Q.522, 62Q.524, or 62Q.585, 
77.19 	including a list of the health benefits to which the eligible organization objects, if applicable; 
77.20 	and (3) the health plan name. The notice must be executed by a person authorized to provide 
77.21 	notice on behalf of the eligible organization.
77.22 	(c) An eligible organization must provide a copy of the notice under paragraph (a) to 
77.23 	prospective employees as part of the hiring process and to all employees at least 30 days 
77.24 	before:
77.25 	(1) an employee enrolls in the health plan; or
77.26 	(2) the effective date of the health plan, whichever occurs first.
77.27 	(d) A health plan company that receives a copy of the notice under paragraph (a) with 
77.28 	respect to a health plan established or maintained by an eligible organization must, for all 
77.29 	future enrollments in the health plan:
77.30 	(1) expressly exclude coverage for those health benefits identified in the notice under 
77.31 	paragraph (a) from the health plan; and
78.1 	(2) provide separate payments for any health benefits required to be covered under 
78.2 	section 62Q.522, 62Q.524, or 62Q.585 for enrollees as long as the enrollee remains enrolled 
78.3 	in the health plan.
78.4 	(e) The health plan company must not impose any cost-sharing requirements, including 
78.5 	co-pays, deductibles, or coinsurance, or directly or indirectly impose any premium, fee, or 
78.6 	other charge for the health benefits under section 62Q.522 on the enrollee. The health plan 
78.7 	company must not directly or indirectly impose any premium, fee, or other charge for the 
78.8 	health benefits under section 62Q.522, 62Q.524, or 62Q.585 on the eligible organization 
78.9 	or health plan.
78.10 	(f) On January 1, 2025, and every year thereafter a health plan company must notify the 
78.11 	commissioner, in a manner determined by the commissioner, of the number of eligible 
78.12 	organizations granted an accommodation under this subdivision.

78.13 	EFFECTIVE DATE. This section is effective January 1, 2025, and applies to health 
78.14 	plans offered, sold, issued, or renewed on or after that date.

78.15 	Sec. 45. Minnesota Statutes 2022, section 62Q.73, subdivision 2, is amended to read:
78.16 		Subd. 2.Exception. (a) This section does not apply to governmental programs except 
78.17 	as permitted under paragraph (b). For purposes of this subdivision, "governmental programs" 
78.18 	means the prepaid medical assistance program,;effective January 1, 2026, the medical 
78.19 	assistance fee-for-service program; the MinnesotaCare program,; the demonstration project 
78.20 	for people with disabilities,; and the federal Medicare program.
78.21 	(b) In the course of a recipient's appeal of a medical determination to the commissioner 
78.22 	of human services under section 256.045, the recipient may request an expert medical 
78.23 	opinion be arranged by the external review entity under contract to provide independent 
78.24 	external reviews under this section. If such a request is made, the cost of the review shall 
78.25 	be paid by the commissioner of human services. Any medical opinion obtained under this 
78.26 	paragraph shall only be used by a state human services judge as evidence in the recipient's 
78.27 	appeal to the commissioner of human services under section 256.045.
78.28 	(c) Nothing in this subdivision shall be construed to limit or restrict the appeal rights 
78.29 	provided in section 256.045 for governmental program recipients.

79.1 	Sec. 46. Minnesota Statutes 2023 Supplement, section 145D.01, subdivision 1, is amended 
79.2 	to read:
79.3 		Subdivision 1.Definitions. (a) For purposes of this chapter section and section 145D.02, 
79.4 	the following terms have the meanings given.
79.5 	(b) "Captive professional entity" means a professional corporation, limited liability 
79.6 	company, or other entity formed to render professional services in which a beneficial owner 
79.7 	is a health care provider employed by, controlled by, or subject to the direction of a hospital 
79.8 	or hospital system.
79.9 	(c) "Commissioner" means the commissioner of health.
79.10 	(d) "Control," including the terms "controlling," "controlled by," and "under common 
79.11 	control with," means the possession, direct or indirect, of the power to direct or cause the 
79.12 	direction of the management and policies of a health care entity, whether through the 
79.13 	ownership of voting securities, membership in an entity formed under chapter 317A, by 
79.14 	contract other than a commercial contract for goods or nonmanagement services, or otherwise, 
79.15 	unless the power is the result of an official position with, corporate office held by, or court 
79.16 	appointment of, the person. Control is presumed to exist if any person, directly or indirectly, 
79.17 	owns, controls, holds with the power to vote, or holds proxies representing 40 percent or 
79.18 	more of the voting securities of any other person, or if any person, directly or indirectly, 
79.19 	constitutes 40 percent or more of the membership of an entity formed under chapter 317A. 
79.20 	The attorney general may determine that control exists in fact, notwithstanding the absence 
79.21 	of a presumption to that effect.
79.22 	(e) "Health care entity" means:
79.23 	(1) a hospital;
79.24 	(2) a hospital system;
79.25 	(3) a captive professional entity;
79.26 	(4) a medical foundation;
79.27 	(5) a health care provider group practice;
79.28 	(6) an entity organized or controlled by an entity listed in clauses (1) to (5); or
79.29 	(7) an entity that owns or exercises control over an entity listed in clauses (1) to (5).
79.30 	(f) "Health care provider" means a physician licensed under chapter 147, a physician 
79.31 	assistant licensed under chapter 147A, or an advanced practice registered nurse as defined 
80.1 	in section 148.171, subdivision 3, who provides health care services, including but not 
80.2 	limited to medical care, consultation, diagnosis, or treatment.
80.3 	(g) "Health care provider group practice" means two or more health care providers legally 
80.4 	organized in a partnership, professional corporation, limited liability company, medical 
80.5 	foundation, nonprofit corporation, faculty practice plan, or other similar entity:
80.6 	(1) in which each health care provider who is a member of the group provides services 
80.7 	that a health care provider routinely provides, including but not limited to medical care, 
80.8 	consultation, diagnosis, and treatment, through the joint use of shared office space, facilities, 
80.9 	equipment, or personnel;
80.10 	(2) for which substantially all services of the health care providers who are group 
80.11 	members are provided through the group and are billed in the name of the group practice 
80.12 	and amounts so received are treated as receipts of the group; or
80.13 	(3) in which the overhead expenses of, and the income from, the group are distributed 
80.14 	in accordance with methods previously determined by members of the group.
80.15 	An entity that otherwise meets the definition of health care provider group practice in this 
80.16 	paragraph shall be considered a health care provider group practice even if its shareholders, 
80.17 	partners, members, or owners include a professional corporation, limited liability company, 
80.18 	or other entity in which any beneficial owner is a health care provider and that is formed to 
80.19 	render professional services.
80.20 	(h) "Hospital" means a health care facility licensed as a hospital under sections 144.50 
80.21 	to 144.56.
80.22 	(i) "Medical foundation" means a nonprofit legal entity through which health care 
80.23 	providers perform research or provide medical services.
80.24 	(j) "Transaction" means a single action, or a series of actions within a five-year period, 
80.25 	which occurs in part within the state of Minnesota or involves a health care entity formed 
80.26 	or licensed in Minnesota, that constitutes:
80.27 	(1) a merger or exchange of a health care entity with another entity;
80.28 	(2) the sale, lease, or transfer of 40 percent or more of the assets of a health care entity 
80.29 	to another entity;
80.30 	(3) the granting of a security interest of 40 percent or more of the property and assets 
80.31 	of a health care entity to another entity;
81.1 	(4) the transfer of 40 percent or more of the shares or other ownership of a health care 
81.2 	entity to another entity;
81.3 	(5) an addition, removal, withdrawal, substitution, or other modification of one or more 
81.4 	members of the health care entity's governing body that transfers control, responsibility for, 
81.5 	or governance of the health care entity to another entity;
81.6 	(6) the creation of a new health care entity;
81.7 	(7) an agreement or series of agreements that results in the sharing of 40 percent or more 
81.8 	of the health care entity's revenues with another entity, including affiliates of such other 
81.9 	entity;
81.10 	(8) an addition, removal, withdrawal, substitution, or other modification of the members 
81.11 	of a health care entity formed under chapter 317A that results in a change of 40 percent or 
81.12 	more of the membership of the health care entity; or
81.13 	(9) any other transfer of control of a health care entity to, or acquisition of control of a 
81.14 	health care entity by, another entity.
81.15 	(k) A transaction as defined in paragraph (j) does not include:
81.16 	(1) an action or series of actions that meets one or more of the criteria set forth in 
81.17 	paragraph (j), clauses (1) to (9), if, immediately prior to all such actions, the health care 
81.18 	entity directly, or indirectly through one or more intermediaries, controls, is controlled by, 
81.19 	or is under common control with, all other parties to the action or series of actions;
81.20 	(2) a mortgage or other secured loan for business improvement purposes entered into 
81.21 	by a health care entity that does not directly affect delivery of health care or governance of 
81.22 	the health care entity;
81.23 	(3) a clinical affiliation of health care entities formed solely for the purpose of 
81.24 	collaborating on clinical trials or providing graduate medical education;
81.25 	(4) the mere offer of employment to, or hiring of, a health care provider by a health care 
81.26 	entity;
81.27 	(5) contracts between a health care entity and a health care provider primarily for clinical 
81.28 	services; or
81.29 	(6) a single action or series of actions within a five-year period involving only entities 
81.30 	that operate solely as a nursing home licensed under chapter 144A; a boarding care home 
81.31 	licensed under sections 144.50 to 144.56; a supervised living facility licensed under sections 
81.32 	144.50 to 144.56; an assisted living facility licensed under chapter 144G; a foster care setting 
82.1 	licensed under Minnesota Rules, parts 9555.5105 to 9555.6265, for a physical location that 
82.2 	is not the primary residence of the license holder; a community residential setting as defined 
82.3 	in section 245D.02, subdivision 4a; or a home care provider licensed under sections 144A.471 
82.4 	to 144A.483.

82.5 	EFFECTIVE DATE. This section is effective July 1, 2025.

82.6 	Sec. 47. [145D.30] DEFINITIONS.
82.7 		Subdivision 1.Application. For purposes of sections 145D.30 to 145D.37, the following 
82.8 	terms have the meanings given unless the context clearly indicates otherwise.
82.9 		Subd. 2.Commissioner "Commissioner" means the commissioner of commerce for a 
82.10 	nonprofit health coverage entity that is a nonprofit health service plan corporation operating 
82.11 	under chapter 62C or the commissioner of health for a nonprofit health coverage entity that 
82.12 	is a nonprofit health maintenance organization operating under chapter 62D.
82.13 		Subd. 3.Control. "Control," including the terms "controlling," "controlled by," and 
82.14 	"under common control with," means the possession, direct or indirect, of the power to 
82.15 	direct or cause the direction of the management and policies of a nonprofit health coverage 
82.16 	entity, whether through the ownership of voting securities, through membership in an entity 
82.17 	formed under chapter 317A, by contract other than a commercial contract for goods or 
82.18 	nonmanagement services, or otherwise, unless the power is the result of an official position 
82.19 	with, corporate office held by, or court appointment of the person. Control is presumed to 
82.20 	exist if any person, directly or indirectly, owns, controls, holds with the power to vote, or 
82.21 	holds proxies representing 40 percent or more of the voting securities of any other person 
82.22 	or if any person, directly or indirectly, constitutes 40 percent or more of the membership 
82.23 	of an entity formed under chapter 317A. The attorney general may determine that control 
82.24 	exists in fact, notwithstanding the absence of a presumption to that effect.
82.25 		Subd. 4.Conversion transaction. "Conversion transaction" means a transaction otherwise 
82.26 	permitted under applicable law in which a nonprofit health coverage entity:
82.27 	(1) merges, consolidates, converts, or transfers all or substantially all of its assets to any 
82.28 	entity except a corporation that is exempt under United States Code, title 26, section 
82.29 	501(c)(3);
82.30 	(2) makes a series of separate transfers within a 60-month period that in the aggregate 
82.31 	constitute a transfer of all or substantially all of the nonprofit health coverage entity's assets 
82.32 	to any entity except a corporation that is exempt under United States Code, title 26, section 
82.33 	501(c)(3); or
83.1 	(3) adds or substitutes one or more directors or officers that effectively transfer the 
83.2 	control of, responsibility for, or governance of the nonprofit health coverage entity to any 
83.3 	entity except a corporation that is exempt under United States Code, title 26, section 
83.4 	501(c)(3).
83.5 		Subd. 5.Corporation. "Corporation" has the meaning given in section 317A.011, 
83.6 	subdivision 6, and also includes a nonprofit limited liability company organized under 
83.7 	section 322C.1101.
83.8 		Subd. 6.Director. "Director" has the meaning given in section 317A.011, subdivision 
83.9 	7.
83.10 		Subd. 7.Family member. "Family member" means a spouse, parent, child, spouse of 
83.11 	a child, brother, sister, or spouse of a brother or sister.
83.12 		Subd. 8.Full and fair value. "Full and fair value" means at least the amount that the 
83.13 	public benefit assets of the nonprofit health coverage entity would be worth if the assets 
83.14 	were equal to stock in the nonprofit health coverage entity, if the nonprofit health coverage 
83.15 	entity was a for-profit corporation and if the nonprofit health coverage entity had 100 percent 
83.16 	of its stock authorized by the corporation and available for purchase without transfer 
83.17 	restrictions. The valuation shall consider market value, investment or earning value, net 
83.18 	asset value, goodwill, amount of donations received, and control premium, if any.
83.19 		Subd. 9.Nonprofit health coverage entity. "Nonprofit health coverage entity" means 
83.20 	a domestic nonprofit health service plan corporation operating under chapter 62C or a 
83.21 	domestic nonprofit health maintenance organization operating under chapter 62D.
83.22 		Subd. 10.Officer. "Officer" has the meaning given in section 317A.011, subdivision 
83.23 	15.
83.24 		Subd. 11.Public benefit assets. "Public benefit assets" means the entirety of a nonprofit 
83.25 	health coverage entity's assets, whether tangible or intangible, including but not limited to 
83.26 	its goodwill and anticipated future revenue.
83.27 		Subd. 12.Related organization. "Related organization" has the meaning given in section 
83.28 	317A.011, subdivision 18.

83.29 	EFFECTIVE DATE. This section is effective July 1, 2025.

83.30 	Sec. 48. [145D.31] CERTAIN CONVERSION TRANSACTIONS PROHIBITED.
83.31 	A nonprofit health coverage entity must not enter into a conversion transaction if:
84.1 	(1) doing so would result in less than the full and fair value of all public benefit assets 
84.2 	remaining dedicated to the public benefit; or
84.3 	(2) an individual who has been an officer, director, or other executive of the nonprofit 
84.4 	health coverage entity or of a related organization, or a family member of such an individual:
84.5 	(i) has held or will hold, whether guaranteed or contingent, an ownership stake, stock, 
84.6 	securities, investment, or other financial interest in an entity to which the nonprofit health 
84.7 	coverage entity transfers public benefit assets in connection with the conversion transaction;
84.8 	(ii) has received or will receive any type of compensation or other financial benefit, 
84.9 	except for salary or wages paid for employment, from an entity to which the nonprofit health 
84.10 	coverage entity transfers public benefit assets in connection with the conversion transaction;
84.11 	(iii) has held or will hold, whether guaranteed or contingent, an ownership stake, stock, 
84.12 	securities, investment, or other financial interest in an entity that has or will have a business 
84.13 	relationship with an entity to which the nonprofit health coverage entity transfers public 
84.14 	benefit assets in connection with the conversion transaction; or
84.15 	(iv) has received or will receive any type of compensation or other financial benefit, 
84.16 	except for salary or wages paid for employment, from an entity that has or will have a 
84.17 	business relationship with an entity to which the nonprofit health coverage entity transfers 
84.18 	public benefit assets in connection with the conversion transaction.

84.19 	EFFECTIVE DATE. This section is effective July 1, 2025.

84.20 	Sec. 49. [145D.32] REQUIREMENTS FOR NONPROFIT HEALTH COVERAGE 
84.21 	ENTITY CONVERSION TRANSACTIONS.
84.22 		Subdivision 1.Notice. (a) Before entering into a conversion transaction, a nonprofit 
84.23 	health coverage entity must notify the attorney general according to section 317A.811. In 
84.24 	addition to the elements listed in section 317A.811, subdivision 1, the notice required by 
84.25 	this subdivision must also include: (1) an itemization of the nonprofit health coverage entity's 
84.26 	public benefit assets and an independent third-party valuation of the nonprofit health coverage 
84.27 	entity's public benefit assets; and (2) other information contained in forms provided by the 
84.28 	attorney general.
84.29 	(b) When the nonprofit health coverage entity provides the attorney general with the 
84.30 	notice and other information required under paragraph (a), the nonprofit health coverage 
84.31 	entity must also provide a copy of this notice and other information to the applicable 
84.32 	commissioner.
85.1 		Subd. 2.Nonprofit health coverage entity requirements. Before entering into a 
85.2 	conversion transaction, a nonprofit health coverage entity must ensure that:
85.3 	(1) the proposed conversion transaction complies with chapters 317A and 501B and 
85.4 	other applicable laws;
85.5 	(2) the proposed conversion transaction does not involve or constitute a breach of 
85.6 	charitable trust;
85.7 	(3) the nonprofit health coverage entity shall receive full and fair value for its public 
85.8 	benefit assets;
85.9 	(4) the value of the public benefit assets to be transferred has not been manipulated in 
85.10 	a manner that causes or caused the value of the assets to decrease;
85.11 	(5) the proceeds of the proposed conversion transaction shall be used in a manner 
85.12 	consistent with the public benefit for which the assets are held by the nonprofit health 
85.13 	coverage entity; and
85.14 	(6) the proposed conversion transaction shall not result in a breach of fiduciary duty.
85.15 		Subd. 3.Listening sessions and public comment. The attorney general or the 
85.16 	commissioner may hold public listening sessions or forums and may solicit public comments 
85.17 	regarding the proposed conversion transaction.
85.18 		Subd. 4.Waiting period. (a) Subject to paragraphs (b) and (c), a nonprofit health 
85.19 	coverage entity must not enter into a conversion transaction until 60 days after the nonprofit 
85.20 	health coverage entity has given written notice as required in subdivision 1.
85.21 	(b) The attorney general may waive all or part of the waiting period or may extend the 
85.22 	waiting period for an additional 60 days by notifying the nonprofit health coverage entity 
85.23 	of the extension in writing.
85.24 	(c) The time periods specified in this subdivision shall be suspended while an 
85.25 	investigation into the conversion transaction is pending or while a request from the attorney 
85.26 	general for additional information is outstanding.
85.27 		Subd. 5.Funds restricted for a particular purpose. Nothing in this section relieves a 
85.28 	nonprofit health coverage entity from complying with requirements for funds that are 
85.29 	restricted for a particular purpose. Funds restricted for a particular purpose must continue 
85.30 	to be used in accordance with the purpose for which they were restricted under sections 
85.31 	317A.671 and 501B.31. A nonprofit health coverage entity may not convert, transfer, or 
86.1 	sell assets if the transaction would result in the use of the assets conflicting with their 
86.2 	restricted purpose.

86.3 	EFFECTIVE DATE. This section is effective July 1, 2025.

86.4 	Sec. 50. [145D.34] ENFORCEMENT AND REMEDIES.
86.5 		Subdivision 1.Investigation. The attorney general has the powers in section 8.31. 
86.6 	Nothing in this subdivision limits the powers, remedies, or responsibilities of the attorney 
86.7 	general under this chapter; chapter 8, 309, 317A, or 501B; or any other chapter. For purposes 
86.8 	of this section, an approval by the commissioner for regulatory purposes does not impair 
86.9 	or inform the attorney general's authority.
86.10 		Subd. 2.Enforcement and penalties. (a) The attorney general may bring an action in 
86.11 	district court to enjoin or unwind a conversion transaction or seek other equitable relief 
86.12 	necessary to protect the public interest if:
86.13 	(1) a nonprofit health coverage entity or conversion transaction violates sections 145D.30 
86.14 	to 145D.32; or
86.15 	(2) the conversion transaction is contrary to the public interest.
86.16 	In seeking injunctive relief, the attorney general must not be required to establish irreparable 
86.17 	harm but must instead establish that a violation of sections 145D.30 to 145D.32 occurred 
86.18 	or that the requested order promotes the public interest.
86.19 	(b) Factors informing whether a conversion transaction is contrary to the public interest 
86.20 	include but are not limited to whether:
86.21 	(1) the conversion transaction shall result in increased health care costs for patients; and
86.22 	(2) the conversion transaction shall adversely impact provider cost trends and containment 
86.23 	of total health care spending.
86.24 	(c) The attorney general may enforce sections 145D.30 to 145D.32 under section 8.31.
86.25 	(d) Failure of the entities involved in a conversion transaction to provide timely 
86.26 	information as required by the attorney general or the commissioner shall be an independent 
86.27 	and sufficient ground for a court to enjoin or unwind the transaction or provide other equitable 
86.28 	relief, provided the attorney general notifies the entities of the inadequacy of the information 
86.29 	provided and provides the entities with a reasonable opportunity to remedy the inadequacy.
86.30 	(e) An officer, director, or other executive found to have violated sections 145D.30 to 
86.31 	145D.32 shall be subject to a civil penalty of up to $100,000 for each violation. A corporation 
87.1 	or other entity which is a party to or materially participated in a conversion transaction 
87.2 	found to have violated sections 145D.30 to 145D.32 shall be subject to a civil penalty of 
87.3 	up to $1,000,000. A court may also award reasonable attorney fees and costs of investigation 
87.4 	and litigation.
87.5 		Subd. 3.Commissioner of health; data and research. The commissioner of health 
87.6 	must provide the attorney general, upon request, with data and research on broader market 
87.7 	trends, impacts on prices and outcomes, public health and population health considerations, 
87.8 	and health care access, for the attorney general to use when evaluating whether a conversion 
87.9 	transaction is contrary to public interest. The commissioner of health may share with the 
87.10 	attorney general, according to section 13.05, subdivision 9, any not public data, as defined 
87.11 	in section 13.02, subdivision 8a, held by the commissioner to aid in the investigation and 
87.12 	review of the conversion transaction, and the attorney general must maintain this data with 
87.13 	the same classification according to section 13.03, subdivision 4, paragraph (c).
87.14 		Subd. 4.Failure to take action. Failure by the attorney general to take action with 
87.15 	respect to a conversion transaction under this section does not constitute approval of the 
87.16 	conversion transaction or waiver, nor shall failure prevent the attorney general from taking 
87.17 	action in the same, similar, or subsequent circumstances.

87.18 	EFFECTIVE DATE. This section is effective July 1, 2025.

87.19 	Sec. 51. [145D.35] DATA PRACTICES.
87.20 	Data provided by a nonprofit health coverage entity to the commissioner or the attorney 
87.21 	general under sections 145D.30 to 145D.32 are, for data on individuals, confidential data 
87.22 	on individuals as defined under section 13.02, subdivision 3, and, for data not on individuals, 
87.23 	protected nonpublic data as defined under section 13.02, subdivision 13. The provided data 
87.24 	are not subject to subpoena and shall not be subject to discovery or admissible in evidence 
87.25 	in any private civil action. The attorney general or the commissioner may provide access 
87.26 	to any data classified as confidential or protected nonpublic under this section to any law 
87.27 	enforcement agency if the attorney general or commissioner determines that the access aids 
87.28 	the law enforcement process. This section shall not be construed to limit the attorney general's 
87.29 	authority to use the data in furtherance of any legal action brought according to section 
87.30 	145D.34.

87.31 	EFFECTIVE DATE. This section is effective July 1, 2025.

88.1 	Sec. 52. [145D.36] COMMISSIONER OF HEALTH; REPORTS AND ANALYSIS.
88.2 	Notwithstanding any law to the contrary, the commissioner of health may use data or 
88.3 	information submitted under sections 60A.135 to 60A.137, 60A.17, 60D.18, 60D.20, 
88.4 	62D.221, and 145D.32 to conduct analyses of the aggregate impact of transactions within 
88.5 	nonprofit health coverage entities and organizations which include nonprofit health coverage 
88.6 	entities or their affiliates on access to or the cost of health care services, health care market 
88.7 	consolidation, and health care quality. The commissioner of health must issue periodic 
88.8 	public reports on the number and types of conversion transactions subject to sections 145D.30 
88.9 	to 145D.35 and on the aggregate impact of conversion transactions on health care costs, 
88.10 	quality, and competition in Minnesota.

88.11 	EFFECTIVE DATE. This section is effective July 1, 2025.

88.12 	Sec. 53. [145D.37] RELATION TO OTHER LAW.
88.13 	(a) Sections 145D.30 to 145D.36 are in addition to and do not affect or limit any power, 
88.14 	remedy, or responsibility of a health maintenance organization, a service plan corporation, 
88.15 	the attorney general, the commissioner of health, or the commissioner of commerce under 
88.16 	this chapter; chapter 8, 62C, 62D, 309, 317A, or 501B; or other law.
88.17 	(b) Nothing in sections 145D.03 to 145D.36 authorizes a nonprofit health coverage entity 
88.18 	to enter into a conversion transaction not otherwise permitted under chapter 317A or 501B 
88.19 	or other law.

88.20 	EFFECTIVE DATE. This section is effective July 1, 2025.

88.21 	Sec. 54. [214.41] PHYSICIAN WELLNESS PROGRAM.
88.22 		Subdivision 1.Definition. For the purposes of this section, "physician wellness program" 
88.23 	means a program of evaluation, counseling, or other modality to address an issue related to 
88.24 	career fatigue or wellness related to work stress for physicians licensed under chapter 147 
88.25 	that is administered by a statewide association that is exempt from taxation under United 
88.26 	States Code, title 26, section 501(c)(6), and that primarily represents physicians and 
88.27 	osteopaths of multiple specialties. Physician wellness program does not include the provision 
88.28 	of services intended to monitor for impairment under the authority of section 214.31.
88.29 		Subd. 2.Confidentiality. Any record of a person's participation in a physician wellness 
88.30 	program is confidential and not subject to discovery, subpoena, or a reporting requirement 
88.31 	to the applicable board, unless the person voluntarily provides for written release of the 
89.1 	information or the disclosure is required to meet the licensee's obligation to report according 
89.2 	to section 147.111.
89.3 		Subd. 3.Civil liability. Any person, agency, institution, facility, or organization employed 
89.4 	by, contracting with, or operating a physician wellness program is immune from civil liability 
89.5 	for any action related to their duties in connection with a physician wellness program when 
89.6 	acting in good faith.

89.7 	Sec. 55. Minnesota Statutes 2022, section 256B.035, is amended to read:
89.8 	256B.035 MANAGED CARE.
89.9 	The commissioner of human services may contract with public or private entities or 
89.10 	operate a preferred provider program to deliver health care services to medical assistance 
89.11 	and MinnesotaCare program recipients. The commissioner may enter into risk-based and 
89.12 	non-risk-based contracts. The commissioner must not enter into a contract with a health 
89.13 	maintenance organization, as defined in section 62D.02, which is not a nonprofit corporation 
89.14 	organized under chapter 317A or a local governmental unit, as defined in section 62D.02. 
89.15 	Contracts may be for the full range of health services, or a portion thereof, for medical 
89.16 	assistance populations to determine the effectiveness of various provider reimbursement 
89.17 	and care delivery mechanisms. The commissioner may seek necessary federal waivers and 
89.18 	implement projects when approval of the waivers is obtained from the Centers for Medicare 
89.19 	and Medicaid Services of the United States Department of Health and Human Services.

89.20 	EFFECTIVE DATE. This section is effective January 1, 2025, and applies to managed 
89.21 	care contracts under medical assistance and MinnesotaCare that take effect on or after that 
89.22 	date.

89.23 	Sec. 56. Minnesota Statutes 2023 Supplement, section 256B.0625, subdivision 3a, is 
89.24 	amended to read:
89.25 		Subd. 3a.Gender-affirming services care. Medical assistance covers gender-affirming 
89.26 	servicescare, as defined in section 62Q.585.

89.27 	EFFECTIVE DATE. This section is effective January 1, 2025.

89.28 	Sec. 57. Minnesota Statutes 2022, section 256B.0625, subdivision 12, is amended to read:
89.29 		Subd. 12.Eyeglasses, dentures, and prosthetic and orthotic devices. (a) Medical 
89.30 	assistance covers eyeglasses, dentures, and prosthetic and orthotic devices if prescribed by 
89.31 	a licensed practitioner.
90.1 	(b) For purposes of prescribing prosthetic and orthotic devices, "licensed practitioner" 
90.2 	includes a physician, an advanced practice registered nurse, a physician assistant, or a 
90.3 	podiatrist.

90.4 	EFFECTIVE DATE. This section is effective January 1, 2025, or upon federal approval, 
90.5 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
90.6 	when federal approval is obtained.

90.7 	Sec. 58. Minnesota Statutes 2023 Supplement, section 256B.0625, subdivision 16, is 
90.8 	amended to read:
90.9 		Subd. 16.Abortion services. Medical assistance covers abortion services determined 
90.10 	to be medically necessary by the treating provider and delivered in accordance with all 
90.11 	applicable Minnesota laws abortions and abortion-related services, including preabortion 
90.12 	services and follow-up services.

90.13 	EFFECTIVE DATE. This section is effective January 1, 2025, or upon federal approval, 
90.14 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
90.15 	when federal approval is obtained.

90.16 	Sec. 59. Minnesota Statutes 2022, section 256B.0625, subdivision 32, is amended to read:
90.17 		Subd. 32.Nutritional products. Medical assistance covers nutritional products needed 
90.18 	for nutritional supplementation because solid food or nutrients thereof cannot be properly 
90.19 	absorbed by the body or needed for treatment of phenylketonuria, hyperlysinemia, maple 
90.20 	syrup urine disease, a combined allergy to human milk, cow's milk, and soy formula, or 
90.21 	any other childhood or adult diseases, conditions, or disorders identified by the commissioner 
90.22 	as requiring a similarly necessary nutritional product. Medical assistance covers amino 
90.23 	acid-based elemental formulas in the same manner as is required under section 62Q.531. 
90.24 	Nutritional products needed for the treatment of a combined allergy to human milk, cow's 
90.25 	milk, and soy formula require prior authorization. Separate payment shall not be made for 
90.26 	nutritional products for residents of long-term care facilities. Payment for dietary 
90.27 	requirements is a component of the per diem rate paid to these facilities.

90.28 	EFFECTIVE DATE. This section is effective January 1, 2025.

90.29 	Sec. 60. Minnesota Statutes 2022, section 256B.0625, is amended by adding a subdivision 
90.30 	to read:
90.31 		Subd. 72.Orthotic and prosthetic devices. Medical assistance covers orthotic and 
90.32 	prosthetic devices, supplies, and services according to section 256B.066.

91.1 	EFFECTIVE DATE. This section is effective January 1, 2025, or upon federal approval, 
91.2 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
91.3 	when federal approval is obtained.

91.4 	Sec. 61. Minnesota Statutes 2022, section 256B.0625, is amended by adding a subdivision 
91.5 	to read:
91.6 		Subd. 73.Rapid whole genome sequencing. Medical assistance covers rapid whole 
91.7 	genome sequencing (rWGS) testing. Coverage and eligibility for rWGS testing, and the use 
91.8 	of genetic data, must meet the requirements specified in section 62A.3098, subdivisions 1 
91.9 	to 3 and 6.

91.10 	EFFECTIVE DATE. This section is effective January 1, 2025.

91.11 	Sec. 62. Minnesota Statutes 2022, section 256B.0625, is amended by adding a subdivision 
91.12 	to read:
91.13 		Subd. 74.Intermittent catheters. Medical assistance covers intermittent urinary catheters 
91.14 	and insertion supplies if intermittent catheterization is recommended by the enrollee's health 
91.15 	care provider. Medical assistance must meet the requirements that would otherwise apply 
91.16 	to a health plan under section 62Q.666.

91.17 	Sec. 63. Minnesota Statutes 2022, section 256B.0625, is amended by adding a subdivision 
91.18 	to read:
91.19 		Subd. 75.Scalp hair prostheses. Medical assistance covers scalp hair prostheses and 
91.20 	all equipment and accessories necessary for their regular use under the conditions and in 
91.21 	compliance with the requirements specified in section 62A.28, except that the limitation on 
91.22 	coverage required per benefit year set forth in section 62A.28, subdivision 2, paragraph (c), 
91.23 	does not apply.

91.24 	EFFECTIVE DATE. This section is effective January 1, 2025.

91.25 	Sec. 64. Minnesota Statutes 2022, section 256B.0625, is amended by adding a subdivision 
91.26 	to read:
91.27 		Subd. 76.Transfer of mothers and newborns. Medical assistance covers the transfer 
91.28 	of mothers or newborns between medical facilities. Medical assistance must meet the same 
91.29 	requirements that would otherwise apply to a health plan under section 62A.0411.

91.30 	EFFECTIVE DATE. This section is effective January 1, 2025.

92.1 	Sec. 65. [256B.066] ORTHOTIC AND PROSTHETIC DEVICES, SUPPLIES, AND 
92.2 	SERVICES.
92.3 		Subdivision 1.Definitions.  All terms used in this section have the meanings given them 
92.4 	in section 62Q.665, subdivision 1.
92.5 		Subd. 2.Coverage requirements.  (a) Medical assistance covers orthotic and prosthetic 
92.6 	devices, supplies, and services:
92.7 	(1) furnished under an order by a prescribing physician or licensed health care prescriber 
92.8 	who has authority in Minnesota to prescribe orthoses and prostheses. Coverage for orthotic 
92.9 	and prosthetic devices, supplies, accessories, and services under this clause includes those 
92.10 	devices or device systems, supplies, accessories, and services that are customized to the 
92.11 	enrollee's needs;
92.12 	(2) determined by the enrollee's provider to be the most appropriate model that meets 
92.13 	the medical needs of the enrollee for purposes of performing physical activities, as applicable, 
92.14 	including but not limited to running, biking, and swimming, and maximizing the enrollee's 
92.15 	limb function; or
92.16 	(3) for showering or bathing.
92.17 	(b) The coverage set forth in paragraph (a) includes the repair and replacement of those 
92.18 	orthotic and prosthetic devices, supplies, and services described therein.
92.19 	(c) Coverage of a prosthetic or orthotic benefit must not be denied for an individual with 
92.20 	limb loss or absence that would otherwise be covered for a nondisabled person seeking 
92.21 	medical or surgical intervention to restore or maintain the ability to perform the same 
92.22 	physical activity.
92.23 	(d) If coverage for prosthetic or custom orthotic devices is provided, payment must be 
92.24 	made for the replacement of a prosthetic or custom orthotic device or for the replacement 
92.25 	of any part of the devices, without regard to useful lifetime restrictions, if an ordering health 
92.26 	care provider determines that the provision of a replacement device, or a replacement part 
92.27 	of a device, is necessary because:
92.28 	(1) of a change in the physiological condition of the enrollee;
92.29 	(2) of an irreparable change in the condition of the device or in a part of the device; or
92.30 	(3) the condition of the device, or the part of the device, requires repairs and the cost of 
92.31 	the repairs would be more than 60 percent of the cost of a replacement device or of the part 
92.32 	being replaced.
93.1 		Subd. 3.Restrictions on coverage. (a) Prior authorization may be required for orthotic 
93.2 	and prosthetic devices, supplies, and services.
93.3 	(b) A utilization review for a request for coverage of prosthetic or orthotic benefits must 
93.4 	apply the most recent version of evidence-based treatment and fit criteria as recognized by 
93.5 	relevant clinical specialists.
93.6 	(c) Utilization review determinations must be rendered in a nondiscriminatory manner 
93.7 	and must not deny coverage for habilitative or rehabilitative benefits, including prosthetics 
93.8 	or orthotics, solely on the basis of an enrollee's actual or perceived disability.
93.9 	(d) Evidence of coverage and any benefit denial letters must include language describing 
93.10 	an enrollee's rights pursuant to paragraphs (b) and (c).
93.11 	(e) Confirmation from a prescribing health care provider may be required if the prosthetic 
93.12 	or custom orthotic device or part being replaced is less than three years old.
93.13 		Subd. 4.Managed care plan access to care.  (a) Managed care plans and county-based 
93.14 	purchasing plans subject to this section must ensure access to medically necessary clinical 
93.15 	care and to prosthetic and custom orthotic devices and technology from at least two distinct 
93.16 	prosthetic and custom orthotic providers in the plan's provider network located in Minnesota.
93.17 	(b) In the event that medically necessary covered orthotics and prosthetics are not 
93.18 	available from an in-network provider, the plan must provide processes to refer an enrollee 
93.19 	to an out-of-network provider and must fully reimburse the out-of-network provider at a 
93.20 	mutually agreed upon rate less enrollee cost sharing determined on an in-network basis.

93.21 	EFFECTIVE DATE. This section is effective January 1, 2025, or upon federal approval, 
93.22 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
93.23 	when federal approval is obtained.

93.24 	Sec. 66. Minnesota Statutes 2022, section 256B.69, subdivision 2, is amended to read:
93.25 		Subd. 2.Definitions. For the purposes of this section, the following terms have the 
93.26 	meanings given.
93.27 	(a) "Commissioner" means the commissioner of human services. For the remainder of 
93.28 	this section, the commissioner's responsibilities for methods and policies for implementing 
93.29 	the project will be proposed by the project advisory committees and approved by the 
93.30 	commissioner.
93.31 	(b) "Demonstration provider" means a nonprofit health maintenance organization, 
93.32 	community integrated service network, or accountable provider network authorized and 
94.1 	operating under chapter 62D, 62N, or 62T that participates in the demonstration project 
94.2 	according to criteria, standards, methods, and other requirements established for the project 
94.3 	and approved by the commissioner. For purposes of this section, a county board, or group 
94.4 	of county boards operating under a joint powers agreement, is considered a demonstration 
94.5 	provider if the county or group of county boards meets the requirements of section 256B.692.
94.6 	(c) "Eligible individuals" means those persons eligible for medical assistance benefits 
94.7 	as defined in sections 256B.055, 256B.056, and 256B.06.
94.8 	(d) "Limitation of choice" means suspending freedom of choice while allowing eligible 
94.9 	individuals to choose among the demonstration providers.

94.10 	EFFECTIVE DATE. This section is effective January 1, 2025.

94.11 	Sec. 67. Minnesota Statutes 2022, section 256L.12, subdivision 7, is amended to read:
94.12 		Subd. 7.Managed care plan vendor requirements. (a) The following requirements 
94.13 	apply to all counties or vendors who contract with the Department of Human Services to 
94.14 	serve MinnesotaCare recipients. Managed care plan contractors:
94.15 	(1) shall authorize and arrange for the provision of the full range of services listed in 
94.16 	section 256L.03 in order to ensure appropriate health care is delivered to enrollees;
94.17 	(2) shall accept the prospective, per capita payment or other contractually defined payment 
94.18 	from the commissioner in return for the provision and coordination of covered health care 
94.19 	services for eligible individuals enrolled in the program;
94.20 	(3) may contract with other health care and social service practitioners to provide services 
94.21 	to enrollees;
94.22 	(4) shall provide for an enrollee grievance process as required by the commissioner and 
94.23 	set forth in the contract with the department;
94.24 	(5) shall retain all revenue from enrollee co-payments;
94.25 	(6) shall accept all eligible MinnesotaCare enrollees, without regard to health status or 
94.26 	previous utilization of health services;
94.27 	(7) shall demonstrate capacity to accept financial risk according to requirements specified 
94.28 	in the contract with the department. A health maintenance organization licensed under 
94.29 	chapter 62D, or a nonprofit health plan licensed under chapter 62C, is not required to 
94.30 	demonstrate financial risk capacity, beyond that which is required to comply with chapters 
94.31 	62C and 62D; and
95.1 	(8) shall submit information as required by the commissioner, including data required 
95.2 	for assessing enrollee satisfaction, quality of care, cost, and utilization of services.
95.3 	(b) A health maintenance organization must be a nonprofit corporation organized under 
95.4 	chapter 317A to serve as a managed care contractor under this section and section 256L.121.

95.5 	EFFECTIVE DATE. This section is effective January 1, 2025.

95.6 	Sec. 68. Minnesota Statutes 2022, section 317A.811, subdivision 1, is amended to read:
95.7 		Subdivision 1.When required. (a) Except as provided in subdivision 6, the following 
95.8 	corporations shall notify the attorney general of their intent to dissolve, merge, consolidate, 
95.9 	or convert, or to transfer all or substantially all of their assets:
95.10 	(1) a corporation that holds assets for a charitable purpose as defined in section 501B.35, 
95.11 	subdivision 2; or
95.12 	(2) a corporation that is exempt under section 501(c)(3) of the Internal Revenue Code 
95.13 	of 1986, or any successor section.; or
95.14 	(3) effective July 1, 2025, a nonprofit health coverage entity as defined in section 
95.15 	145D.30.
95.16 	(b) The notice must include:
95.17 	(1) the purpose of the corporation that is giving the notice;
95.18 	(2) a list of assets owned or held by the corporation for charitable purposes;
95.19 	(3) a description of restricted assets and purposes for which the assets were received;
95.20 	(4) a description of debts, obligations, and liabilities of the corporation;
95.21 	(5) a description of tangible assets being converted to cash and the manner in which 
95.22 	they will be sold;
95.23 	(6) anticipated expenses of the transaction, including attorney fees;
95.24 	(7) a list of persons to whom assets will be transferred, if known, or the name of the 
95.25 	converted organization;
95.26 	(8) the purposes of persons receiving the assets or of the converted organization; and
95.27 	(9) the terms, conditions, or restrictions, if any, to be imposed on the transferred or 
95.28 	converted assets.
95.29 	The notice must be signed on behalf of the corporation by an authorized person.

96.1 	Sec. 69. SUPERSEDING EFFECT.
 96.2 	Minnesota Statutes, section 62Q.679, in this article shall supersede Minnesota Statutes, 
96.3 	section 62Q.679, in 2024 S.F. No. 4097, article 1, section 8, if enacted.

96.4 	Sec. 70. INITIAL REPORTS TO COMMISSIONER OF HEALTH; PRIOR 
96.5 	AUTHORIZATIONS.
 96.6 	Utilization review organizations must submit initial reports to the commissioner of health 
96.7 	under Minnesota Statutes, section 62M.19, by September 1, 2025.

96.8 	Sec. 71. REPEALER.
 96.9 	(a) Minnesota Statutes 2022, section 62A.041, subdivision 3, is repealed.
96.10 	(b) Minnesota Statutes 2023 Supplement, section 62Q.522, subdivisions 3 and 4, are 
96.11 	repealed.

96.12 	EFFECTIVE DATE. This section is effective January 1, 2025, and applies to health 
96.13 	plans offered, sold, issued, or renewed on or after that date.

96.14 	ARTICLE 5
96.15 	DEPARTMENT OF HEALTH FINANCE

96.16 	Section 1. Minnesota Statutes 2022, section 103I.621, subdivision 1, is amended to read:
96.17 		Subdivision 1.Permit. (a) Notwithstanding any department or agency rule to the contrary, 
96.18 	the commissioner shall issue, on request by the owner of the property and payment of the 
96.19 	permit fee, permits for the reinjection of water by a properly constructed well into the same 
96.20 	aquifer from which the water was drawn for the operation of a groundwater thermal exchange 
96.21 	device.
96.22 	(b) As a condition of the permit, an applicant must agree to allow inspection by the 
96.23 	commissioner during regular working hours for department inspectors.
96.24 	(c) Not more than 200 permits may be issued for small systems having maximum 
96.25 	capacities of 20 gallons per minute or less and that are compliant with the natural resource 
96.26 	water-use requirements under subdivision 2. The small systems are subject to inspection 
96.27 	twice a year.
96.28 	(d) Not more than ten 100 permits may be issued for larger systems having maximum 
96.29 	capacities from over 20 to 50 gallons per minute and that are compliant with the natural 
97.1 	resource water-use requirements under subdivision 2. The larger systems are subject to 
97.2 	inspection four times a year.
97.3 	(e) A person issued a permit must comply with this section and permit conditions deemed 
97.4 	necessary to protect public health and safety of the groundwater for the permit to be valid. 
97.5 	The permit conditions may include but are not limited to requirements for:
97.6 	(1) notification to the commissioner at intervals specified in the permit conditions;
97.7 	(2) system operation and maintenance;
97.8 	(3) system location and construction;
97.9 	(4) well location and construction;
97.10 	(5) signage;
97.11 	(6) reports of system construction, performance, operation, and maintenance;
97.12 	(7) removal of the system upon termination of its use or system failure;
97.13 	(8) disclosure of the system at the time of property transfer;
97.14 	(9) obtaining approval from the commissioner prior to deviation from the approval plan 
97.15 	and conditions;
97.16 	(10) groundwater level monitoring; and
97.17 	(11) groundwater quality monitoring.
97.18 	(f) The property owner or the property owner's agent must submit to the commissioner 
97.19 	a permit application on a form provided by the commissioner, or in a format approved by 
97.20 	the commissioner, that provides any information necessary to protect public health and 
97.21 	safety of the groundwater.
97.22 	(g) A permit granted under this section is not valid if a water-use permit is required for 
97.23 	the project and is not approved by the commissioner of natural resources.

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

97.25 	Sec. 2. Minnesota Statutes 2022, section 103I.621, subdivision 2, is amended to read:
97.26 		Subd. 2.Water-use requirements apply. Water-use permit requirements and penalties 
97.27 	under chapter 103F 103G and related rules adopted and enforced by the commissioner of 
97.28 	natural resources apply to groundwater thermal exchange permit recipients. A person who 
97.29 	violates a provision of this section is subject to enforcement or penalties for the noncomplying 
97.30 	activity that are available to the commissioner and the Pollution Control Agency.

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

98.2 	Sec. 3. Minnesota Statutes 2023 Supplement, section 144.1501, subdivision 2, is amended 
98.3 	to read:
98.4 		Subd. 2.Creation of account Availability. (a) A health professional education loan 
98.5 	forgiveness program account is established. The commissioner of health shall use money 
98.6 	from the account to establish a appropriated for health professional education loan forgiveness 
98.7 	program in this section:
98.8 	(1) for medical residents, physicians, mental health professionals, and alcohol and drug 
98.9 	counselors agreeing to practice in designated rural areas or underserved urban communities 
98.10 	or specializing in the area of pediatric psychiatry;
98.11 	(2) for midlevel practitioners agreeing to practice in designated rural areas or to teach 
98.12 	at least 12 credit hours, or 720 hours per year in the nursing field in a postsecondary program 
98.13 	at the undergraduate level or the equivalent at the graduate level;
98.14 	(3) for nurses who agree to practice in a Minnesota nursing home; in an intermediate 
98.15 	care facility for persons with developmental disability; in a hospital if the hospital owns 
98.16 	and operates a Minnesota nursing home and a minimum of 50 percent of the hours worked 
98.17 	by the nurse is in the nursing home; in an assisted living facility as defined in section 
98.18 	144G.08, subdivision 7; or for a home care provider as defined in section 144A.43, 
98.19 	subdivision 4; or agree to teach at least 12 credit hours, or 720 hours per year in the nursing 
98.20 	field in a postsecondary program at the undergraduate level or the equivalent at the graduate 
98.21 	level;
98.22 	(4) for other health care technicians agreeing to teach at least 12 credit hours, or 720 
98.23 	hours per year in their designated field in a postsecondary program at the undergraduate 
98.24 	level or the equivalent at the graduate level. The commissioner, in consultation with the 
98.25 	Healthcare Education-Industry Partnership, shall determine the health care fields where the 
98.26 	need is the greatest, including, but not limited to, respiratory therapy, clinical laboratory 
98.27 	technology, radiologic technology, and surgical technology;
98.28 	(5) for pharmacists, advanced dental therapists, dental therapists, and public health nurses 
98.29 	who agree to practice in designated rural areas;
98.30 	(6) for dentists agreeing to deliver at least 25 percent of the dentist's yearly patient 
98.31 	encounters to state public program enrollees or patients receiving sliding fee schedule 
98.32 	discounts through a formal sliding fee schedule meeting the standards established by the 
99.1 	United States Department of Health and Human Services under Code of Federal Regulations, 
99.2 	title 42, section 51, chapter 303 51c.303; and
99.3 	(7) for nurses employed as a hospital nurse by a nonprofit hospital and providing direct 
99.4 	care to patients at the nonprofit hospital.
99.5 	(b) Appropriations made to the account for health professional education loan forgiveness 
99.6 	in this section do not cancel and are available until expended, except that at the end of each 
99.7 	biennium, any remaining balance in the account that is not committed by contract and not 
99.8 	needed to fulfill existing commitments shall cancel to the fund.

99.9 	Sec. 4. Minnesota Statutes 2022, section 144.1501, subdivision 5, is amended to read:
99.10 		Subd. 5.Penalty for nonfulfillment. If a participant does not fulfill the required 
99.11 	minimum commitment of service according to subdivision 3, the commissioner of health 
99.12 	shall collect from the participant the total amount paid to the participant under the loan 
99.13 	forgiveness program plus interest at a rate established according to section 270C.40. The 
99.14 	commissioner shall deposit the money collected in the health care access fund to be credited 
99.15 	to a dedicated account in the special revenue fund. The balance of the account is appropriated 
99.16 	annually to the commissioner for the health professional education loan forgiveness program 
99.17 	account established in subdivision 2. The commissioner shall allow waivers of all or part 
99.18 	of the money owed the commissioner as a result of a nonfulfillment penalty if emergency 
99.19 	circumstances prevented fulfillment of the minimum service commitment.

99.20 	Sec. 5. Minnesota Statutes 2022, section 144.555, subdivision 1a, is amended to read:
99.21 		Subd. 1a.Notice of closing, curtailing operations, relocating services, or ceasing to 
99.22 	offer certain services; hospitals. (a) The controlling persons of a hospital licensed under 
99.23 	sections 144.50 to 144.56 or a hospital campus must notify the commissioner of health and,
99.24 	the public, and others at least 120 182 days before the hospital or hospital campus voluntarily 
99.25 	plans to implement one of the following scheduled actions listed in paragraph (b), unless 
99.26 	the controlling persons can demonstrate to the commissioner that meeting the advanced 
99.27 	notice requirement is not feasible and the commissioner approves a shorter advanced notice.
99.28 	(b) The following scheduled actions require advanced notice under paragraph (a):
99.29 	(1) cease ceasing operations;
99.30 	(2) curtail curtailing operations to the extent that patients must be relocated;
99.31 	(3) relocate relocating the provision of health services to another hospital or another 
99.32 	hospital campus; or
100.1 	(4) cease offering ceasing to offer maternity care and newborn care services, intensive 
100.2 	care unit services, inpatient mental health services, or inpatient substance use disorder 
100.3 	treatment services.
100.4 	(c) A notice required under this subdivision must comply with the requirements in 
100.5 	subdivision 1d.
100.6 	(b) (d) The commissioner shall cooperate with the controlling persons and advise them 
100.7 	about relocating the patients.

100.8 	Sec. 6. Minnesota Statutes 2022, section 144.555, subdivision 1b, is amended to read:
100.9 		Subd. 1b.Public hearing. Within 45 30 days after receiving notice under subdivision 
100.10 	1a, the commissioner shall conduct a public hearing on the scheduled cessation of operations, 
100.11 	curtailment of operations, relocation of health services, or cessation in offering health 
100.12 	services. The commissioner must provide adequate public notice of the hearing in a time 
100.13 	and manner determined by the commissioner. The controlling persons of the hospital or 
100.14 	hospital campus must participate in the public hearing. The public hearing must be held at 
100.15 	a location that is within ten miles of the hospital or hospital campus or with the 
100.16 	commissioner's approval as close as is practicable, and that is provided or arranged by the 
100.17 	hospital or hospital campus. Video conferencing technology must be used to allow members 
100.18 	of the public to view and participate in the hearing. The public hearing must include:
100.19 	(1) an explanation by the controlling persons of the reasons for ceasing or curtailing 
100.20 	operations, relocating health services, or ceasing to offer any of the listed health services;
100.21 	(2) a description of the actions that controlling persons will take to ensure that residents 
100.22 	in the hospital's or campus's service area have continued access to the health services being 
100.23 	eliminated, curtailed, or relocated;
100.24 	(3) an opportunity for public testimony on the scheduled cessation or curtailment of 
100.25 	operations, relocation of health services, or cessation in offering any of the listed health 
100.26 	services, and on the hospital's or campus's plan to ensure continued access to those health 
100.27 	services being eliminated, curtailed, or relocated; and
100.28 	(4) an opportunity for the controlling persons to respond to questions from interested 
100.29 	persons.

101.1 	Sec. 7. Minnesota Statutes 2022, section 144.555, is amended by adding a subdivision to 
101.2 	read:
101.3 		Subd. 1d.Methods of providing notice; content of notice. (a) A notice required under 
101.4 	subdivision 1a must be provided to patients, hospital personnel, the public, local units of 
101.5 	government, and the commissioner of health using at least the following methods:
101.6 	(1) posting a notice of the proposed cessation of operations, curtailment, relocation of 
101.7 	health services, or cessation in offering health services at the main public entrance of the 
101.8 	hospital or hospital campus;
101.9 	(2) providing written notice to the commissioner of health, to the city council in the city 
101.10 	where the hospital or hospital campus is located, and to the county board in the county 
101.11 	where the hospital or hospital campus is located;
101.12 	(3) providing written notice to the local health department as defined in section 145A.02, 
101.13 	subdivision 8b, for the community where the hospital or hospital campus is located;
101.14 	(4) providing notice to the public through a written public announcement which must 
101.15 	be distributed to local media outlets;
101.16 	(5) providing written notice to existing patients of the hospital or hospital campus; and
101.17 	(6) notifying all personnel currently employed in the unit, hospital, or hospital campus 
101.18 	impacted by the proposed cessation, curtailment, or relocation.
101.19 	(b) A notice required under subdivision 1a must include:
101.20 	(1) a description of the proposed cessation of operations, curtailment, relocation of health 
101.21 	services, or cessation in offering health services. The description must include:
101.22 	(i) the number of beds, if any, that will be eliminated, repurposed, reassigned, or otherwise 
101.23 	reconfigured to serve populations or patients other than those currently served;
101.24 	(ii) the current number of beds in the impacted unit, hospital, or hospital campus, and 
101.25 	the number of beds in the impacted unit, hospital, or hospital campus after the proposed 
101.26 	cessation, curtailment, or relocation takes place;
101.27 	(iii) the number of existing patients who will be impacted by the proposed cessation, 
101.28 	curtailment, or relocation;
101.29 	(iv) any decrease in personnel, or relocation of personnel to a different unit, hospital, or 
101.30 	hospital campus, caused by the proposed cessation, curtailment, or relocation;
102.1 	(v) a description of the health services provided by the unit, hospital, or hospital campus 
102.2 	impacted by the proposed cessation, curtailment, or relocation; and
102.3 	(vi) identification of the three nearest available health care facilities where patients may 
102.4 	obtain the health services provided by the unit, hospital, or hospital campus impacted by 
102.5 	the proposed cessation, curtailment, or relocation, and any potential barriers to seamlessly 
102.6 	transition patients to receive services at one of these facilities. If the unit, hospital, or hospital 
102.7 	campus impacted by the proposed cessation, curtailment, or relocation serves medical 
102.8 	assistance or Medicare enrollees, the information required under this item must specify 
102.9 	whether any of the three nearest available facilities serves medical assistance or Medicare 
102.10 	enrollees; and
102.11 	(2) a telephone number, email address, and address for each of the following, to which 
102.12 	interested parties may offer comments on the proposed cessation, curtailment, or relocation:
102.13 	(i) the hospital or hospital campus; and
102.14 	(ii) the parent entity, if any, or the entity under contract, if any, that acts as the corporate 
102.15 	administrator of the hospital or hospital campus.

102.16 	Sec. 8. Minnesota Statutes 2022, section 144.555, subdivision 2, is amended to read:
102.17 		Subd. 2.Penalty; facilities other than hospitals. Failure to notify the commissioner 
102.18 	under subdivision 1, 1a, or 1c or failure to participate in a public hearing under subdivision 
102.19 	1b may result in issuance of a correction order under section 144.653, subdivision 5.

102.20 	Sec. 9. Minnesota Statutes 2022, section 144.555, is amended by adding a subdivision to 
102.21 	read:
102.22 		Subd. 3.Penalties; hospitals. (a) Failure to participate in a public hearing under 
102.23 	subdivision 1b or failure to notify the commissioner under subdivision 1c may result in 
102.24 	issuance of a correction order under section 144.653, subdivision 5.
102.25 	(b) Notwithstanding any law to the contrary, the commissioner must impose on the 
102.26 	controlling persons of a hospital or hospital campus a fine of $20,000 for each failure to 
102.27 	provide notice to an individual or entity or at a location required under subdivision 1d, 
102.28 	paragraph (a). The cumulative fines imposed under this paragraph must not exceed $60,000 
102.29 	for any scheduled action requiring notice under subdivision 1a. The commissioner is not 
102.30 	required to issue a correction order before imposing a fine under this paragraph. Section 
102.31 	144.653, subdivision 8, applies to fines imposed under this paragraph.

103.1 	Sec. 10. [144.556] RIGHT OF FIRST REFUSAL; SALE OF HOSPITAL OR 
103.2 	HOSPITAL CAMPUS.
103.3 	(a) The controlling persons of a hospital licensed under sections 144.50 to 144.56 or a 
103.4 	hospital campus must not sell or convey the hospital or hospital campus, offer to sell or 
103.5 	convey the hospital or hospital campus to a person other than a local unit of government 
103.6 	listed in this paragraph, or voluntarily cease operations of the hospital or hospital campus 
103.7 	unless the controlling persons have first made a good faith offer to sell or convey the hospital 
103.8 	or hospital campus to the home rule charter or statutory city, county, town, or hospital 
103.9 	district in which the hospital or hospital campus is located.
103.10 	(b) The offer to sell or convey the hospital or hospital campus to a local unit of 
103.11 	government under paragraph (a) must be at a price that does not exceed the current fair 
103.12 	market value of the hospital or hospital campus. A party to whom an offer is made under 
103.13 	paragraph (a) must accept or decline the offer within 60 days of receipt. If the party to whom 
103.14 	the offer is made fails to respond within 60 days of receipt, the offer is deemed declined.

103.15 	Sec. 11. Minnesota Statutes 2022, section 144A.61, subdivision 3a, is amended to read:
103.16 		Subd. 3a.Competency evaluation program. (a) The commissioner of health shall 
103.17 	approve the competency evaluation program.
103.18 	(b) A competency evaluation must be administered to persons who desire to be listed 
103.19 	in the nursing assistant registry. The tests may only be administered by technical colleges, 
103.20 	community colleges, or other organizations approved by the Department of Health
103.21 	commissioner of health. The commissioner must ensure any written portions of the 
103.22 	competency evaluation are available in languages other than English that are commonly 
103.23 	spoken by persons who desire to be listed in the nursing assistant registry. The commissioner 
103.24 	may consult with the state demographer or the commissioner of employment and economic 
103.25 	development when identifying languages that are commonly spoken by persons who desire 
103.26 	to be listed in the nursing assistant registry.
103.27 	(c) The commissioner of health shall approve a nursing assistant for the registry without 
103.28 	requiring a competency evaluation if the nursing assistant is in good standing on a nursing 
103.29 	assistant registry in another state.

103.30 	EFFECTIVE DATE. This section is effective January 1, 2025.

104.1 	Sec. 12. Minnesota Statutes 2022, section 144A.70, subdivision 3, is amended to read:
104.2 		Subd. 3.Controlling person. "Controlling person" means a business entity or entities, 
104.3 	officer, program administrator, or director, whose responsibilities include the direction of 
104.4 	the management or policies of a supplemental nursing services agency the management and 
104.5 	decision-making authority to establish or control business policy and all other policies of a 
104.6 	supplemental nursing services agency. Controlling person also means an individual who, 
104.7 	directly or indirectly, beneficially owns an interest in a corporation, partnership, or other 
104.8 	business association that is a controlling person.

104.9 	Sec. 13. Minnesota Statutes 2022, section 144A.70, subdivision 5, is amended to read:
104.10 		Subd. 5.Person. "Person" includes an individual, firm, corporation, partnership, limited 
104.11 	liability company, or association.

104.12 	Sec. 14. Minnesota Statutes 2022, section 144A.70, subdivision 6, is amended to read:
104.13 		Subd. 6.Supplemental nursing services agency. "Supplemental nursing services 
104.14 	agency" means a person, firm, corporation, partnership, limited liability company, or 
104.15 	association engaged for hire in the business of providing or procuring temporary employment 
104.16 	in health care facilities for nurses, nursing assistants, nurse aides, and orderlies. Supplemental 
104.17 	nursing services agency does not include an individual who only engages in providing the 
104.18 	individual's services on a temporary basis to health care facilities. Supplemental nursing 
104.19 	services agency does not include a professional home care agency licensed under section 
104.20 	144A.471 that only provides staff to other home care providers.

104.21 	Sec. 15. Minnesota Statutes 2022, section 144A.70, subdivision 7, is amended to read:
104.22 		Subd. 7.Oversight. The commissioner is responsible for the oversight of supplemental 
104.23 	nursing services agencies through annual semiannual unannounced surveys and follow-up 
104.24 	surveys, complaint investigations under sections 144A.51 to 144A.53, and other actions 
104.25 	necessary to ensure compliance with sections 144A.70 to 144A.74.

104.26 	Sec. 16. Minnesota Statutes 2022, section 144A.71, subdivision 2, is amended to read:
104.27 		Subd. 2.Application information and fee. The commissioner shall establish forms and 
104.28 	procedures for processing each supplemental nursing services agency registration application. 
104.29 	An application for a supplemental nursing services agency registration must include at least 
104.30 	the following:
105.1 	(1) the names and addresses of the owner or owners all owners and controlling persons
105.2 	of the supplemental nursing services agency;
105.3 	(2) if the owner is a corporation, copies of its articles of incorporation and current bylaws, 
105.4 	together with the names and addresses of its officers and directors;
105.5 	(3) satisfactory proof of compliance with section 144A.72, subdivision 1, clauses (5) to 
105.6 	(7) if the owner is a limited liability company, copies of its articles of organization and 
105.7 	operating agreement, together with the names and addresses of its officers and directors;
105.8 	(4) documentation that the supplemental nursing services agency has medical malpractice 
105.9 	insurance to insure against the loss, damage, or expense of a claim arising out of the death 
105.10 	or injury of any person as the result of negligence or malpractice in the provision of health 
105.11 	care services by the supplemental nursing services agency or by any employee of the agency;
105.12 	(5) documentation that the supplemental nursing services agency has an employee 
105.13 	dishonesty bond in the amount of $10,000;
105.14 	(6) documentation that the supplemental nursing services agency has insurance coverage 
105.15 	for workers' compensation for all nurses, nursing assistants, nurse aides, and orderlies 
105.16 	provided or procured by the agency;
105.17 	(7) documentation that the supplemental nursing services agency filed with the 
105.18 	commissioner of revenue: (i) the name and address of the bank, savings bank, or savings 
105.19 	association in which the supplemental nursing services agency deposits all employee income 
105.20 	tax withholdings; and (ii) the name and address of any nurse, nursing assistant, nurse aide, 
105.21 	or orderly whose income is derived from placement by the agency, if the agency purports 
105.22 	the income is not subject to withholding;
105.23 	(4) (8) any other relevant information that the commissioner determines is necessary to 
105.24 	properly evaluate an application for registration;
105.25 	(5) (9) a policy and procedure that describes how the supplemental nursing services 
105.26 	agency's records will be immediately available at all times to the commissioner and facility; 
105.27 	and
105.28 	(6) (10) a nonrefundable registration fee of $2,035.
105.29 	If a supplemental nursing services agency fails to provide the items in this subdivision 
105.30 	to the department, the commissioner shall immediately suspend or refuse to issue the 
105.31 	supplemental nursing services agency registration. The supplemental nursing services agency 
105.32 	may appeal the commissioner's findings according to section 144A.475, subdivisions 3a 
106.1 	and 7, except that the hearing must be conducted by an administrative law judge within 60 
106.2 	calendar days of the request for hearing assignment.

106.3 	Sec. 17. Minnesota Statutes 2022, section 144A.71, is amended by adding a subdivision 
106.4 	to read:
106.5 		Subd. 2a.Renewal applications. An applicant for registration renewal must complete 
106.6 	the registration application form supplied by the department. An application must be 
106.7 	submitted at least 60 days before the expiration of the current registration.

106.8 	Sec. 18. [144A.715] PENALTIES.
106.9 		Subdivision 1.Authority. The fines imposed under this section are in accordance with 
106.10 	section 144.653, subdivision 6.
106.11 		Subd. 2.Fines. Each violation of sections 144A.70 to 144A.74, not corrected at the time 
106.12 	of a follow-up survey, is subject to a fine. A fine must be assessed according to the schedules 
106.13 	established in the sections violated.
106.14 		Subd. 3.Failure to correct. If, upon a subsequent follow-up survey after a fine has been 
106.15 	imposed under subdivision 2, a violation is still not corrected, another fine shall be assessed. 
106.16 	The fine shall be double the amount of the previous fine.
106.17 		Subd. 4.Payment of fines. Payment of fines is due 15 business days from the registrant's 
106.18 	receipt of notice of the fine from the department.

106.19 	Sec. 19. Minnesota Statutes 2022, section 144A.72, subdivision 1, is amended to read:
106.20 		Subdivision 1.Minimum criteria. (a) The commissioner shall require that, as a condition 
106.21 	of registration:
106.22 	(1) all owners and controlling persons must complete a background study under section 
106.23 	144.057 and receive a clearance or set aside of any disqualification;
106.24 	(1) (2) the supplemental nursing services agency shall document that each temporary 
106.25 	employee provided to health care facilities currently meets the minimum licensing, training, 
106.26 	and continuing education standards for the position in which the employee will be working
106.27 	and verifies competency for the position. A supplemental nursing services agency that 
106.28 	violates this clause may be subject to a fine of $3,000;
106.29 	(2) (3) the supplemental nursing services agency shall comply with all pertinent 
106.30 	requirements relating to the health and other qualifications of personnel employed in health 
106.31 	care facilities;
107.1 	(3) (4) the supplemental nursing services agency must not restrict in any manner the 
107.2 	employment opportunities of its employees;. A supplemental nursing services agency that 
107.3 	violates this clause may be subject to a fine of $3,000;
107.4 	(4) the supplemental nursing services agency shall carry medical malpractice insurance 
107.5 	to insure against the loss, damage, or expense incident to a claim arising out of the death 
107.6 	or injury of any person as the result of negligence or malpractice in the provision of health 
107.7 	care services by the supplemental nursing services agency or by any employee of the agency;
107.8 	(5) the supplemental nursing services agency shall carry an employee dishonesty bond 
107.9 	in the amount of $10,000;
107.10 	(6) the supplemental nursing services agency shall maintain insurance coverage for 
107.11 	workers' compensation for all nurses, nursing assistants, nurse aides, and orderlies provided 
107.12 	or procured by the agency;
107.13 	(7) the supplemental nursing services agency shall file with the commissioner of revenue: 
107.14 	(i) the name and address of the bank, savings bank, or savings association in which the 
107.15 	supplemental nursing services agency deposits all employee income tax withholdings; and 
107.16 	(ii) the name and address of any nurse, nursing assistant, nurse aide, or orderly whose income 
107.17 	is derived from placement by the agency, if the agency purports the income is not subject 
107.18 	to withholding;
107.19 	(8) (5) the supplemental nursing services agency must not, in any contract with any 
107.20 	employee or health care facility, require the payment of liquidated damages, employment 
107.21 	fees, or other compensation should the employee be hired as a permanent employee of a 
107.22 	health care facility;. A supplemental nursing services agency that violates this clause may 
107.23 	be subject to a fine of $3,000;
107.24 	(9) (6) the supplemental nursing services agency shall document that each temporary 
107.25 	employee provided to health care facilities is an employee of the agency and is not an 
107.26 	independent contractor; and
107.27 	(10) (7) the supplemental nursing services agency shall retain all records for five calendar 
107.28 	years. All records of the supplemental nursing services agency must be immediately available 
107.29 	to the department.
107.30 	(b) In order to retain registration, the supplemental nursing services agency must provide 
107.31 	services to a health care facility during the year in Minnesota within the past 12 months
107.32 	preceding the supplemental nursing services agency's registration renewal date.

108.1 	Sec. 20. Minnesota Statutes 2022, section 144A.73, is amended to read:
108.2 	144A.73 COMPLAINT SYSTEM.
108.3 	The commissioner shall establish a system for reporting complaints against a supplemental 
108.4 	nursing services agency or its employees. Complaints may be made by any member of the 
108.5 	public. Complaints against a supplemental nursing services agency shall be investigated by 
108.6 	the Office of Health Facility Complaints commissioner of health under sections 144A.51
108.7 	to 144A.53.

108.8 	Sec. 21. Minnesota Statutes 2022, section 149A.02, subdivision 3, is amended to read:
108.9 		Subd. 3.Arrangements for disposition. "Arrangements for disposition" means any 
108.10 	action normally taken by a funeral provider in anticipation of or preparation for the 
108.11 	entombment, burial in a cemetery, alkaline hydrolysis, or cremation, or, effective July 1, 
108.12 	2025, natural organic reduction of a dead human body.

108.13 	Sec. 22. Minnesota Statutes 2022, section 149A.02, subdivision 16, is amended to read:
108.14 		Subd. 16.Final disposition. "Final disposition" means the acts leading to and the 
108.15 	entombment, burial in a cemetery, alkaline hydrolysis, or cremation, or, effective July 1, 
108.16 	2025, natural organic reduction of a dead human body.

108.17 	Sec. 23. Minnesota Statutes 2022, section 149A.02, subdivision 26a, is amended to read:
108.18 		Subd. 26a.Inurnment. "Inurnment" means placing hydrolyzed or cremated remains in 
108.19 	a hydrolyzed or cremated remains container suitable for placement, burial, or shipment.
108.20 	Effective July 1, 2025, inurnment also includes placing naturally reduced remains in a 
108.21 	naturally reduced remains container suitable for placement, burial, or shipment.

108.22 	Sec. 24. Minnesota Statutes 2022, section 149A.02, subdivision 27, is amended to read:
108.23 		Subd. 27.Licensee. "Licensee" means any person or entity that has been issued a license 
108.24 	to practice mortuary science, to operate a funeral establishment, to operate an alkaline 
108.25 	hydrolysis facility, or to operate a crematory, or, effective July 1, 2025, to operate a natural 
108.26 	organic reduction facility by the Minnesota commissioner of health.

109.1 	Sec. 25. Minnesota Statutes 2022, section 149A.02, is amended by adding a subdivision 
109.2 	to read:
109.3 		Subd. 30b.Natural organic reduction or naturally reduce. "Natural organic reduction" 
109.4 	or "naturally reduce" means the contained, accelerated conversion of a dead human body 
109.5 	to soil. This subdivision is effective July 1, 2025.

109.6 	Sec. 26. Minnesota Statutes 2022, section 149A.02, is amended by adding a subdivision 
109.7 	to read:
109.8 		Subd. 30c.Natural organic reduction facility. "Natural organic reduction facility" 
109.9 	means a structure, room, or other space in a building or real property where natural organic 
109.10 	reduction of a dead human body occurs. This subdivision is effective July 1, 2025.

109.11 	Sec. 27. Minnesota Statutes 2022, section 149A.02, is amended by adding a subdivision 
109.12 	to read:
109.13 		Subd. 30d.Natural organic reduction vessel. "Natural organic reduction vessel" means 
109.14 	the enclosed container in which natural organic reduction takes place. This subdivision is 
109.15 	effective July 1, 2025.

109.16 	Sec. 28. Minnesota Statutes 2022, section 149A.02, is amended by adding a subdivision 
109.17 	to read:
109.18 		Subd. 30e.Naturally reduced remains. "Naturally reduced remains" means the soil 
109.19 	remains following the natural organic reduction of a dead human body and the accompanying 
109.20 	plant material. This subdivision is effective July 1, 2025.

109.21 	Sec. 29. Minnesota Statutes 2022, section 149A.02, is amended by adding a subdivision 
109.22 	to read:
109.23 		Subd. 30f.Naturally reduced remains container. "Naturally reduced remains container" 
109.24 	means a receptacle in which naturally reduced remains are placed. This subdivision is 
109.25 	effective July 1, 2025.

109.26 	Sec. 30. Minnesota Statutes 2022, section 149A.02, subdivision 35, is amended to read:
109.27 		Subd. 35.Processing. "Processing" means the removal of foreign objects, drying or 
109.28 	cooling, and the reduction of the hydrolyzed orremains, cremated remains, or, effective 
109.29 	July 1, 2025, naturally reduced remains by mechanical means including, but not limited to, 
110.1 	grinding, crushing, or pulverizing, to a granulated appearance appropriate for final disposition 
110.2 	or the final reduction to naturally reduced remains.

110.3 	Sec. 31. Minnesota Statutes 2022, section 149A.02, subdivision 37c, is amended to read:
110.4 		Subd. 37c.Scattering. "Scattering" means the authorized dispersal of hydrolyzed or
110.5 	remains, cremated remains, or, effective July 1, 2025, naturally reduced remains in a defined 
110.6 	area of a dedicated cemetery or in areas where no local prohibition exists provided that the 
110.7 	hydrolyzed or, cremated, or naturally reduced remains are not distinguishable to the public, 
110.8 	are not in a container, and that the person who has control over disposition of the hydrolyzed 
110.9 	or, cremated, or naturally reduced remains has obtained written permission of the property 
110.10 	owner or governing agency to scatter on the property.

110.11 	Sec. 32. Minnesota Statutes 2022, section 149A.03, is amended to read:
110.12 	149A.03 DUTIES OF COMMISSIONER.
110.13 	The commissioner shall:
110.14 	(1) enforce all laws and adopt and enforce rules relating to the:
110.15 	(i) removal, preparation, transportation, arrangements for disposition, and final disposition 
110.16 	of dead human bodies;
110.17 	(ii) licensure and professional conduct of funeral directors, morticians, interns, practicum 
110.18 	students, and clinical students;
110.19 	(iii) licensing and operation of a funeral establishment;
110.20 	(iv) licensing and operation of an alkaline hydrolysis facility; and
110.21 	(v) licensing and operation of a crematory; and
110.22 	(vi) effective July 1, 2025, licensing and operation of a natural organic reduction facility;
110.23 	(2) provide copies of the requirements for licensure and permits to all applicants;
110.24 	(3) administer examinations and issue licenses and permits to qualified persons and other 
110.25 	legal entities;
110.26 	(4) maintain a record of the name and location of all current licensees and interns;
110.27 	(5) perform periodic compliance reviews and premise inspections of licensees;
110.28 	(6) accept and investigate complaints relating to conduct governed by this chapter;
110.29 	(7) maintain a record of all current preneed arrangement trust accounts;
111.1 	(8) maintain a schedule of application, examination, permit, and licensure fees, initial 
111.2 	and renewal, sufficient to cover all necessary operating expenses;
111.3 	(9) educate the public about the existence and content of the laws and rules for mortuary 
111.4 	science licensing and the removal, preparation, transportation, arrangements for disposition, 
111.5 	and final disposition of dead human bodies to enable consumers to file complaints against 
111.6 	licensees and others who may have violated those laws or rules;
111.7 	(10) evaluate the laws, rules, and procedures regulating the practice of mortuary science 
111.8 	in order to refine the standards for licensing and to improve the regulatory and enforcement 
111.9 	methods used; and
111.10 	(11) initiate proceedings to address and remedy deficiencies and inconsistencies in the 
111.11 	laws, rules, or procedures governing the practice of mortuary science and the removal, 
111.12 	preparation, transportation, arrangements for disposition, and final disposition of dead 
111.13 	human bodies.

111.14 	Sec. 33. [149A.56] LICENSE TO OPERATE A NATURAL ORGANIC REDUCTION 
111.15 	FACILITY.
111.16 		Subdivision 1.License requirement. This section is effective July 1, 2025. Except as 
111.17 	provided in section 149A.01, subdivision 3, no person shall maintain, manage, or operate 
111.18 	a place or premises devoted to or used in the holding and natural organic reduction of a 
111.19 	dead human body without possessing a valid license to operate a natural organic reduction 
111.20 	facility issued by the commissioner of health.
111.21 		Subd. 2.Requirements for natural organic reduction facility. (a) A natural organic 
111.22 	reduction facility licensed under this section must consist of:
111.23 	(1) a building or structure that complies with applicable local and state building codes, 
111.24 	zoning laws and ordinances, and environmental standards, and that contains one or more 
111.25 	natural organic reduction vessels for the natural organic reduction of dead human bodies;
111.26 	(2) a motorized mechanical device for processing the remains in natural reduction; and
111.27 	(3) an appropriate refrigerated holding facility for dead human bodies awaiting natural 
111.28 	organic reduction.
111.29 	(b) A natural organic reduction facility licensed under this section may also contain a 
111.30 	display room for funeral goods.
112.1 		Subd. 3.Application procedure; documentation; initial inspection. (a) An applicant 
112.2 	for a license to operate a natural organic reduction facility shall submit a completed 
112.3 	application to the commissioner. A completed application includes:
112.4 	(1) a completed application form, as provided by the commissioner;
112.5 	(2) proof of business form and ownership; and
112.6 	(3) proof of liability insurance coverage or other financial documentation, as determined 
112.7 	by the commissioner, that demonstrates the applicant's ability to respond in damages for 
112.8 	liability arising from the ownership, maintenance, management, or operation of a natural 
112.9 	organic reduction facility.
112.10 	(b) Upon receipt of the application and appropriate fee, the commissioner shall review 
112.11 	and verify all information. Upon completion of the verification process and resolution of 
112.12 	any deficiencies in the application information, the commissioner shall conduct an initial 
112.13 	inspection of the premises to be licensed. After the inspection and resolution of any 
112.14 	deficiencies found and any reinspections as may be necessary, the commissioner shall make 
112.15 	a determination, based on all the information available, to grant or deny licensure. If the 
112.16 	commissioner's determination is to grant the license, the applicant shall be notified and the 
112.17 	license shall issue and remain valid for a period prescribed on the license, but not to exceed 
112.18 	one calendar year from the date of issuance of the license. If the commissioner's determination 
112.19 	is to deny the license, the commissioner must notify the applicant, in writing, of the denial 
112.20 	and provide the specific reason for denial.
112.21 		Subd. 4.Nontransferability of license. A license to operate a natural organic reduction 
112.22 	facility is not assignable or transferable and shall not be valid for any entity other than the 
112.23 	one named. Each license issued to operate a natural organic reduction facility is valid only 
112.24 	for the location identified on the license. A 50 percent or more change in ownership or 
112.25 	location of the natural organic reduction facility automatically terminates the license. Separate 
112.26 	licenses shall be required of two or more persons or other legal entities operating from the 
112.27 	same location.
112.28 		Subd. 5.Display of license. Each license to operate a natural organic reduction facility 
112.29 	must be conspicuously displayed in the natural organic reduction facility at all times. 
112.30 	"Conspicuous display" means in a location where a member of the general public within 
112.31 	the natural organic reduction facility is able to observe and read the license.
112.32 		Subd. 6.Period of licensure. All licenses to operate a natural organic reduction facility 
112.33 	issued by the commissioner are valid for a period of one calendar year beginning on July 1 
112.34 	and ending on June 30, regardless of the date of issuance.
113.1 		Subd. 7.Reporting changes in license information. Any change of license information 
113.2 	must be reported to the commissioner, on forms provided by the commissioner, no later 
113.3 	than 30 calendar days after the change occurs. Failure to report changes is grounds for 
113.4 	disciplinary action.
113.5 		Subd. 8.Licensing information. Section 13.41 applies to data collected and maintained 
113.6 	by the commissioner pursuant to this section.

113.7 	Sec. 34. [149A.57] RENEWAL OF LICENSE TO OPERATE A NATURAL 
113.8 	ORGANIC REDUCTION FACILITY.
113.9 		Subdivision 1.Renewal required. This section is effective July 1, 2025. All licenses 
113.10 	to operate a natural organic reduction facility issued by the commissioner expire on June 
113.11 	30 following the date of issuance of the license and must be renewed to remain valid.
113.12 		Subd. 2.Renewal procedure and documentation. (a) Licensees who wish to renew 
113.13 	their licenses must submit to the commissioner a completed renewal application no later 
113.14 	than June 30 following the date the license was issued. A completed renewal application 
113.15 	includes:
113.16 	(1) a completed renewal application form, as provided by the commissioner; and
113.17 	(2) proof of liability insurance coverage or other financial documentation, as determined 
113.18 	by the commissioner, that demonstrates the applicant's ability to respond in damages for 
113.19 	liability arising from the ownership, maintenance, management, or operation of a natural 
113.20 	organic reduction facility.
113.21 	(b) Upon receipt of the completed renewal application, the commissioner shall review 
113.22 	and verify the information. Upon completion of the verification process and resolution of 
113.23 	any deficiencies in the renewal application information, the commissioner shall make a 
113.24 	determination, based on all the information available, to reissue or refuse to reissue the 
113.25 	license. If the commissioner's determination is to reissue the license, the applicant shall be 
113.26 	notified and the license shall issue and remain valid for a period prescribed on the license, 
113.27 	but not to exceed one calendar year from the date of issuance of the license. If the 
113.28 	commissioner's determination is to refuse to reissue the license, section 149A.09, subdivision 
113.29 	2, applies.
113.30 		Subd. 3.Penalty for late filing. Renewal applications received after the expiration date 
113.31 	of a license will result in the assessment of a late filing penalty. The late filing penalty must 
113.32 	be paid before the reissuance of the license and received by the commissioner no later than 
113.33 	31 calendar days after the expiration date of the license.
114.1 		Subd. 4.Lapse of license. A license to operate a natural organic reduction facility shall 
114.2 	automatically lapse when a completed renewal application is not received by the 
114.3 	commissioner within 31 calendar days after the expiration date of a license, or a late filing 
114.4 	penalty assessed under subdivision 3 is not received by the commissioner within 31 calendar 
114.5 	days after the expiration of a license.
114.6 		Subd. 5.Effect of lapse of license. Upon the lapse of a license, the person to whom the 
114.7 	license was issued is no longer licensed to operate a natural organic reduction facility in 
114.8 	Minnesota. The commissioner shall issue a cease and desist order to prevent the lapsed 
114.9 	license holder from operating a natural organic reduction facility in Minnesota and may 
114.10 	pursue any additional lawful remedies as justified by the case.
114.11 		Subd. 6.Restoration of lapsed license. The commissioner may restore a lapsed license 
114.12 	upon receipt and review of a completed renewal application, receipt of the late filing penalty, 
114.13 	and reinspection of the premises, provided that the receipt is made within one calendar year 
114.14 	from the expiration date of the lapsed license and the cease and desist order issued by the 
114.15 	commissioner has not been violated. If a lapsed license is not restored within one calendar 
114.16 	year from the expiration date of the lapsed license, the holder of the lapsed license cannot 
114.17 	be relicensed until the requirements in section 149A.56 are met.
114.18 		Subd. 7.Reporting changes in license information. Any change of license information 
114.19 	must be reported to the commissioner, on forms provided by the commissioner, no later 
114.20 	than 30 calendar days after the change occurs. Failure to report changes is grounds for 
114.21 	disciplinary action.
114.22 		Subd. 8.Licensing information. Section 13.41 applies to data collected and maintained 
114.23 	by the commissioner pursuant to this section.

114.24 	Sec. 35. Minnesota Statutes 2022, section 149A.65, is amended by adding a subdivision 
114.25 	to read:
114.26 		Subd. 6a.Natural organic reduction facilities. This subdivision is effective July 1, 
114.27 	2025. The initial and renewal fee for a natural organic reduction facility is $425. The late 
114.28 	fee charge for a license renewal is $100.

114.29 	Sec. 36. Minnesota Statutes 2022, section 149A.70, subdivision 1, is amended to read:
114.30 		Subdivision 1.Use of titles. Only a person holding a valid license to practice mortuary 
114.31 	science issued by the commissioner may use the title of mortician, funeral director, or any 
114.32 	other title implying that the licensee is engaged in the business or practice of mortuary 
115.1 	science. Only the holder of a valid license to operate an alkaline hydrolysis facility issued 
115.2 	by the commissioner may use the title of alkaline hydrolysis facility, water cremation, 
115.3 	water-reduction, biocremation, green-cremation, resomation, dissolution, or any other title, 
115.4 	word, or term implying that the licensee operates an alkaline hydrolysis facility. Only the 
115.5 	holder of a valid license to operate a funeral establishment issued by the commissioner may 
115.6 	use the title of funeral home, funeral chapel, funeral service, or any other title, word, or 
115.7 	term implying that the licensee is engaged in the business or practice of mortuary science. 
115.8 	Only the holder of a valid license to operate a crematory issued by the commissioner may 
115.9 	use the title of crematory, crematorium, green-cremation, or any other title, word, or term 
115.10 	implying that the licensee operates a crematory or crematorium. Effective July 1, 2025,
115.11 	only the holder of a valid license to operate a natural organic reduction facility issued by 
115.12 	the commissioner may use the title of natural organic reduction facility, human composting, 
115.13 	or any other title, word, or term implying that the licensee operates a natural organic reduction 
115.14 	facility.

115.15 	Sec. 37. Minnesota Statutes 2022, section 149A.70, subdivision 2, is amended to read:
115.16 		Subd. 2.Business location. A funeral establishment, alkaline hydrolysis facility, or
115.17 	crematory, or, effective July 1, 2025, natural organic reduction facility shall not do business 
115.18 	in a location that is not licensed as a funeral establishment, alkaline hydrolysis facility, or
115.19 	crematory, or natural organic reduction facility and shall not advertise a service that is 
115.20 	available from an unlicensed location.

115.21 	Sec. 38. Minnesota Statutes 2022, section 149A.70, subdivision 3, is amended to read:
115.22 		Subd. 3.Advertising. No licensee, clinical student, practicum student, or intern shall 
115.23 	publish or disseminate false, misleading, or deceptive advertising. False, misleading, or 
115.24 	deceptive advertising includes, but is not limited to:
115.25 	(1) identifying, by using the names or pictures of, persons who are not licensed to practice 
115.26 	mortuary science in a way that leads the public to believe that those persons will provide 
115.27 	mortuary science services;
115.28 	(2) using any name other than the names under which the funeral establishment, alkaline 
115.29 	hydrolysis facility, or crematory, or, effective July 1, 2025, natural organic reduction facility
115.30 	is known to or licensed by the commissioner;
115.31 	(3) using a surname not directly, actively, or presently associated with a licensed funeral 
115.32 	establishment, alkaline hydrolysis facility, or crematory, or, effective July 1, 2025, natural 
115.33 	organic reduction facility, unless the surname had been previously and continuously used 
116.1 	by the licensed funeral establishment, alkaline hydrolysis facility, or crematory, or natural 
116.2 	organic reduction facility; and
116.3 	(4) using a founding or establishing date or total years of service not directly or 
116.4 	continuously related to a name under which the funeral establishment, alkaline hydrolysis 
116.5 	facility, or crematory, or, effective July 1, 2025, natural organic reduction facility is currently 
116.6 	or was previously licensed.
116.7 	Any advertising or other printed material that contains the names or pictures of persons 
116.8 	affiliated with a funeral establishment, alkaline hydrolysis facility, or crematory, or, effective 
116.9 	July 1, 2025, natural organic reduction facility shall state the position held by the persons 
116.10 	and shall identify each person who is licensed or unlicensed under this chapter.

116.11 	Sec. 39. Minnesota Statutes 2022, section 149A.70, subdivision 5, is amended to read:
116.12 		Subd. 5.Reimbursement prohibited. No licensee, clinical student, practicum student, 
116.13 	or intern shall offer, solicit, or accept a commission, fee, bonus, rebate, or other 
116.14 	reimbursement in consideration for recommending or causing a dead human body to be 
116.15 	disposed of by a specific body donation program, funeral establishment, alkaline hydrolysis 
116.16 	facility, crematory, mausoleum, or cemetery, or, effective July 1, 2025, natural organic 
116.17 	reduction facility.

116.18 	Sec. 40. Minnesota Statutes 2022, section 149A.71, subdivision 2, is amended to read:
116.19 		Subd. 2.Preventive requirements. (a) To prevent unfair or deceptive acts or practices, 
116.20 	the requirements of this subdivision must be met. This subdivision applies to natural organic 
116.21 	reduction and naturally reduced remains goods and services effective July 1, 2025.
116.22 	(b) Funeral providers must tell persons who ask by telephone about the funeral provider's 
116.23 	offerings or prices any accurate information from the price lists described in paragraphs (c) 
116.24 	to (e) and any other readily available information that reasonably answers the questions 
116.25 	asked.
116.26 	(c) Funeral providers must make available for viewing to people who inquire in person 
116.27 	about the offerings or prices of funeral goods or burial site goods, separate printed or 
116.28 	typewritten price lists using a ten-point font or larger. Each funeral provider must have a 
116.29 	separate price list for each of the following types of goods that are sold or offered for sale:
116.30 	(1) caskets;
116.31 	(2) alternative containers;
117.1 	(3) outer burial containers;
117.2 	(4) alkaline hydrolysis containers;
117.3 	(5) cremation containers;
117.4 	(6) hydrolyzed remains containers;
117.5 	(7) cremated remains containers;
117.6 	(8) markers; and
117.7 	(9) headstones.; and
117.8 	(10) naturally reduced remains containers.
117.9 	(d) Each separate price list must contain the name of the funeral provider's place of 
117.10 	business, address, and telephone number and a caption describing the list as a price list for 
117.11 	one of the types of funeral goods or burial site goods described in paragraph (c), clauses 
117.12 	(1) to (9) (10). The funeral provider must offer the list upon beginning discussion of, but 
117.13 	in any event before showing, the specific funeral goods or burial site goods and must provide 
117.14 	a photocopy of the price list, for retention, if so asked by the consumer. The list must contain, 
117.15 	at least, the retail prices of all the specific funeral goods and burial site goods offered which 
117.16 	do not require special ordering, enough information to identify each, and the effective date 
117.17 	for the price list. However, funeral providers are not required to make a specific price list 
117.18 	available if the funeral providers place the information required by this paragraph on the 
117.19 	general price list described in paragraph (e).
117.20 	(e) Funeral providers must give a printed price list, for retention, to persons who inquire 
117.21 	in person about the funeral goods, funeral services, burial site goods, or burial site services 
117.22 	or prices offered by the funeral provider. The funeral provider must give the list upon 
117.23 	beginning discussion of either the prices of or the overall type of funeral service or disposition 
117.24 	or specific funeral goods, funeral services, burial site goods, or burial site services offered 
117.25 	by the provider. This requirement applies whether the discussion takes place in the funeral 
117.26 	establishment or elsewhere. However, when the deceased is removed for transportation to 
117.27 	the funeral establishment, an in-person request for authorization to embalm does not, by 
117.28 	itself, trigger the requirement to offer the general price list. If the provider, in making an 
117.29 	in-person request for authorization to embalm, discloses that embalming is not required by 
117.30 	law except in certain special cases, the provider is not required to offer the general price 
117.31 	list. Any other discussion during that time about prices or the selection of funeral goods, 
117.32 	funeral services, burial site goods, or burial site services triggers the requirement to give 
118.1 	the consumer a general price list. The general price list must contain the following 
118.2 	information:
118.3 	(1) the name, address, and telephone number of the funeral provider's place of business;
118.4 	(2) a caption describing the list as a "general price list";
118.5 	(3) the effective date for the price list;
118.6 	(4) the retail prices, in any order, expressed either as a flat fee or as the prices per hour, 
118.7 	mile, or other unit of computation, and other information described as follows:
118.8 	(i) forwarding of remains to another funeral establishment, together with a list of the 
118.9 	services provided for any quoted price;
118.10 	(ii) receiving remains from another funeral establishment, together with a list of the 
118.11 	services provided for any quoted price;
118.12 	(iii) separate prices for each alkaline hydrolysis, natural organic reduction, or cremation 
118.13 	offered by the funeral provider, with the price including an alternative container or alkaline 
118.14 	hydrolysis facility or cremation container,; any alkaline hydrolysis, natural organic reduction 
118.15 	facility, or crematory charges,; and a description of the services and container included in 
118.16 	the price, where applicable, and the price of alkaline hydrolysis or cremation where the 
118.17 	purchaser provides the container;
118.18 	(iv) separate prices for each immediate burial offered by the funeral provider, including 
118.19 	a casket or alternative container, and a description of the services and container included 
118.20 	in that price, and the price of immediate burial where the purchaser provides the casket or 
118.21 	alternative container;
118.22 	(v) transfer of remains to the funeral establishment or other location;
118.23 	(vi) embalming;
118.24 	(vii) other preparation of the body;
118.25 	(viii) use of facilities, equipment, or staff for viewing;
118.26 	(ix) use of facilities, equipment, or staff for funeral ceremony;
118.27 	(x) use of facilities, equipment, or staff for memorial service;
118.28 	(xi) use of equipment or staff for graveside service;
118.29 	(xii) hearse or funeral coach;
118.30 	(xiii) limousine; and
119.1 	(xiv) separate prices for all cemetery-specific goods and services, including all goods 
119.2 	and services associated with interment and burial site goods and services and excluding 
119.3 	markers and headstones;
119.4 	(5) the price range for the caskets offered by the funeral provider, together with the 
119.5 	statement "A complete price list will be provided at the funeral establishment or casket sale 
119.6 	location." or the prices of individual caskets, as disclosed in the manner described in 
119.7 	paragraphs (c) and (d);
119.8 	(6) the price range for the alternative containers or shrouds offered by the funeral provider, 
119.9 	together with the statement "A complete price list will be provided at the funeral 
119.10 	establishment or alternative container sale location." or the prices of individual alternative 
119.11 	containers, as disclosed in the manner described in paragraphs (c) and (d);
119.12 	(7) the price range for the outer burial containers offered by the funeral provider, together 
119.13 	with the statement "A complete price list will be provided at the funeral establishment or 
119.14 	outer burial container sale location." or the prices of individual outer burial containers, as 
119.15 	disclosed in the manner described in paragraphs (c) and (d);
119.16 	(8) the price range for the alkaline hydrolysis container offered by the funeral provider, 
119.17 	together with the statement "A complete price list will be provided at the funeral 
119.18 	establishment or alkaline hydrolysis container sale location." or the prices of individual 
119.19 	alkaline hydrolysis containers, as disclosed in the manner described in paragraphs (c) and 
119.20 	(d);
119.21 	(9) the price range for the hydrolyzed remains container offered by the funeral provider, 
119.22 	together with the statement "A complete price list will be provided at the funeral 
119.23 	establishment or hydrolyzed remains container sale location." or the prices of individual 
119.24 	hydrolyzed remains container, as disclosed in the manner described in paragraphs (c) and 
119.25 	(d);
119.26 	(10) the price range for the cremation containers offered by the funeral provider, together 
119.27 	with the statement "A complete price list will be provided at the funeral establishment or 
119.28 	cremation container sale location." or the prices of individual cremation containers, as 
119.29 	disclosed in the manner described in paragraphs (c) and (d);
119.30 	(11) the price range for the cremated remains containers offered by the funeral provider, 
119.31 	together with the statement, "A complete price list will be provided at the funeral 
119.32 	establishment or cremated remains container sale location," or the prices of individual 
119.33 	cremation containers as disclosed in the manner described in paragraphs (c) and (d);
120.1 	(12) the price range for the naturally reduced remains containers offered by the funeral 
120.2 	provider, together with the statement, "A complete price list will be provided at the funeral 
120.3 	establishment or naturally reduced remains container sale location," or the prices of individual 
120.4 	naturally reduced remains containers as disclosed in the manner described in paragraphs 
120.5 	(c) and (d);
120.6 	(12) (13) the price for the basic services of funeral provider and staff, together with a 
120.7 	list of the principal basic services provided for any quoted price and, if the charge cannot 
120.8 	be declined by the purchaser, the statement "This fee for our basic services will be added 
120.9 	to the total cost of the funeral arrangements you select. (This fee is already included in our 
120.10 	charges for alkaline hydrolysis, natural organic reduction, direct cremations, immediate 
120.11 	burials, and forwarding or receiving remains.)" If the charge cannot be declined by the 
120.12 	purchaser, the quoted price shall include all charges for the recovery of unallocated funeral 
120.13 	provider overhead, and funeral providers may include in the required disclosure the phrase 
120.14 	"and overhead" after the word "services." This services fee is the only funeral provider fee 
120.15 	for services, facilities, or unallocated overhead permitted by this subdivision to be 
120.16 	nondeclinable, unless otherwise required by law;
120.17 	(13) (14) the price range for the markers and headstones offered by the funeral provider, 
120.18 	together with the statement "A complete price list will be provided at the funeral 
120.19 	establishment or marker or headstone sale location." or the prices of individual markers and 
120.20 	headstones, as disclosed in the manner described in paragraphs (c) and (d); and
120.21 	(14) (15) any package priced funerals offered must be listed in addition to and following 
120.22 	the information required in paragraph (e) and must clearly state the funeral goods and 
120.23 	services being offered, the price being charged for those goods and services, and the 
120.24 	discounted savings.
120.25 	(f) Funeral providers must give an itemized written statement, for retention, to each 
120.26 	consumer who arranges an at-need funeral or other disposition of human remains at the 
120.27 	conclusion of the discussion of the arrangements. The itemized written statement must be 
120.28 	signed by the consumer selecting the goods and services as required in section 149A.80. If 
120.29 	the statement is provided by a funeral establishment, the statement must be signed by the 
120.30 	licensed funeral director or mortician planning the arrangements. If the statement is provided 
120.31 	by any other funeral provider, the statement must be signed by an authorized agent of the 
120.32 	funeral provider. The statement must list the funeral goods, funeral services, burial site 
120.33 	goods, or burial site services selected by that consumer and the prices to be paid for each 
120.34 	item, specifically itemized cash advance items (these prices must be given to the extent then 
120.35 	known or reasonably ascertainable if the prices are not known or reasonably ascertainable, 
121.1 	a good faith estimate shall be given and a written statement of the actual charges shall be 
121.2 	provided before the final bill is paid), and the total cost of goods and services selected. At 
121.3 	the conclusion of an at-need arrangement, the funeral provider is required to give the 
121.4 	consumer a copy of the signed itemized written contract that must contain the information 
121.5 	required in this paragraph.
121.6 	(g) Upon receiving actual notice of the death of an individual with whom a funeral 
121.7 	provider has entered a preneed funeral agreement, the funeral provider must provide a copy 
121.8 	of all preneed funeral agreement documents to the person who controls final disposition of 
121.9 	the human remains or to the designee of the person controlling disposition. The person 
121.10 	controlling final disposition shall be provided with these documents at the time of the 
121.11 	person's first in-person contact with the funeral provider, if the first contact occurs in person 
121.12 	at a funeral establishment, alkaline hydrolysis facility, crematory, natural organic reduction 
121.13 	facility, or other place of business of the funeral provider. If the contact occurs by other 
121.14 	means or at another location, the documents must be provided within 24 hours of the first 
121.15 	contact.

121.16 	Sec. 41. Minnesota Statutes 2022, section 149A.71, subdivision 4, is amended to read:
121.17 		Subd. 4.Casket, alternate container, alkaline hydrolysis container, naturally reduced 
121.18 	remains container, and cremation container sales; records; required disclosures. Any 
121.19 	funeral provider who sells or offers to sell a casket, alternate container, alkaline hydrolysis 
121.20 	container, hydrolyzed remains container, cremation container, or cremated remains container, 
121.21 	or, effective July 1, 2025, naturally reduced remains container to the public must maintain 
121.22 	a record of each sale that includes the name of the purchaser, the purchaser's mailing address, 
121.23 	the name of the decedent, the date of the decedent's death, and the place of death. These 
121.24 	records shall be open to inspection by the regulatory agency. Any funeral provider selling 
121.25 	a casket, alternate container, or cremation container to the public, and not having charge of 
121.26 	the final disposition of the dead human body, shall provide a copy of the statutes and rules 
121.27 	controlling the removal, preparation, transportation, arrangements for disposition, and final 
121.28 	disposition of a dead human body. This subdivision does not apply to morticians, funeral 
121.29 	directors, funeral establishments, crematories, or wholesale distributors of caskets, alternate 
121.30 	containers, alkaline hydrolysis containers, or cremation containers.

121.31 	Sec. 42. Minnesota Statutes 2022, section 149A.72, subdivision 3, is amended to read:
121.32 		Subd. 3.Casket for alkaline hydrolysis, natural organic reduction, or cremation 
121.33 	provisions; deceptive acts or practices. In selling or offering to sell funeral goods or 
122.1 	funeral services to the public, it is a deceptive act or practice for a funeral provider to 
122.2 	represent that a casket is required for alkaline hydrolysis or, cremations, or, effective July 
122.3 	1, 2025, natural organic reduction by state or local law or otherwise.

122.4 	Sec. 43. Minnesota Statutes 2022, section 149A.72, subdivision 9, is amended to read:
122.5 		Subd. 9.Deceptive acts or practices. In selling or offering to sell funeral goods, funeral 
122.6 	services, burial site goods, or burial site services to the public, it is a deceptive act or practice 
122.7 	for a funeral provider to represent that federal, state, or local laws, or particular cemeteries, 
122.8 	alkaline hydrolysis facilities, or crematories, or, effective July 1, 2025, natural organic 
122.9 	reduction facilities require the purchase of any funeral goods, funeral services, burial site 
122.10 	goods, or burial site services when that is not the case.

122.11 	Sec. 44. Minnesota Statutes 2022, section 149A.73, subdivision 1, is amended to read:
122.12 		Subdivision 1.Casket for alkaline hydrolysis, natural organic reduction, or cremation 
122.13 	provisions; deceptive acts or practices. In selling or offering to sell funeral goods, funeral 
122.14 	services, burial site goods, or burial site services to the public, it is a deceptive act or practice 
122.15 	for a funeral provider to require that a casket be purchased for alkaline hydrolysis or,
122.16 	cremation, or, effective July 1, 2025, natural organic reduction.

122.17 	Sec. 45. Minnesota Statutes 2022, section 149A.74, subdivision 1, is amended to read:
122.18 		Subdivision 1.Services provided without prior approval; deceptive acts or 
122.19 	practices. In selling or offering to sell funeral goods or funeral services to the public, it is 
122.20 	a deceptive act or practice for any funeral provider to embalm a dead human body unless 
122.21 	state or local law or regulation requires embalming in the particular circumstances regardless 
122.22 	of any funeral choice which might be made, or prior approval for embalming has been 
122.23 	obtained from an individual legally authorized to make such a decision. In seeking approval 
122.24 	to embalm, the funeral provider must disclose that embalming is not required by law except 
122.25 	in certain circumstances; that a fee will be charged if a funeral is selected which requires 
122.26 	embalming, such as a funeral with viewing; and that no embalming fee will be charged if 
122.27 	the family selects a service which does not require embalming, such as direct alkaline 
122.28 	hydrolysis, direct cremation, or immediate burial, or, effective July 1, 2025, natural organic 
122.29 	reduction.

123.1 	Sec. 46. Minnesota Statutes 2022, section 149A.93, subdivision 3, is amended to read:
123.2 		Subd. 3.Disposition permit. A disposition permit is required before a body can be 
123.3 	buried, entombed, alkaline hydrolyzed, or cremated, or, effective July 1, 2025, naturally 
123.4 	reduced. No disposition permit shall be issued until a fact of death record has been completed 
123.5 	and filed with the state registrar of vital records.

123.6 	Sec. 47. Minnesota Statutes 2022, section 149A.94, subdivision 1, is amended to read:
123.7 		Subdivision 1.Generally. Every dead human body lying within the state, except 
123.8 	unclaimed bodies delivered for dissection by the medical examiner, those delivered for 
123.9 	anatomical study pursuant to section 149A.81, subdivision 2, or lawfully carried through 
123.10 	the state for the purpose of disposition elsewhere; and the remains of any dead human body 
123.11 	after dissection or anatomical study, shall be decently buried or entombed in a public or 
123.12 	private cemetery, alkaline hydrolyzed, or cremated, or, effective July 1, 2025, naturally 
123.13 	reduced within a reasonable time after death. Where final disposition of a body will not be 
123.14 	accomplished, or, effective July 1, 2025, when natural organic reduction will not be initiated,
123.15 	within 72 hours following death or release of the body by a competent authority with 
123.16 	jurisdiction over the body, the body must be properly embalmed, refrigerated, or packed 
123.17 	with dry ice. A body may not be kept in refrigeration for a period exceeding six calendar 
123.18 	days, or packed in dry ice for a period that exceeds four calendar days, from the time of 
123.19 	death or release of the body from the coroner or medical examiner.

123.20 	Sec. 48. Minnesota Statutes 2022, section 149A.94, subdivision 3, is amended to read:
123.21 		Subd. 3.Permit required. No dead human body shall be buried, entombed, or cremated, 
123.22 	alkaline hydrolyzed, or, effective July 1, 2025, naturally reduced without a disposition 
123.23 	permit. The disposition permit must be filed with the person in charge of the place of final 
123.24 	disposition. Where a dead human body will be transported out of this state for final 
123.25 	disposition, the body must be accompanied by a certificate of removal.

123.26 	Sec. 49. Minnesota Statutes 2022, section 149A.94, subdivision 4, is amended to read:
123.27 		Subd. 4.Alkaline hydrolysis or, cremation, or natural organic reduction. Inurnment 
123.28 	of alkaline hydrolyzed or remains, cremated remains, or, effective July 1, 2025, naturally 
123.29 	reduced remains and release to an appropriate party is considered final disposition and no 
123.30 	further permits or authorizations are required for transportation, interment, entombment, or 
123.31 	placement of the cremated remains, except as provided in section 149A.95, subdivision 16.

124.1 	Sec. 50. [149A.955] NATURAL ORGANIC REDUCTION FACILITIES AND 
124.2 	NATURAL ORGANIC REDUCTION.
124.3 		Subdivision 1.License required. This section is effective July 1, 2025. A dead human 
124.4 	body may only undergo natural organic reduction in this state at a natural organic reduction 
124.5 	facility licensed by the commissioner of health.
124.6 		Subd. 2.General requirements. Any building to be used as a natural organic reduction 
124.7 	facility must comply with all applicable local and state building codes, zoning laws and 
124.8 	ordinances, and environmental standards. A natural organic reduction facility must have on 
124.9 	site a natural organic reduction system approved by the commissioner and a motorized 
124.10 	mechanical device for processing the remains in natural reduction and must have in the 
124.11 	building a refrigerated holding facility for the retention of dead human bodies awaiting 
124.12 	natural organic reduction. The holding facility must be secure from access by anyone except 
124.13 	the authorized personnel of the natural organic reduction facility, preserve the dignity of 
124.14 	the remains, and protect the health and safety of the natural organic reduction facility 
124.15 	personnel.
124.16 		Subd. 3.Aerobic reduction vessel. A natural organic reduction facility must use as a 
124.17 	natural organic reduction vessel a contained reduction vessel that is designed to promote 
124.18 	aerobic reduction and that minimizes odors.
124.19 		Subd. 4.Any room where body is prepared. Any room where the deceased will be 
124.20 	prepared for natural organic reduction must be properly lit and ventilated with an exhaust 
124.21 	fan. It must be equipped with a functional sink with hot and cold running water. It must 
124.22 	have nonporous flooring, such that a sanitary condition is provided. The walls and ceiling 
124.23 	of the room must run from floor to ceiling and be covered with tile, or by plaster or sheetrock 
124.24 	painted with washable paint or other appropriate material, such that a sanitary condition is 
124.25 	provided. The doors, walls, ceiling, and windows must be constructed to prevent odors from 
124.26 	entering any other part of the building.
124.27 		Subd. 5.Access and privacy. (a) The room where a licensed mortician prepares a body 
124.28 	must be private and must not have a general passageway through it. All windows or other 
124.29 	openings to the outside must be treated in a manner that prevents viewing into the room 
124.30 	where the deceased will be prepared for natural organic reduction. A viewing window for 
124.31 	authorized family members or their designees is not a violation of this subdivision.
124.32 	(b) The room must, at all times, be secure from the entrance of unauthorized persons.
124.33 	(c) For purposes of this section, "authorized persons" are:
125.1 	(1) licensed morticians;
125.2 	(2) registered interns or students as described in section 149A.91, subdivision 6;
125.3 	(3) public officials or representatives in the discharge of their official duties;
125.4 	(4) trained natural organic reduction facility operators; and
125.5 	(5) the person or persons with the right to control the dead human body as defined in 
125.6 	section 149A.80, subdivision 2, and their designees.
125.7 	(d) Each door allowing ingress or egress must carry a sign that indicates that the room 
125.8 	is private and access is limited. All authorized persons who are present in or enter the room 
125.9 	while a body is being prepared for final disposition must be attired according to all applicable 
125.10 	state and federal regulations regarding the control of infectious disease and occupational 
125.11 	and workplace health and safety.
125.12 		Subd. 6.Areas for vessels or naturally organic reduction operations. Any rooms or 
125.13 	areas where the vessels reside or where any operation takes place involving the handling 
125.14 	of the vessels or the remains must be ventilated with exhaust fans. The doors, walls, ceiling, 
125.15 	and windows shall be constructed to prevent odors from entering any other part of the 
125.16 	building. All windows must be treated in a manner that maintains privacy when the remains 
125.17 	are handled. A sanitary condition must be provided. Any area where human remains are 
125.18 	transferred, prepared, or processed must have nonpourous flooring, and the walls and ceiling 
125.19 	of the rooms must run from floor to ceiling and be covered with tile, or by plaster, sheetrock, 
125.20 	or concrete painted with washable paint or other appropriate material, such that a sanitary 
125.21 	condition is provided. Access to the vessel holding area must only be granted to individuals 
125.22 	outlined in subdivision 5 and to authorized visitors at the discretion of the licensed facility 
125.23 	under the direct supervision of trained facility staff, provided that such access does not 
125.24 	violate subdivision 18.
125.25 		Subd. 7.Equipment and supplies. The natural organic reduction facility must have a 
125.26 	functional emergency eye wash and quick drench shower.
125.27 		Subd. 8.Sanitary conditions and permitted use. The room where the deceased will 
125.28 	be prepared for natural organic reduction, the area where the natural organic reduction 
125.29 	vessels are located or where the natural organic reduction operations are undertaken, and 
125.30 	all fixtures, equipment, instruments, receptacles, clothing, and other appliances or supplies 
125.31 	stored or used in these operations must be maintained in a clean and sanitary condition at 
125.32 	all times.
126.1 		Subd. 9.Occupational and workplace safety. All applicable provisions of state and 
126.2 	federal regulations regarding exposure to workplace hazards and accidents must be followed 
126.3 	to protect the health and safety of all authorized persons at the natural organic reduction 
126.4 	facility.
126.5 		Subd. 10.Unlicensed personnel. A licensed natural organic reduction facility may 
126.6 	employ unlicensed personnel, provided that all applicable provisions of this chapter are 
126.7 	followed. It is the duty of the licensed natural organic reduction facility to provide proper 
126.8 	training for all unlicensed personnel, and the licensed natural organic reduction facility shall 
126.9 	be strictly accountable for compliance with this chapter and other applicable state and federal 
126.10 	regulations regarding occupational and workplace health and safety.
126.11 		Subd. 11.Authorization to naturally reduce. No natural organic reduction facility 
126.12 	shall naturally reduce or cause to be naturally reduced any dead human body or identifiable 
126.13 	body part without receiving written authorization to do so from the person or persons who 
126.14 	have the legal right to control disposition as described in section 149A.80 or the person's 
126.15 	legal designee. The written authorization must include:
126.16 	(1) the name of the deceased and the date of death of the deceased;
126.17 	(2) a statement authorizing the natural organic reduction facility to naturally reduce the 
126.18 	body;
126.19 	(3) the name, address, phone number, relationship to the deceased, and signature of the 
126.20 	person or persons with the legal right to control final disposition or a legal designee;
126.21 	(4) directions for the disposition of any non-naturally reduced materials or items recovered 
126.22 	from the natural organic reduction vessel;
126.23 	(5) acknowledgment that some of the remains will be mechanically reduced to a 
126.24 	granulated appearance and returned to the natural reduction vessel with the remains for final 
126.25 	reduction; and
126.26 	(6) directions for the ultimate disposition of the naturally reduced remains.
126.27 		Subd. 12.Limitation of liability. The limitations in section 149A.95, subdivision 5, 
126.28 	apply to natural organic reduction facilities.
126.29 		Subd. 13.Acceptance of delivery of body. (a) No dead human body shall be accepted 
126.30 	for final disposition by natural organic reduction unless the body is:
126.31 	(1) wrapped in a container, such as a pouch, that is impermeable or leak-resistant;
127.1 	(2) accompanied by a disposition permit issued pursuant to section 149A.93, subdivision 
127.2 	3, including a photocopy of the complete death record or a signed release authorizing natural 
127.3 	organic reduction received from a coroner or medical examiner; and
127.4 	(3) accompanied by a natural organic reduction authorization that complies with 
127.5 	subdivision 5.
127.6 	(b) A natural organic reduction facility shall refuse to accept delivery of the dead human 
127.7 	body:
127.8 	(1) where there is a known dispute concerning natural organic reduction of the body 
127.9 	delivered;
127.10 	(2) where there is a reasonable basis for questioning any of the representations made on 
127.11 	the written authorization to naturally reduce; or
127.12 	(3) for any other lawful reason.
127.13 	(c) When a container or pouch containing a dead human body shows evidence of leaking 
127.14 	bodily fluid, the container or pouch and the body must be returned to the contracting funeral 
127.15 	establishment, or the body must be transferred to a new container or pouch by a licensed 
127.16 	mortician.
127.17 	(d) If a dead human body is delivered to a natural organic reduction facility in a container 
127.18 	or pouch that is not suitable for placement in a natural organic reduction vessel, the transfer 
127.19 	of the body to the vessel must be performed by a licensed mortician.
127.20 		Subd. 14.Bodies awaiting natural organic reduction. A dead human body must be 
127.21 	placed in the natural organic reduction vessel to initiate the natural reduction process within 
127.22 	24 hours after the natural organic reduction facility accepts legal and physical custody of 
127.23 	the body.
127.24 		Subd. 15.Handling of dead human bodies. All natural organic reduction facility 
127.25 	employees handling the containers or pouches for dead human bodies shall use universal 
127.26 	precautions and otherwise exercise all reasonable precautions to minimize the risk of 
127.27 	transmitting any communicable disease from the body. No dead human body shall be 
127.28 	removed from the container or pouch in which it is delivered to the natural organic reduction 
127.29 	facility without express written authorization of the person or persons with legal right to 
127.30 	control the disposition and only by a licensed mortician. The remains shall be considered 
127.31 	a dead human body until after the final reduction. The person or persons with the legal right 
127.32 	to control the body may be involved with preparation of the body pursuant to section 
127.33 	149A.01, subdivision 3, paragraph (c).
128.1 		Subd. 16.Identification of the body. All licensed natural organic reduction facilities 
128.2 	shall develop, implement, and maintain an identification procedure whereby dead human 
128.3 	bodies can be identified from the time the natural organic reduction facility accepts delivery 
128.4 	of the body until the naturally reduced remains are released to an authorized party. After 
128.5 	natural organic reduction, an identifying disk, tab, or other permanent label shall be placed 
128.6 	within the naturally reduced remains container or containers before the remains are released 
128.7 	from the natural organic reduction facility. Each identification disk, tab, or label shall have 
128.8 	a number that shall be recorded on all paperwork regarding the decedent. This procedure 
128.9 	shall be designed to reasonably ensure that the proper body is naturally reduced and that 
128.10 	the remains are returned to the appropriate party. Loss of all or part of the remains or the 
128.11 	inability to individually identify the remains is a violation of this subdivision.
128.12 		Subd. 17.Natural organic reduction vessel for human remains. A licensed natural 
128.13 	organic reduction facility shall knowingly naturally reduce only dead human bodies or 
128.14 	human remains in a natural organic reduction vessel.
128.15 		Subd. 18.Natural organic reduction procedures; privacy. The final disposition of 
128.16 	dead human bodies by natural organic reduction shall be done in privacy. Unless there is 
128.17 	written authorization from the person with the legal right to control the final disposition, 
128.18 	only authorized natural organic reduction facility personnel shall be permitted in the natural 
128.19 	organic reduction area while any human body is awaiting placement or being placed in a 
128.20 	natural organic reduction vessel, being removed from the vessel, or being processed for 
128.21 	placement for final reduction. This does not prohibit an in-person laying-in ceremony to 
128.22 	honor the deceased and the transition prior to the placement.
128.23 		Subd. 19.Natural organic reduction procedures; commingling of bodies 
128.24 	prohibited. Except with the express written permission of the person with the legal right 
128.25 	to control the final disposition, no natural organic reduction facility shall naturally reduce 
128.26 	more than one dead human body at the same time and in the same natural organic reduction 
128.27 	vessel or introduce a second dead human body into same natural organic reduction vessel 
128.28 	until reasonable efforts have been employed to remove all fragments of remains from the 
128.29 	preceding natural organic reduction. This subdivision does not apply where commingling 
128.30 	of human remains during natural organic reduction is otherwise provided by law. The fact 
128.31 	that there is incidental and unavoidable residue in the natural organic reduction vessel used 
128.32 	in a prior natural organic reduction is not a violation of this subdivision.
128.33 		Subd. 20.Natural organic reduction procedures; removal from natural organic 
128.34 	reduction vessel. Upon completion of the natural organic reduction process, reasonable 
128.35 	efforts shall be made to remove from the natural organic reduction vessel all the recoverable 
129.1 	remains. The remains shall be transported to the processing area, and any non-naturally 
129.2 	reducible materials or items shall be separated from the remains and disposed of, in any 
129.3 	lawful manner, by the natural organic reduction facility.
129.4 		Subd. 21.Natural organic reduction procedures; processing remains. The remains 
129.5 	that remain intact shall be reduced by a motorized mechanical processor to a granulated 
129.6 	appearance. The granulated remains and the rest of the naturally reduced remains shall be 
129.7 	returned to a natural organic reduction vessel for final reduction. The remains shall be 
129.8 	considered a dead human body until after the final reduction.
129.9 		Subd. 22.Natural organic reduction procedures; commingling of remains 
129.10 	prohibited. Except with the express written permission of the person with the legal right 
129.11 	to control the final deposition or otherwise provided by law, no natural organic reduction 
129.12 	facility shall mechanically process the remains of more than one body at a time in the same 
129.13 	mechanical processor or introduce the remains of a second body into a mechanical processor 
129.14 	until reasonable efforts have been employed to remove all fragments of remains already in 
129.15 	the processor. The fact that there is incidental and unavoidable residue in the mechanical 
129.16 	processor is not a violation of this subdivision.
129.17 		Subd. 23.Natural organic reduction procedures; testing naturally reduced 
129.18 	remains. A natural organic reduction facility must:
129.19 	(1) ensure that the material in the natural organic reduction vessel naturally reaches and 
129.20 	maintains a minimum temperature of 131 degrees Fahrenheit for a minimum of 72 
129.21 	consecutive hours during the process of natural organic reduction;
129.22 	(2) analyze each instance of the naturally reduced remains for physical contaminants, 
129.23 	including but not limited to intact bone, dental fillings, and medical implants, and ensure 
129.24 	naturally reduced remains have less than 0.01 mg/kg dry weight of any physical contaminants;
129.25 	(3) collect material samples for analysis that are representative of each instance of natural 
129.26 	organic reduction, using a sampling method such as those described in the U.S. Composting 
129.27 	Council 2002 Test Methods for the Examination of Composting and Compost, method 
129.28 	02.01-A through E;
129.29 	(4) develop and use a natural organic reduction process in which the naturally reduced 
129.30 	remains from the process do not exceed the following limits:

129.31
129.32		Metals and other testing 
parameters
	Limit (mg/kg dry weight), unless otherwise 
specified
	
129.34129.33
		Fecal coliform
	Less than 1,000 most probable number per gram 
of total solids (dry weight)
	
130.2130.1
		Salmonella
	Less than 3 most probable number per 4 grams 
of total solids (dry weight)
	
130.3		Arsenic
	Less than or equal to 11 ppm
	
130.4		Cadmium
	Less than or equal to 7.1 ppm
	
130.5		Lead
	Less than or equal to 150 ppm
	
130.6		Mercury
	Less than or equal to 5 ppm
	
130.7		Selenium
	Less than or equal to 18 ppm;
	
130.8 	(5) analyze, using a third-party laboratory, the natural organic reduction facility's material 
130.9 	samples of naturally reduced remains according to the following schedule:
130.10 	(i) the natural organic reduction facility must analyze each of the first 20 instances of 
130.11 	naturally reduced remains for the parameters in clause (4);
130.12 	(ii) if any of the first 20 instances of naturally reduced remains yield results exceeding 
130.13 	the limits in clause (4), the natural organic reduction facility must conduct appropriate 
130.14 	processes to correct the levels of the substances in clause (4) and have the resultant remains 
130.15 	tested to ensure they fall within the identified limits;
130.16 	(iii) if any of the first 20 instances of naturally reduced remains yield results exceeding 
130.17 	the limits in clause (4), the natural organic reduction facility must analyze each additional 
130.18 	instance of naturally reduced remains for the parameters in clause (4) until a total of 20 
130.19 	samples, not including those from remains that were reprocessed as required in item (ii), 
130.20 	have yielded results within the limits in clause (4) on initial testing;
130.21 	(iv) after 20 material samples of naturally reduced remains have met the limits in clause 
130.22 	(4), the natural organic reduction facility must analyze at least 25 percent of the natural 
130.23 	organic reduction facility's monthly instances of naturally reduced remains for the parameters 
130.24 	in clause (4) until 80 total material samples of naturally reduced remains are found to meet 
130.25 	the limits in clause (4), not including any samples that required reprocessing to meet those 
130.26 	limits; and
130.27 	(v) after 80 material samples of naturally reduced remains are found to meet the limits 
130.28 	in clause (4), the natural organic reduction facility must analyze at least one randomly chosen 
130.29 	instance of naturally reduced remains each month for the parameters in clause (4). If fecal 
130.30 	coliform or salmonella in the tested remains exceeds the limit for that substance in clause 
130.31 	(4), the natural organic reduction facility must analyze each subsequent instance of naturally 
130.32 	reduced remains for fecal coliform and salmonella until ten total material samples are found 
130.33 	to meet the limits for those substances in clause (4) on initial testing, demonstrating the 
130.34 	natural organic reduction process was effectively corrected;
131.1 	(6) comply with any testing requirements established by the commissioner for content 
131.2 	parameters in addition to those specified in clause (4);
131.3 	(7) not release any naturally reduced remains that exceed the limits in clause (4); and
131.4 	(8) prepare, maintain, and provide to the commissioner upon request, a report for each 
131.5 	calendar year detailing the natural organic reduction facility's activities during the previous 
131.6 	calendar year. The report must include the following information:
131.7 	(i) the name and address of the natural organic reduction facility;
131.8 	(ii) the calendar year covered by the report;
131.9 	(iii) the annual quantity of naturally reduced remains;
131.10 	(iv) the results of any laboratory analyses of naturally reduced remains; and
131.11 	(v) any additional information required by the commissioner.
131.12 		Subd. 24.Natural organic reduction procedures; use of more than one naturally 
131.13 	reduced remains container. If the naturally reduced remains are to be separated into two 
131.14 	or more naturally reduced remains containers according to the directives provided in the 
131.15 	written authorization for natural organic reduction, all of the containers shall contain duplicate 
131.16 	identification disks, tabs, or permanent labels and all paperwork regarding the given body 
131.17 	shall include a notation of the number of and disposition of each container, as provided in 
131.18 	the written authorization.
131.19 		Subd. 25.Natural organic reduction procedures; disposition of accumulated 
131.20 	residue. Every natural organic reduction facility shall provide for the removal and disposition 
131.21 	of any accumulated residue from any natural organic reduction vessel, mechanical processor, 
131.22 	or other equipment used in natural organic reduction. Disposition of accumulated residue 
131.23 	shall be by any lawful manner deemed appropriate.
131.24 		Subd. 26.Natural organic reduction procedures; release of naturally reduced 
131.25 	remains. Following completion of the natural organic reduction process, the inurned naturally 
131.26 	reduced remains shall be released according to the instructions given on the written 
131.27 	authorization for natural organic reduction. If the remains are to be shipped, they must be 
131.28 	securely packaged and transported by a method that has an internal tracing system available 
131.29 	and which provides a receipt signed by the person accepting delivery. Where there is a 
131.30 	dispute over release or disposition of the naturally reduced remains, a natural organic 
131.31 	reduction facility may deposit the naturally reduced remains in accordance with the directives 
131.32 	of a court of competent jurisdiction pending resolution of the dispute or retain the naturally 
131.33 	reduced remains until the person with the legal right to control disposition presents 
132.1 	satisfactory indication that the dispute is resolved. A natural organic reduction facility must 
132.2 	make every effort to ensure naturally reduced remains are not sold or used for commercial 
132.3 	purposes.
132.4 		Subd. 27.Unclaimed naturally reduced remains. If, after 30 calendar days following 
132.5 	the inurnment, the naturally reduced remains are not claimed or disposed of according to 
132.6 	the written authorization for natural organic reduction, the natural organic reduction facility 
132.7 	shall give written notice, by certified mail, to the person with the legal right to control the 
132.8 	final disposition or a legal designee, that the naturally reduced remains are unclaimed and 
132.9 	requesting further release directions. Should the naturally reduced remains be unclaimed 
132.10 	120 calendar days following the mailing of the written notification, the natural organic 
132.11 	reduction facility may return the remains to the earth respectfully in any lawful manner 
132.12 	deemed appropriate.
132.13 		Subd. 28.Required records. Every natural organic reduction facility shall create and 
132.14 	maintain on its premises or other business location in Minnesota an accurate record of every 
132.15 	natural organic reduction provided. The record shall include all of the following information 
132.16 	for each natural organic reduction:
132.17 	(1) the name of the person or funeral establishment delivering the body for natural 
132.18 	organic reduction;
132.19 	(2) the name of the deceased and the identification number assigned to the body;
132.20 	(3) the date of acceptance of delivery;
132.21 	(4) the names of the operator of the natural organic reduction process and mechanical 
132.22 	processor operator;
132.23 	(5) the times and dates that the body was placed in and removed from the natural organic 
132.24 	reduction vessel;
132.25 	(6) the time and date that processing and inurnment of the naturally reduced remains 
132.26 	was completed;
132.27 	(7) the time, date, and manner of release of the naturally reduced remains;
132.28 	(8) the name and address of the person who signed the authorization for natural organic 
132.29 	reduction;
132.30 	(9) all supporting documentation, including any transit or disposition permits, a photocopy 
132.31 	of the death record, and the authorization for natural organic reduction; and
132.32 	(10) the type of natural organic reduction vessel.
133.1 		Subd. 29.Retention of records. Records required under subdivision 28 shall be 
133.2 	maintained for a period of three calendar years after the release of the naturally reduced 
133.3 	remains. Following this period and subject to any other laws requiring retention of records, 
133.4 	the natural organic reduction facility may then place the records in storage or reduce them 
133.5 	to microfilm, a digital format, or any other method that can produce an accurate reproduction 
133.6 	of the original record, for retention for a period of ten calendar years from the date of release 
133.7 	of the naturally reduced remains. At the end of this period and subject to any other laws 
133.8 	requiring retention of records, the natural organic reduction facility may destroy the records 
133.9 	by shredding, incineration, or any other manner that protects the privacy of the individuals 
133.10 	identified.

133.11 	Sec. 51. STILLBIRTH PREVENTION THROUGH TRACKING FETAL 
133.12 	MOVEMENT PILOT PROGRAM.
 133.13 		Subdivision 1.Grant. The commissioner of health shall issue a grant to a grant recipient 
133.14 	to support a stillbirth prevention through tracking fetal movement pilot program and to 
133.15 	provide evidence of the efficacy of tracking fetal movements in preventing stillbirths in 
133.16 	Minnesota. The pilot program shall operate in fiscal years 2025, 2026, and 2027.
133.17 		Subd. 2.Use of grant funds. The grant recipient must use grant funds:
133.18 	(1) for activities to ensure that expectant parents in Minnesota receive information about 
133.19 	the importance of tracking fetal movement in the third trimester of pregnancy, by providing 
133.20 	evidence-based information to organizations that include but are not limited to community 
133.21 	organizations, hospitals, birth centers, maternal health providers, and higher education 
133.22 	institutions that educate maternal health providers;
133.23 	(2) to provide maternal health providers and expectant parents in Minnesota with access 
133.24 	to free, evidence-based educational materials on fetal movement tracking, including 
133.25 	brochures, posters, reminder cards, continuing education materials, and digital resources;
133.26 	(3) to assist in raising awareness with health care providers about:
133.27 	(i) the availability of free fetal movement tracking education for providers through an 
133.28 	initial education campaign;
133.29 	(ii) the importance of tracking fetal movement in the third trimester of pregnancy by 
133.30 	offering at least three to five webinars and conferences per year; and
133.31 	(iii) the importance of tracking fetal movement in the third trimester of pregnancy through 
133.32 	provider participation in a public relations campaign; and
134.1 	(4) to assist in raising public awareness about the availability of free fetal movement 
134.2 	tracking resources through social media marketing and traditional marketing throughout 
134.3 	Minnesota.
134.4 		Subd. 3.Data-sharing and monitoring. (a) During the operation of the pilot program, 
134.5 	the grant recipient shall provide the following information to the commissioner on at least 
134.6 	a quarterly basis:
134.7 	(1) the number of educational materials distributed under the pilot program, broken 
134.8 	down by zip code and the type of facility or organization that ordered the materials, including 
134.9 	hospitals, birth centers, maternal health clinics, WIC clinics, and community organizations;
134.10 	(2) the number of fetal movement tracking application downloads that may be attributed 
134.11 	to the pilot program, broken down by zip code;
134.12 	(3) the reach of and engagement with marketing materials provided under the pilot 
134.13 	program; and
134.14 	(4) provider attendance and participation in awareness-raising events under the pilot 
134.15 	program, such as webinars and conferences.
134.16 	(b) Each year during the pilot program and at the conclusion of the pilot program, the 
134.17 	grant recipient shall provide the commissioner with an annual report that includes information 
134.18 	on how the pilot program has affected:
134.19 	(1) fetal death rates in Minnesota;
134.20 	(2) fetal death rates in Minnesota among American Indian, Black, Hispanic, and Asian 
134.21 	Pacific Islander populations; and
134.22 	(3) fetal death rates by region in Minnesota.
134.23 		Subd. 4.Reports. The commissioner must submit to the legislative committees with 
134.24 	jurisdiction over public health an interim report and a final report on the operation of the 
134.25 	pilot program. The interim report must be submitted by December 1, 2025, and the final 
134.26 	report must be submitted by December 1, 2027. Each report must at least describe the pilot 
134.27 	program's operations and provide information, to the extent available, on the effectiveness 
134.28 	of the pilot program in preventing stillbirths in Minnesota, including lessons learned in 
134.29 	implementing the pilot program and recommendations for future action.

135.1 	ARTICLE 6
135.2 	DEPARTMENT OF HEALTH POLICY

135.3 	Section 1. Minnesota Statutes 2022, section 62D.14, subdivision 1, is amended to read:
135.4 		Subdivision 1.Examination authority. The commissioner of health may make an 
135.5 	examination of the affairs of any health maintenance organization and its contracts, 
135.6 	agreements, or other arrangements with any participating entity as often as the commissioner 
135.7 	of health deems necessary for the protection of the interests of the people of this state, but 
135.8 	not less frequently than once every three five years. Examinations of participating entities 
135.9 	pursuant to this subdivision shall be limited to their dealings with the health maintenance 
135.10 	organization and its enrollees, except that examinations of major participating entities may 
135.11 	include inspection of the entity's financial statements kept in the ordinary course of business. 
135.12 	The commissioner may require major participating entities to submit the financial statements 
135.13 	directly to the commissioner. Financial statements of major participating entities are subject 
135.14 	to the provisions of section 13.37, subdivision 1, clause (b), upon request of the major 
135.15 	participating entity or the health maintenance organization with which it contracts.

135.16 	Sec. 2. [62J.461] 340B COVERED ENTITY REPORT.
135.17 		Subdivision 1.Definitions. (a) For purposes of this section, the following definitions 
135.18 	apply.
135.19 	(b) "340B covered entity" or "covered entity" means a covered entity as defined in United 
135.20 	States Code, title 42, section 256b(a)(4), with a service address in Minnesota as of January 
135.21 	1 of the reporting year. 340B covered entity includes all entity types and grantees. All 
135.22 	facilities that are identified as child sites or grantee associated sites under the federal 340B 
135.23 	Drug Pricing Program are considered part of the 340B covered entity.
135.24 	(c) "340B Drug Pricing Program" or "340B program" means the drug discount program 
135.25 	established under United States Code, title 42, section 256b.
135.26 	(d) "340B entity type" is the designation of the 340B covered entity according to the 
135.27 	entity types specified in United States Code, title 42, section 256b(a)(4).
135.28 	(e) "340B ID" is the unique identification number provided by the Health Resources 
135.29 	and Services Administration to identify a 340B-eligible entity in the 340B Office of Pharmacy 
135.30 	Affairs Information System.
135.31 	(f) "Contract pharmacy" means a pharmacy with which a 340B covered entity has an 
135.32 	arrangement to dispense drugs purchased under the 340B Drug Pricing Program.
136.1 	(g) "Pricing unit" means the smallest dispensable amount of a prescription drug product 
136.2 	that can be dispensed or administered.
136.3 		Subd. 2.Current registration. Beginning April 1, 2024, each 340B covered entity must 
136.4 	maintain a current registration with the commissioner in a form and manner prescribed by 
136.5 	the commissioner. The registration must include the following information:
136.6 	(1) the name of the 340B covered entity;
136.7 	(2) the 340B ID of the 340B covered entity;
136.8 	(3) the servicing address of the 340B covered entity; and
136.9 	(4) the 340B entity type of the 340B covered entity.
136.10 		Subd. 3.Reporting by covered entities to the commissioner. (a) Each 340B covered 
136.11 	entity shall report to the commissioner by April 1 of each year the following information 
136.12 	for transactions conducted by the 340B covered entity or on its behalf, and related to its 
136.13 	participation in the federal 340B program for the previous calendar year:
136.14 	(1) the aggregated acquisition cost for prescription drugs obtained under the 340B 
136.15 	program;
136.16 	(2) the aggregated payment amount received for drugs obtained under the 340B program 
136.17 	and dispensed or administered to patients;
136.18 	(3) the number of pricing units dispensed or administered for prescription drugs described 
136.19 	in clause (2); and
136.20 	(4) the aggregated payments made:
136.21 	(i) to contract pharmacies to dispense drugs obtained under the 340B program;
136.22 	(ii) to any other entity that is not the covered entity and is not a contract pharmacy for 
136.23 	managing any aspect of the covered entity's 340B program; and
136.24 	(iii) for all other expenses related to administering the 340B program.
136.25 	The information under clauses (2) and (3) must be reported by payer type, including but 
136.26 	not limited to commercial insurance, medical assistance, MinnesotaCare, and Medicare, in 
136.27 	the form and manner prescribed by the commissioner.
136.28 	(b) For covered entities that are hospitals, the information required under paragraph (a), 
136.29 	clauses (1) to (3), must also be reported at the national drug code level for the 50 most 
136.30 	frequently dispensed or administered drugs by the facility under the 340B program.
137.1 	(c) Data submitted to the commissioner under paragraphs (a) and (b) are classified as 
137.2 	nonpublic data, as defined in section 13.02, subdivision 9.
137.3 		Subd. 4.Enforcement and exceptions. (a) Any health care entity subject to reporting 
137.4 	under this section that fails to provide data in the form and manner prescribed by the 
137.5 	commissioner is subject to a fine paid to the commissioner of up to $500 for each day the 
137.6 	data are past due. Any fine levied against the entity under this subdivision is subject to the 
137.7 	contested case and judicial review provisions of sections 14.57 and 14.69.
137.8 	(b) The commissioner may grant an entity an extension of or exemption from the reporting 
137.9 	obligations under this subdivision, upon a showing of good cause by the entity.
137.10 		Subd. 5.Reports to the legislature. By November 15, 2024, and by November 15 of 
137.11 	each year thereafter, the commissioner shall submit to the chairs and ranking minority 
137.12 	members of the legislative committees with jurisdiction over health care finance and policy, 
137.13 	a report that aggregates the data submitted under subdivision 3, paragraphs (a) and (b). The 
137.14 	following information must be included in the report for all 340B entities whose net 340B 
137.15 	revenue constitutes a significant share, as determined by the commissioner, of all net 340B 
137.16 	revenue across all 340B covered entities in Minnesota:
137.17 	(1) the information submitted under subdivision 2; and
137.18 	(2) for each 340B entity identified in subdivision 2, that entity's 340B net revenue as 
137.19 	calculated using the data submitted under subdivision 3, paragraph (a), with net revenue 
137.20 	being subdivision 3, paragraph (a), clause (2), less the sum of subdivision 3, paragraph (a), 
137.21 	clauses (1) and (4).
137.22 	For all other entities, the data in the report must be aggregated to the entity type or groupings 
137.23 	of entity types in a manner that prevents the identification of an individual entity and any 
137.24 	entity's specific data value reported for an individual data element.

137.25 	Sec. 3. Minnesota Statutes 2022, section 62J.61, subdivision 5, is amended to read:
137.26 		Subd. 5.Biennial review of rulemaking procedures and rules Opportunity for 
137.27 	comment. The commissioner shall biennially seek comments from affected parties maintain 
137.28 	an email address for submission of comments from interested parties to provide input about 
137.29 	the effectiveness of and continued need for the rulemaking procedures set out in subdivision 
137.30 	2 and about the quality and effectiveness of rules adopted using these procedures. The 
137.31 	commissioner shall seek comments by holding a meeting and by publishing a notice in the 
137.32 	State Register that contains the date, time, and location of the meeting and a statement that 
137.33 	invites oral or written comments. The notice must be published at least 30 days before the 
138.1 	meeting date. The commissioner shall write a report summarizing the comments and shall 
138.2 	submit the report to the Minnesota Health Data Institute and to the Minnesota Administrative 
138.3 	Uniformity Committee by January 15 of every even-numbered year may seek additional 
138.4 	input and provide additional opportunities for input as needed.

138.5 	Sec. 4. Minnesota Statutes 2023 Supplement, section 62J.84, subdivision 10, is amended 
138.6 	to read:
138.7 		Subd. 10.Notice of prescription drugs of substantial public interest. (a) No later than 
138.8 	January 31, 2024, and quarterly thereafter, the commissioner shall produce and post on the 
138.9 	department's website a list of prescription drugs that the commissioner determines to represent 
138.10 	a substantial public interest and for which the commissioner intends to request data under 
138.11 	subdivisions 11 to 14, subject to paragraph (c). The commissioner shall base its inclusion 
138.12 	of prescription drugs on any information the commissioner determines is relevant to providing 
138.13 	greater consumer awareness of the factors contributing to the cost of prescription drugs in 
138.14 	the state, and the commissioner shall consider drug product families that include prescription 
138.15 	drugs:
138.16 	(1) that triggered reporting under subdivision 3 or 4 during the previous calendar quarter;
138.17 	(2) for which average claims paid amounts exceeded 125 percent of the price as of the 
138.18 	claim incurred date during the most recent calendar quarter for which claims paid amounts 
138.19 	are available; or
138.20 	(3) that are identified by members of the public during a public comment process.
138.21 	(b) Not sooner than 30 days after publicly posting the list of prescription drugs under 
138.22 	paragraph (a), the department shall notify, via email, reporting entities registered with the 
138.23 	department of the requirement to report under subdivisions 11 to 14.
138.24 	(c) The commissioner must not designate more than 500 prescription drugs as having a 
138.25 	substantial public interest in any one notice.
138.26 	(d) Notwithstanding subdivision 16, the commissioner is exempt from chapter 14, 
138.27 	including section 14.386, in implementing this subdivision.

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

138.29 	Sec. 5. Minnesota Statutes 2022, section 144.05, subdivision 6, is amended to read:
138.30 		Subd. 6.Reports on interagency agreements and intra-agency transfers. The 
138.31 	commissioner of health shall provide quarterly reports to the chairs and ranking minority 
139.1 	members of the legislative committees with jurisdiction over health and human services 
139.2 	policy and finance on:
139.3 	(1) interagency agreements or service-level agreements and any renewals or extensions 
139.4 	of existing interagency or service-level agreements with a state department under section 
139.5 	15.01, state agency under section 15.012, or the Department of Information Technology 
139.6 	Services, with a value of more than $100,000, or related agreements with the same department 
139.7 	or agency with a cumulative value of more than $100,000; and
139.8 	(2) transfers of appropriations of more than $100,000 between accounts within or between 
139.9 	agencies.
139.10 	The report must include the statutory citation authorizing the agreement, transfer or dollar 
139.11 	amount, purpose, and effective date of the agreement, and duration of the agreement, and 
139.12 	a copy of the agreement.

139.13 	Sec. 6. Minnesota Statutes 2022, section 144.05, subdivision 7, is amended to read:
139.14 		Subd. 7.Expiration of report mandates. (a) If the submission of a report by the 
139.15 	commissioner of health to the legislature is mandated by statute and the enabling legislation 
139.16 	does not include a date for the submission of a final report, the mandate to submit the report 
139.17 	shall expire in accordance with this section.
139.18 	(b) If the mandate requires the submission of an annual report and the mandate was 
139.19 	enacted before January 1, 2021, the mandate shall expire on January 1, 2023. If the mandate 
139.20 	requires the submission of a biennial or less frequent report and the mandate was enacted 
139.21 	before January 1, 2021, the mandate shall expire on January 1, 2024.
139.22 	(c) Any reporting mandate enacted on or after January 1, 2021, shall expire three years 
139.23 	after the date of enactment if the mandate requires the submission of an annual report and 
139.24 	shall expire five years after the date of enactment if the mandate requires the submission 
139.25 	of a biennial or less frequent report, unless the enacting legislation provides for a different 
139.26 	expiration date.
139.27 	(d) The commissioner shall submit a list to the chairs and ranking minority members of 
139.28 	the legislative committees with jurisdiction over health by February 15 of each year, 
139.29 	beginning February 15, 2022, of all reports set to expire during the following calendar year 
139.30 	in accordance with this section. The mandate to submit a report to the legislature under this 
139.31 	paragraph does not expire.

139.32 	EFFECTIVE DATE. This section is effective retroactively from January 1, 2024.

140.1 	Sec. 7. Minnesota Statutes 2023 Supplement, section 144.0526, subdivision 1, is amended 
140.2 	to read:
140.3 		Subdivision 1.Establishment. The commissioner of health shall establish the Minnesota 
140.4 	One Health Antimicrobial Stewardship Collaborative. The commissioner shall appoint hire
140.5 	a director to execute operations, conduct health education, and provide technical assistance.

140.6 	Sec. 8. Minnesota Statutes 2022, section 144.058, is amended to read:
140.7 	144.058 INTERPRETER SERVICES QUALITY INITIATIVE.
140.8 	(a) The commissioner of health shall establish a voluntary statewide roster, and develop 
140.9 	a plan for a registry and certification process for interpreters who provide high quality, 
140.10 	spoken language health care interpreter services. The roster, registry, and certification 
140.11 	process shall be based on the findings and recommendations set forth by the Interpreter 
140.12 	Services Work Group required under Laws 2007, chapter 147, article 12, section 13.
140.13 	(b) By January 1, 2009, the commissioner shall establish a roster of all available 
140.14 	interpreters to address access concerns, particularly in rural areas.
140.15 	(c) By January 15, 2010, the commissioner shall:
140.16 	(1) develop a plan for a registry of spoken language health care interpreters, including:
140.17 	(i) development of standards for registration that set forth educational requirements, 
140.18 	training requirements, demonstration of language proficiency and interpreting skills, 
140.19 	agreement to abide by a code of ethics, and a criminal background check;
140.20 	(ii) recommendations for appropriate alternate requirements in languages for which 
140.21 	testing and training programs do not exist;
140.22 	(iii) recommendations for appropriate fees; and
140.23 	(iv) recommendations for establishing and maintaining the standards for inclusion in 
140.24 	the registry; and
140.25 	(2) develop a plan for implementing a certification process based on national testing and 
140.26 	certification processes for spoken language interpreters 12 months after the establishment 
140.27 	of a national certification process.
140.28 	(d) The commissioner shall consult with the Interpreter Stakeholder Group of the Upper 
140.29 	Midwest Translators and Interpreters Association for advice on the standards required to 
140.30 	plan for the development of a registry and certification process.
141.1 	(e) The commissioner shall charge an annual fee of $50 to include an interpreter in the 
141.2 	roster. Fee revenue shall be deposited in the state government special revenue fund. All fees 
141.3 	are nonrefundable.

141.4 	Sec. 9. Minnesota Statutes 2022, section 144.0724, subdivision 2, is amended to read:
141.5 		Subd. 2.Definitions. For purposes of this section, the following terms have the meanings 
141.6 	given.
141.7 	(a) "Assessment reference date" or "ARD" means the specific end point for look-back 
141.8 	periods in the MDS assessment process. This look-back period is also called the observation 
141.9 	or assessment period.
141.10 	(b) "Case mix index" means the weighting factors assigned to the RUG-IVcase mix 
141.11 	reimbursement classifications determined by an assessment.
141.12 	(c) "Index maximization" means classifying a resident who could be assigned to more 
141.13 	than one category, to the category with the highest case mix index.
141.14 	(d) "Minimum Data Set" or "MDS" means a core set of screening, clinical assessment, 
141.15 	and functional status elements, that include common definitions and coding categories 
141.16 	specified by the Centers for Medicare and Medicaid Services and designated by the 
141.17 	Department of Health.
141.18 	(e) "Representative" means a person who is the resident's guardian or conservator, the 
141.19 	person authorized to pay the nursing home expenses of the resident, a representative of the 
141.20 	Office of Ombudsman for Long-Term Care whose assistance has been requested, or any 
141.21 	other individual designated by the resident.
141.22 	(f) "Resource utilization groups" or "RUG" means the system for grouping a nursing 
141.23 	facility's residents according to their clinical and functional status identified in data supplied 
141.24 	by the facility's Minimum Data Set.
141.25 	(g) (f) "Activities of daily living" includes personal hygiene, dressing, bathing, 
141.26 	transferring, bed mobility, locomotion, eating, and toileting.
141.27 	(h) (g) "Nursing facility level of care determination" means the assessment process that 
141.28 	results in a determination of a resident's or prospective resident's need for nursing facility 
141.29 	level of care as established in subdivision 11 for purposes of medical assistance payment 
141.30 	of long-term care services for:
141.31 	(1) nursing facility services under section 256B.434 or chapter 256R;
141.32 	(2) elderly waiver services under chapter 256S;
142.1 	(3) CADI and BI waiver services under section 256B.49; and
142.2 	(4) state payment of alternative care services under section 256B.0913.

142.3 	Sec. 10. Minnesota Statutes 2022, section 144.0724, subdivision 3a, is amended to read:
142.4 		Subd. 3a.Resident reimbursement case mix reimbursement classifications beginning 
142.5 	January 1, 2012. (a) Beginning January 1, 2012, Resident reimbursement case mix 
142.6 	reimbursement classifications shall be based on the Minimum Data Set, version 3.0 
142.7 	assessment instrument, or its successor version mandated by the Centers for Medicare and 
142.8 	Medicaid Services that nursing facilities are required to complete for all residents. The 
142.9 	commissioner of health shall establish resident classifications according to the RUG-IV, 
142.10 	48 group, resource utilization groups. Resident classification must be established based on 
142.11 	the individual items on the Minimum Data Set, which must be completed according to the 
142.12 	Long Term Care Facility Resident Assessment Instrument User's Manual Version 3.0 or its 
142.13 	successor issued by the Centers for Medicare and Medicaid Services. Case mix 
142.14 	reimbursement classifications shall also be based on assessments required under subdivision 
142.15 	4. Assessments must be completed according to the Long Term Care Facility Resident 
142.16 	Assessment Instrument User's Manual Version 3.0 or a successor manual issued by the 
142.17 	Centers for Medicare and Medicaid Services. The optional state assessment must be 
142.18 	completed according to the OSA Manual Version 1.0 v.2.
142.19 	(b) Each resident must be classified based on the information from the Minimum Data 
142.20 	Set according to the general categories issued by the Minnesota Department of Health, 
142.21 	utilized for reimbursement purposes.

142.22 	Sec. 11. Minnesota Statutes 2022, section 144.0724, subdivision 4, is amended to read:
142.23 		Subd. 4.Resident assessment schedule. (a) A facility must conduct and electronically 
142.24 	submit to the federal database MDS assessments that conform with the assessment schedule 
142.25 	defined by the Long Term Care Facility Resident Assessment Instrument User's Manual, 
142.26 	version 3.0, or its successor issued by the Centers for Medicare and Medicaid Services. The 
142.27 	commissioner of health may substitute successor manuals or question and answer documents 
142.28 	published by the United States Department of Health and Human Services, Centers for 
142.29 	Medicare and Medicaid Services, to replace or supplement the current version of the manual 
142.30 	or document.
142.31 	(b) The assessments required under the Omnibus Budget Reconciliation Act of 1987 
142.32 	(OBRA) used to determine a case mix reimbursement classification for reimbursement
142.33 	include:
143.1 	(1) a new admission comprehensive assessment, which must have an assessment reference 
143.2 	date (ARD) within 14 calendar days after admission, excluding readmissions;
143.3 	(2) an annual comprehensive assessment, which must have an ARD within 92 days of 
143.4 	a previous quarterly review assessment or a previous comprehensive assessment, which 
143.5 	must occur at least once every 366 days;
143.6 	(3) a significant change in status comprehensive assessment, which must have an ARD 
143.7 	within 14 days after the facility determines, or should have determined, that there has been 
143.8 	a significant change in the resident's physical or mental condition, whether an improvement 
143.9 	or a decline, and regardless of the amount of time since the last comprehensive assessment 
143.10 	or quarterly review assessment;
143.11 	(4) a quarterly review assessment must have an ARD within 92 days of the ARD of the 
143.12 	previous quarterly review assessment or a previous comprehensive assessment;
143.13 	(5) any significant correction to a prior comprehensive assessment, if the assessment 
143.14 	being corrected is the current one being used for RUG reimbursement classification;
143.15 	(6) any significant correction to a prior quarterly review assessment, if the assessment 
143.16 	being corrected is the current one being used for RUG reimbursement classification; and
143.17 	(7) a required significant change in status assessment when:
143.18 	(i) all speech, occupational, and physical therapies have ended. If the most recent OBRA 
143.19 	comprehensive or quarterly assessment completed does not result in a rehabilitation case 
143.20 	mix classification, then the significant change in status assessment is not required. The ARD 
143.21 	of this assessment must be set on day eight after all therapy services have ended; and
143.22 	(ii) isolation for an infectious disease has ended. If isolation was not coded on the most 
143.23 	recent OBRA comprehensive or quarterly assessment completed, then the significant change 
143.24 	in status assessment is not required. The ARD of this assessment must be set on day 15 after 
143.25 	isolation has ended; and
143.26 	(8) (7) any modifications to the most recent assessments under clauses (1) to (7) (6).
143.27 	(c) The optional state assessment must accompany all OBRA assessments. The optional 
143.28 	state assessment is also required to determine reimbursement when:
143.29 	(i) all speech, occupational, and physical therapies have ended. If the most recent optional 
143.30 	state assessment completed does not result in a rehabilitation case mix reimbursement 
143.31 	classification, then the optional state assessment is not required. The ARD of this assessment 
143.32 	must be set on day eight after all therapy services have ended; and
144.1 	(ii) isolation for an infectious disease has ended. If isolation was not coded on the most 
144.2 	recent optional state assessment completed, then the optional state assessment is not required. 
144.3 	The ARD of this assessment must be set on day 15 after isolation has ended.
144.4 	(c) (d) In addition to the assessments listed in paragraph paragraphs (b) and (c), the 
144.5 	assessments used to determine nursing facility level of care include the following:
144.6 	(1) preadmission screening completed under section 256.975, subdivisions 7a to 7c, by 
144.7 	the Senior LinkAge Line or other organization under contract with the Minnesota Board on 
144.8 	Aging; and
144.9 	(2) a nursing facility level of care determination as provided for under section 256B.0911, 
144.10 	subdivision 26, as part of a face-to-face long-term care consultation assessment completed 
144.11 	under section 256B.0911, by a county, tribe, or managed care organization under contract 
144.12 	with the Department of Human Services.

144.13 	Sec. 12. Minnesota Statutes 2022, section 144.0724, subdivision 6, is amended to read:
144.14 		Subd. 6.Penalties for late or nonsubmission. (a) A facility that fails to complete or 
144.15 	submit an assessment according to subdivisions 4 and 5 for a RUG-IV case mix 
144.16 	reimbursement classification within seven days of the time requirements listed in the 
144.17 	Long-Term Care Facility Resident Assessment Instrument User's Manual when the 
144.18 	assessment is due is subject to a reduced rate for that resident. The reduced rate shall be the 
144.19 	lowest rate for that facility. The reduced rate is effective on the day of admission for new 
144.20 	admission assessments, on the ARD for significant change in status assessments, or on the 
144.21 	day that the assessment was due for all other assessments and continues in effect until the 
144.22 	first day of the month following the date of submission and acceptance of the resident's 
144.23 	assessment.
144.24 	(b) If loss of revenue due to penalties incurred by a facility for any period of 92 days 
144.25 	are equal to or greater than 0.1 percent of the total operating costs on the facility's most 
144.26 	recent annual statistical and cost report, a facility may apply to the commissioner of human 
144.27 	services for a reduction in the total penalty amount. The commissioner of human services, 
144.28 	in consultation with the commissioner of health, may, at the sole discretion of the 
144.29 	commissioner of human services, limit the penalty for residents covered by medical assistance 
144.30 	to ten days.

145.1 	Sec. 13. Minnesota Statutes 2022, section 144.0724, subdivision 7, is amended to read:
145.2 		Subd. 7.Notice of resident reimbursement case mix reimbursement classification. (a) 
145.3 	The commissioner of health shall provide to a nursing facility a notice for each resident of 
145.4 	the classification established under subdivision 1. The notice must inform the resident of 
145.5 	the case mix reimbursement classification assigned, the opportunity to review the 
145.6 	documentation supporting the classification, the opportunity to obtain clarification from the 
145.7 	commissioner, and the opportunity to request a reconsideration of the classification, and 
145.8 	the address and telephone number of the Office of Ombudsman for Long-Term Care. The 
145.9 	commissioner must transmit the notice of resident classification by electronic means to the 
145.10 	nursing facility. The nursing facility is responsible for the distribution of the notice to each 
145.11 	resident or the resident's representative. This notice must be distributed within three business 
145.12 	days after the facility's receipt.
145.13 	(b) If a facility submits a modifying modified assessment resulting in a change in the 
145.14 	case mix reimbursement classification, the facility must provide a written notice to the 
145.15 	resident or the resident's representative regarding the item or items that were modified and 
145.16 	the reason for the modifications. The written notice must be provided within three business 
145.17 	days after distribution of the resident case mix reimbursement classification notice.

145.18 	Sec. 14. Minnesota Statutes 2022, section 144.0724, subdivision 8, is amended to read:
145.19 		Subd. 8.Request for reconsideration of resident classifications. (a) The resident, or
145.20 	the resident's representative, or the nursing facility, or the boarding care home may request 
145.21 	that the commissioner of health reconsider the assigned reimbursement case mix
145.22 	reimbursement classification and any item or items changed during the audit process. The 
145.23 	request for reconsideration must be submitted in writing to the commissioner of health.
145.24 	(b) For reconsideration requests initiated by the resident or the resident's representative:
145.25 	(1) The resident or the resident's representative must submit in writing a reconsideration 
145.26 	request to the facility administrator within 30 days of receipt of the resident classification 
145.27 	notice. The written request must include the reasons for the reconsideration request.
145.28 	(2) Within three business days of receiving the reconsideration request, the nursing 
145.29 	facility must submit to the commissioner of health a completed reconsideration request 
145.30 	form, a copy of the resident's or resident's representative's written request, and all supporting 
145.31 	documentation used to complete the assessment being considered reconsidered. If the facility 
145.32 	fails to provide the required information, the reconsideration will be completed with the 
146.1 	information submitted and the facility cannot make further reconsideration requests on this 
146.2 	classification.
146.3 	(3) Upon written request and within three business days, the nursing facility must give 
146.4 	the resident or the resident's representative a copy of the assessment being reconsidered and 
146.5 	all supporting documentation used to complete the assessment. Notwithstanding any law 
146.6 	to the contrary, the facility may not charge a fee for providing copies of the requested 
146.7 	documentation. If a facility fails to provide the required documents within this time, it is 
146.8 	subject to the issuance of a correction order and penalty assessment under sections 144.653
146.9 	and 144A.10. Notwithstanding those sections, any correction order issued under this 
146.10 	subdivision must require that the nursing facility immediately comply with the request for 
146.11 	information, and as of the date of the issuance of the correction order, the facility shall 
146.12 	forfeit to the state a $100 fine for the first day of noncompliance, and an increase in the 
146.13 	$100 fine by $50 increments for each day the noncompliance continues.
146.14 	(c) For reconsideration requests initiated by the facility:
146.15 	(1) The facility is required to inform the resident or the resident's representative in writing 
146.16 	that a reconsideration of the resident's case mix reimbursement classification is being 
146.17 	requested. The notice must inform the resident or the resident's representative:
146.18 	(i) of the date and reason for the reconsideration request;
146.19 	(ii) of the potential for a case mix reimbursement classification change and subsequent 
146.20 	rate change;
146.21 	(iii) of the extent of the potential rate change;
146.22 	(iv) that copies of the request and supporting documentation are available for review; 
146.23 	and
146.24 	(v) that the resident or the resident's representative has the right to request a 
146.25 	reconsideration also.
146.26 	(2) Within 30 days of receipt of the audit exit report or resident classification notice, the 
146.27 	facility must submit to the commissioner of health a completed reconsideration request 
146.28 	form, all supporting documentation used to complete the assessment being reconsidered, 
146.29 	and a copy of the notice informing the resident or the resident's representative that a 
146.30 	reconsideration of the resident's classification is being requested.
146.31 	(3) If the facility fails to provide the required information, the reconsideration request 
146.32 	may be denied and the facility may not make further reconsideration requests on this 
146.33 	classification.
147.1 	(d) Reconsideration by the commissioner must be made by individuals not involved in 
147.2 	reviewing the assessment, audit, or reconsideration that established the disputed classification. 
147.3 	The reconsideration must be based upon the assessment that determined the classification 
147.4 	and upon the information provided to the commissioner of health under paragraphs (a) to 
147.5 	(c). If necessary for evaluating the reconsideration request, the commissioner may conduct 
147.6 	on-site reviews. Within 15 business days of receiving the request for reconsideration, the 
147.7 	commissioner shall affirm or modify the original resident classification. The original 
147.8 	classification must be modified if the commissioner determines that the assessment resulting 
147.9 	in the classification did not accurately reflect characteristics of the resident at the time of 
147.10 	the assessment. The commissioner must transmit the reconsideration classification notice 
147.11 	by electronic means to the nursing facility. The nursing facility is responsible for the 
147.12 	distribution of the notice to the resident or the resident's representative. The notice must be 
147.13 	distributed by the nursing facility within three business days after receipt. A decision by 
147.14 	the commissioner under this subdivision is the final administrative decision of the agency 
147.15 	for the party requesting reconsideration.
147.16 	(e) The case mix reimbursement classification established by the commissioner shall be 
147.17 	the classification which applies to the resident while the request for reconsideration is 
147.18 	pending. If a request for reconsideration applies to an assessment used to determine nursing 
147.19 	facility level of care under subdivision 4, paragraph (c) (d), the resident shall continue to 
147.20 	be eligible for nursing facility level of care while the request for reconsideration is pending.
147.21 	(f) The commissioner may request additional documentation regarding a reconsideration 
147.22 	necessary to make an accurate reconsideration determination.
147.23 	(g) Data collected as part of the reconsideration process under this section is classified 
147.24 	as private data on individuals and nonpublic data pursuant to section 13.02. Notwithstanding 
147.25 	the classification of these data as private or nonpublic, the commissioner is authorized to 
147.26 	share these data with the U.S. Centers for Medicare and Medicaid Services and the 
147.27 	commissioner of human services as necessary for reimbursement purposes.

147.28 	Sec. 15. Minnesota Statutes 2022, section 144.0724, subdivision 9, is amended to read:
147.29 		Subd. 9.Audit authority. (a) The commissioner shall audit the accuracy of resident 
147.30 	assessments performed under section 256R.17 through any of the following: desk audits; 
147.31 	on-site review of residents and their records; and interviews with staff, residents, or residents' 
147.32 	families. The commissioner shall reclassify a resident if the commissioner determines that 
147.33 	the resident was incorrectly classified.
147.34 	(b) The commissioner is authorized to conduct on-site audits on an unannounced basis.
148.1 	(c) A facility must grant the commissioner access to examine the medical records relating 
148.2 	to the resident assessments selected for audit under this subdivision. The commissioner may 
148.3 	also observe and speak to facility staff and residents.
148.4 	(d) The commissioner shall consider documentation under the time frames for coding 
148.5 	items on the minimum data set as set out in the Long-Term Care Facility Resident Assessment 
148.6 	Instrument User's Manual or OSA Manual version 1.0 v.2 published by the Centers for 
148.7 	Medicare and Medicaid Services.
148.8 	(e) The commissioner shall develop an audit selection procedure that includes the 
148.9 	following factors:
148.10 	(1) Each facility shall be audited annually. If a facility has two successive audits in which 
148.11 	the percentage of change is five percent or less and the facility has not been the subject of 
148.12 	a special audit in the past 36 months, the facility may be audited biannually. A stratified 
148.13 	sample of 15 percent, with a minimum of ten assessments, of the most current assessments 
148.14 	shall be selected for audit. If more than 20 percent of the RUG-IV case mix reimbursement
148.15 	classifications are changed as a result of the audit, the audit shall be expanded to a second 
148.16 	15 percent sample, with a minimum of ten assessments. If the total change between the first 
148.17 	and second samples is 35 percent or greater, the commissioner may expand the audit to all 
148.18 	of the remaining assessments.
148.19 	(2) If a facility qualifies for an expanded audit, the commissioner may audit the facility 
148.20 	again within six months. If a facility has two expanded audits within a 24-month period, 
148.21 	that facility will be audited at least every six months for the next 18 months.
148.22 	(3) The commissioner may conduct special audits if the commissioner determines that 
148.23 	circumstances exist that could alter or affect the validity of case mix reimbursement
148.24 	classifications of residents. These circumstances include, but are not limited to, the following:
148.25 	(i) frequent changes in the administration or management of the facility;
148.26 	(ii) an unusually high percentage of residents in a specific case mix reimbursement
148.27 	classification;
148.28 	(iii) a high frequency in the number of reconsideration requests received from a facility;
148.29 	(iv) frequent adjustments of case mix reimbursement classifications as the result of 
148.30 	reconsiderations or audits;
148.31 	(v) a criminal indictment alleging provider fraud;
148.32 	(vi) other similar factors that relate to a facility's ability to conduct accurate assessments;
149.1 	(vii) an atypical pattern of scoring minimum data set items;
149.2 	(viii) nonsubmission of assessments;
149.3 	(ix) late submission of assessments; or
149.4 	(x) a previous history of audit changes of 35 percent or greater.
149.5 	(f) If the audit results in a case mix reimbursement classification change, the 
149.6 	commissioner must transmit the audit classification notice by electronic means to the nursing 
149.7 	facility within 15 business days of completing an audit. The nursing facility is responsible 
149.8 	for distribution of the notice to each resident or the resident's representative. This notice 
149.9 	must be distributed by the nursing facility within three business days after receipt. The 
149.10 	notice must inform the resident of the case mix reimbursement classification assigned, the 
149.11 	opportunity to review the documentation supporting the classification, the opportunity to 
149.12 	obtain clarification from the commissioner, the opportunity to request a reconsideration of 
149.13 	the classification, and the address and telephone number of the Office of Ombudsman for 
149.14 	Long-Term Care.

149.15 	Sec. 16. Minnesota Statutes 2022, section 144.0724, subdivision 11, is amended to read:
149.16 		Subd. 11.Nursing facility level of care. (a) For purposes of medical assistance payment 
149.17 	of long-term care services, a recipient must be determined, using assessments defined in 
149.18 	subdivision 4, to meet one of the following nursing facility level of care criteria:
149.19 	(1) the person requires formal clinical monitoring at least once per day;
149.20 	(2) the person needs the assistance of another person or constant supervision to begin 
149.21 	and complete at least four of the following activities of living: bathing, bed mobility, dressing, 
149.22 	eating, grooming, toileting, transferring, and walking;
149.23 	(3) the person needs the assistance of another person or constant supervision to begin 
149.24 	and complete toileting, transferring, or positioning and the assistance cannot be scheduled;
149.25 	(4) the person has significant difficulty with memory, using information, daily decision 
149.26 	making, or behavioral needs that require intervention;
149.27 	(5) the person has had a qualifying nursing facility stay of at least 90 days;
149.28 	(6) the person meets the nursing facility level of care criteria determined 90 days after 
149.29 	admission or on the first quarterly assessment after admission, whichever is later; or
149.30 	(7) the person is determined to be at risk for nursing facility admission or readmission 
149.31 	through a face-to-face long-term care consultation assessment as specified in section 
150.1 	256B.0911, subdivision 17 to 21, 23, 24, 27, or 28, by a county, tribe, or managed care 
150.2 	organization under contract with the Department of Human Services. The person is 
150.3 	considered at risk under this clause if the person currently lives alone or will live alone or 
150.4 	be homeless without the person's current housing and also meets one of the following criteria:
150.5 	(i) the person has experienced a fall resulting in a fracture;
150.6 	(ii) the person has been determined to be at risk of maltreatment or neglect, including 
150.7 	self-neglect; or
150.8 	(iii) the person has a sensory impairment that substantially impacts functional ability 
150.9 	and maintenance of a community residence.
150.10 	(b) The assessment used to establish medical assistance payment for nursing facility 
150.11 	services must be the most recent assessment performed under subdivision 4, paragraph
150.12 	paragraphs (b) and (c), that occurred no more than 90 calendar days before the effective 
150.13 	date of medical assistance eligibility for payment of long-term care services. In no case 
150.14 	shall medical assistance payment for long-term care services occur prior to the date of the 
150.15 	determination of nursing facility level of care.
150.16 	(c) The assessment used to establish medical assistance payment for long-term care 
150.17 	services provided under chapter 256S and section 256B.49 and alternative care payment 
150.18 	for services provided under section 256B.0913 must be the most recent face-to-face 
150.19 	assessment performed under section 256B.0911, subdivisions 17 to 21, 23, 24, 27, or 28, 
150.20 	that occurred no more than 60 calendar days before the effective date of medical assistance 
150.21 	eligibility for payment of long-term care services.

150.22 	Sec. 17. Minnesota Statutes 2022, section 144.1464, subdivision 1, is amended to read:
150.23 		Subdivision 1.Summer internships. The commissioner of health, through a contract 
150.24 	with a nonprofit organization as required by subdivision 4, shall award grants, within 
150.25 	available appropriations, to hospitals, clinics, nursing facilities, assisted living facilities, 
150.26 	and home care providers to establish a secondary and postsecondary summer health care 
150.27 	intern program. The purpose of the program is to expose interested secondary and 
150.28 	postsecondary pupils to various careers within the health care profession.

150.29 	Sec. 18. Minnesota Statutes 2022, section 144.1464, subdivision 2, is amended to read:
150.30 		Subd. 2.Criteria. (a) The commissioner, through the organization under contract, shall 
150.31 	award grants to hospitals, clinics, nursing facilities, assisted living facilities, and home care 
150.32 	providers that agree to:
151.1 	(1) provide secondary and postsecondary summer health care interns with formal exposure 
151.2 	to the health care profession;
151.3 	(2) provide an orientation for the secondary and postsecondary summer health care 
151.4 	interns;
151.5 	(3) pay one-half the costs of employing the secondary and postsecondary summer health 
151.6 	care intern;
151.7 	(4) interview and hire secondary and postsecondary pupils for a minimum of six weeks 
151.8 	and a maximum of 12 weeks; and
151.9 	(5) employ at least one secondary student for each postsecondary student employed, to 
151.10 	the extent that there are sufficient qualifying secondary student applicants.
151.11 	(b) In order to be eligible to be hired as a secondary summer health intern by a hospital, 
151.12 	clinic, nursing facility, assisted living facility, or home care provider, a pupil must:
151.13 	(1) intend to complete high school graduation requirements and be between the junior 
151.14 	and senior year of high school; and
151.15 	(2) be from a school district in proximity to the facility.
151.16 	(c) In order to be eligible to be hired as a postsecondary summer health care intern by 
151.17 	a hospital or clinic, a pupil must:
151.18 	(1) intend to complete a health care training program or a two-year or four-year degree 
151.19 	program and be planning on enrolling in or be enrolled in that training program or degree 
151.20 	program; and
151.21 	(2) be enrolled in a Minnesota educational institution or be a resident of the state of 
151.22 	Minnesota; priority must be given to applicants from a school district or an educational 
151.23 	institution in proximity to the facility.
151.24 	(d) Hospitals, clinics, nursing facilities, assisted living facilities, and home care providers 
151.25 	awarded grants may employ pupils as secondary and postsecondary summer health care 
151.26 	interns beginning on or after June 15, 1993, if they agree to pay the intern, during the period 
151.27 	before disbursement of state grant money, with money designated as the facility's 50 percent 
151.28 	contribution towards internship costs.

151.29 	Sec. 19. Minnesota Statutes 2022, section 144.1464, subdivision 3, is amended to read:
151.30 		Subd. 3.Grants. The commissioner, through the organization under contract, shall 
151.31 	award separate grants to hospitals, clinics, nursing facilities, assisted living facilities, and 
152.1 	home care providers meeting the requirements of subdivision 2. The grants must be used 
152.2 	to pay one-half of the costs of employing secondary and postsecondary pupils in a hospital, 
152.3 	clinic, nursing facility, assisted living facility, or home care setting during the course of the 
152.4 	program. No more than 50 percent of the participants may be postsecondary students, unless 
152.5 	the program does not receive enough qualified secondary applicants per fiscal year. No 
152.6 	more than five pupils may be selected from any secondary or postsecondary institution to 
152.7 	participate in the program and no more than one-half of the number of pupils selected may 
152.8 	be from the seven-county metropolitan area.

152.9 	Sec. 20. Minnesota Statutes 2023 Supplement, section 144.1505, subdivision 2, is amended 
152.10 	to read:
152.11 		Subd. 2.Programs. (a) For advanced practice provider clinical training expansion grants, 
152.12 	the commissioner of health shall award health professional training site grants to eligible 
152.13 	physician assistant, advanced practice registered nurse, pharmacy, dental therapy, and mental 
152.14 	health professional programs to plan and implement expanded clinical training. A planning 
152.15 	grant shall not exceed $75,000, and a three-year training grant shall not exceed $150,000 
152.16 	for the first year, $100,000 for the second year, and $50,000 for the third year $300,000 per 
152.17 	program project. The commissioner may provide a one-year, no-cost extension for grants.
152.18 	(b) For health professional rural and underserved clinical rotations grants, the 
152.19 	commissioner of health shall award health professional training site grants to eligible 
152.20 	physician, physician assistant, advanced practice registered nurse, pharmacy, dentistry, 
152.21 	dental therapy, and mental health professional programs to augment existing clinical training 
152.22 	programs to add rural and underserved rotations or clinical training experiences, such as 
152.23 	credential or certificate rural tracks or other specialized training. For physician and dentist 
152.24 	training, the expanded training must include rotations in primary care settings such as 
152.25 	community clinics, hospitals, health maintenance organizations, or practices in rural 
152.26 	communities.
152.27 	(c) Funds may be used for:
152.28 	(1) establishing or expanding rotations and clinical training;
152.29 	(2) recruitment, training, and retention of students and faculty;
152.30 	(3) connecting students with appropriate clinical training sites, internships, practicums, 
152.31 	or externship activities;
152.32 	(4) travel and lodging for students;
152.33 	(5) faculty, student, and preceptor salaries, incentives, or other financial support;
153.1 	(6) development and implementation of cultural competency training;
153.2 	(7) evaluations;
153.3 	(8) training site improvements, fees, equipment, and supplies required to establish, 
153.4 	maintain, or expand a training program; and
153.5 	(9) supporting clinical education in which trainees are part of a primary care team model.

153.6 	Sec. 21. Minnesota Statutes 2022, section 144.1911, subdivision 2, is amended to read:
153.7 		Subd. 2.Definitions. (a) For the purposes of this section, the following terms have the 
153.8 	meanings given.
153.9 	(b) "Commissioner" means the commissioner of health.
153.10 	(c) "Immigrant international medical graduate" means an international medical graduate 
153.11 	who was born outside the United States, now resides permanently in the United States or 
153.12 	who has entered the United States on a temporary status based on urgent humanitarian or 
153.13 	significant public benefit reasons, and who did not enter the United States on a J1 or similar 
153.14 	nonimmigrant visa following acceptance into a United States medical residency or fellowship 
153.15 	program.
153.16 	(d) "International medical graduate" means a physician who received a basic medical 
153.17 	degree or qualification from a medical school located outside the United States and Canada.
153.18 	(e) "Minnesota immigrant international medical graduate" means an immigrant 
153.19 	international medical graduate who has lived in Minnesota for at least two years.
153.20 	(f) "Rural community" means a statutory and home rule charter city or township that is 
153.21 	outside the seven-county metropolitan area as defined in section 473.121, subdivision 2, 
153.22 	excluding the cities of Duluth, Mankato, Moorhead, Rochester, and St. Cloud.
153.23 	(g) "Underserved community" means a Minnesota area or population included in the 
153.24 	list of designated primary medical care health professional shortage areas, medically 
153.25 	underserved areas, or medically underserved populations (MUPs) maintained and updated 
153.26 	by the United States Department of Health and Human Services.

153.27 	Sec. 22. Minnesota Statutes 2022, section 144.212, is amended by adding a subdivision 
153.28 	to read:
153.29 		Subd. 5a.Replacement. "Replacement" means a completion, addition, removal, or 
153.30 	change made to certification items on a vital record after a vital event is registered and a 
154.1 	record is established that has no notation of a change on a certificate and seals the prior vital 
154.2 	record.

154.3 	Sec. 23. Minnesota Statutes 2022, section 144.216, subdivision 2, is amended to read:
154.4 		Subd. 2.Status of foundling reports. A report registered under subdivision 1 shall 
154.5 	constitute the record of birth for the child. Information about the newborn shall be registered 
154.6 	by the state registrar in accordance with Minnesota Rules, part 4601.0600, subpart 4, item 
154.7 	C. If the child is identified and a record of birth is found or obtained, the report registered 
154.8 	under subdivision 1 shall be confidential pursuant to section 13.02, subdivision 3, and shall 
154.9 	not be disclosed except pursuant to court order.

154.10 	Sec. 24. Minnesota Statutes 2022, section 144.216, is amended by adding a subdivision 
154.11 	to read:
154.12 		Subd. 3.Reporting safe place newborns. Hospitals that receive a newborn under section 
154.13 	145.902 shall report the birth of the newborn to the Office of Vital Records within five days 
154.14 	after receiving the newborn. Information about the newborn shall be registered by the state 
154.15 	registrar in accordance with Minnesota Rules, part 4601.0600, subpart 4, item C.

154.16 	Sec. 25. Minnesota Statutes 2022, section 144.216, is amended by adding a subdivision 
154.17 	to read:
154.18 		Subd. 4.Status of safe place birth reports and registrations. (a) Information about a 
154.19 	safe place newborn registered under subdivision 3 shall constitute the record of birth for 
154.20 	the child. The record shall be confidential pursuant to section 13.02, subdivision 3. 
154.21 	Information on the birth record or a birth certificate issued from the birth record shall be 
154.22 	disclosed only to the responsible social services agency or pursuant to a court order.
154.23 	(b) Information about a safe place newborn registered under subdivision 3 shall constitute 
154.24 	the record of birth for the child. If the safe place newborn was born in a hospital and it is 
154.25 	known that a record of birth was registered, filed, or amended, the original birth record 
154.26 	registered under section 144.215 shall be replaced pursuant to section 144.218, subdivision 
154.27 	6.

154.28 	Sec. 26. Minnesota Statutes 2022, section 144.218, is amended by adding a subdivision 
154.29 	to read:
154.30 		Subd. 6.Safe place newborn; birth record. If a safe place infant birth is registered 
154.31 	pursuant to section 144.216, subdivision 4, paragraph (b), the state registrar shall issue a 
155.1 	replacement birth record free of information that identifies a parent. The prior vital record 
155.2 	shall be confidential pursuant to section 13.02, subdivision 3, and shall not be disclosed 
155.3 	except pursuant to a court order.

155.4 	Sec. 27. Minnesota Statutes 2022, section 144.493, is amended by adding a subdivision 
155.5 	to read:
155.6 		Subd. 2a.Thrombectomy-capable stroke center. A hospital meets the criteria for a 
155.7 	thrombectomy-capable stroke center if the hospital has been certified as a 
155.8 	thrombectomy-capable stroke center by the joint commission or another nationally recognized 
155.9 	accreditation entity, or is a primary stroke center that is not certified as a thrombectomy-based 
155.10 	capable stroke center but the hospital has attained a level of stroke care distinction by offering 
155.11 	mechanical endovascular therapies and has been certified by a department approved certifying 
155.12 	body that is a nationally recognized guidelines-based organization.

155.13 	Sec. 28. Minnesota Statutes 2022, section 144.494, subdivision 2, is amended to read:
155.14 		Subd. 2.Designation. A hospital that voluntarily meets the criteria for a comprehensive 
155.15 	stroke center, thrombectomy-capable stroke center, primary stroke center, or acute stroke 
155.16 	ready hospital may apply to the commissioner for designation, and upon the commissioner's 
155.17 	review and approval of the application, shall be designated as a comprehensive stroke center, 
155.18 	a thrombectomy-capable stroke center, a primary stroke center, or an acute stroke ready 
155.19 	hospital for a three-year period. If a hospital loses its certification as a comprehensive stroke 
155.20 	center or primary stroke center from the joint commission or other nationally recognized 
155.21 	accreditation entity, or no longer participates in the Minnesota stroke registry program, its 
155.22 	Minnesota designation shall be immediately withdrawn. Prior to the expiration of the 
155.23 	three-year designation period, a hospital seeking to remain part of the voluntary acute stroke 
155.24 	system may reapply to the commissioner for designation.

155.25 	Sec. 29. Minnesota Statutes 2022, section 144.551, subdivision 1, is amended to read:
155.26 		Subdivision 1.Restricted construction or modification. (a) The following construction 
155.27 	or modification may not be commenced:
155.28 	(1) any erection, building, alteration, reconstruction, modernization, improvement, 
155.29 	extension, lease, or other acquisition by or on behalf of a hospital that increases the bed 
155.30 	capacity of a hospital, relocates hospital beds from one physical facility, complex, or site 
155.31 	to another, or otherwise results in an increase or redistribution of hospital beds within the 
155.32 	state; and
156.1 	(2) the establishment of a new hospital.
156.2 	(b) This section does not apply to:
156.3 	(1) construction or relocation within a county by a hospital, clinic, or other health care 
156.4 	facility that is a national referral center engaged in substantial programs of patient care, 
156.5 	medical research, and medical education meeting state and national needs that receives more 
156.6 	than 40 percent of its patients from outside the state of Minnesota;
156.7 	(2) a project for construction or modification for which a health care facility held an 
156.8 	approved certificate of need on May 1, 1984, regardless of the date of expiration of the 
156.9 	certificate;
156.10 	(3) a project for which a certificate of need was denied before July 1, 1990, if a timely 
156.11 	appeal results in an order reversing the denial;
156.12 	(4) a project exempted from certificate of need requirements by Laws 1981, chapter 200, 
156.13 	section 2;
156.14 	(5) a project involving consolidation of pediatric specialty hospital services within the 
156.15 	Minneapolis-St. Paul metropolitan area that would not result in a net increase in the number 
156.16 	of pediatric specialty hospital beds among the hospitals being consolidated;
156.17 	(6) a project involving the temporary relocation of pediatric-orthopedic hospital beds to 
156.18 	an existing licensed hospital that will allow for the reconstruction of a new philanthropic, 
156.19 	pediatric-orthopedic hospital on an existing site and that will not result in a net increase in 
156.20 	the number of hospital beds. Upon completion of the reconstruction, the licenses of both 
156.21 	hospitals must be reinstated at the capacity that existed on each site before the relocation;
156.22 	(7) the relocation or redistribution of hospital beds within a hospital building or 
156.23 	identifiable complex of buildings provided the relocation or redistribution does not result 
156.24 	in: (i) an increase in the overall bed capacity at that site; (ii) relocation of hospital beds from 
156.25 	one physical site or complex to another; or (iii) redistribution of hospital beds within the 
156.26 	state or a region of the state;
156.27 	(8) relocation or redistribution of hospital beds within a hospital corporate system that 
156.28 	involves the transfer of beds from a closed facility site or complex to an existing site or 
156.29 	complex provided that: (i) no more than 50 percent of the capacity of the closed facility is 
156.30 	transferred; (ii) the capacity of the site or complex to which the beds are transferred does 
156.31 	not increase by more than 50 percent; (iii) the beds are not transferred outside of a federal 
156.32 	health systems agency boundary in place on July 1, 1983; (iv) the relocation or redistribution 
156.33 	does not involve the construction of a new hospital building; and (v) the transferred beds 
157.1 	are used first to replace within the hospital corporate system the total number of beds 
157.2 	previously used in the closed facility site or complex for mental health services and substance 
157.3 	use disorder services. Only after the hospital corporate system has fulfilled the requirements 
157.4 	of this item may the remainder of the available capacity of the closed facility site or complex 
157.5 	be transferred for any other purpose;
157.6 	(9) a construction project involving up to 35 new beds in a psychiatric hospital in Rice 
157.7 	County that primarily serves adolescents and that receives more than 70 percent of its 
157.8 	patients from outside the state of Minnesota;
157.9 	(10) a project to replace a hospital or hospitals with a combined licensed capacity of 
157.10 	130 beds or less if: (i) the new hospital site is located within five miles of the current site; 
157.11 	and (ii) the total licensed capacity of the replacement hospital, either at the time of 
157.12 	construction of the initial building or as the result of future expansion, will not exceed 70
157.13 	100 licensed hospital beds, or the combined licensed capacity of the hospitals, whichever 
157.14 	is less;
157.15 	(11) the relocation of licensed hospital beds from an existing state facility operated by 
157.16 	the commissioner of human services to a new or existing facility, building, or complex 
157.17 	operated by the commissioner of human services; from one regional treatment center site 
157.18 	to another; or from one building or site to a new or existing building or site on the same 
157.19 	campus;
157.20 	(12) the construction or relocation of hospital beds operated by a hospital having a 
157.21 	statutory obligation to provide hospital and medical services for the indigent that does not 
157.22 	result in a net increase in the number of hospital beds, notwithstanding section 144.552, 27 
157.23 	beds, of which 12 serve mental health needs, may be transferred from Hennepin County 
157.24 	Medical Center to Regions Hospital under this clause;
157.25 	(13) a construction project involving the addition of up to 31 new beds in an existing 
157.26 	nonfederal hospital in Beltrami County;
157.27 	(14) a construction project involving the addition of up to eight new beds in an existing 
157.28 	nonfederal hospital in Otter Tail County with 100 licensed acute care beds;
157.29 	(15) a construction project involving the addition of 20 new hospital beds in an existing 
157.30 	hospital in Carver County serving the southwest suburban metropolitan area;
157.31 	(16) a project for the construction or relocation of up to 20 hospital beds for the operation 
157.32 	of up to two psychiatric facilities or units for children provided that the operation of the 
157.33 	facilities or units have received the approval of the commissioner of human services;
158.1 	(17) a project involving the addition of 14 new hospital beds to be used for rehabilitation 
158.2 	services in an existing hospital in Itasca County;
158.3 	(18) a project to add 20 licensed beds in existing space at a hospital in Hennepin County 
158.4 	that closed 20 rehabilitation beds in 2002, provided that the beds are used only for 
158.5 	rehabilitation in the hospital's current rehabilitation building. If the beds are used for another 
158.6 	purpose or moved to another location, the hospital's licensed capacity is reduced by 20 beds;
158.7 	(19) a critical access hospital established under section 144.1483, clause (9), and section 
158.8 	1820 of the federal Social Security Act, United States Code, title 42, section 1395i-4, that 
158.9 	delicensed beds since enactment of the Balanced Budget Act of 1997, Public Law 105-33, 
158.10 	to the extent that the critical access hospital does not seek to exceed the maximum number 
158.11 	of beds permitted such hospital under federal law;
158.12 	(20) notwithstanding section 144.552, a project for the construction of a new hospital 
158.13 	in the city of Maple Grove with a licensed capacity of up to 300 beds provided that:
158.14 	(i) the project, including each hospital or health system that will own or control the entity 
158.15 	that will hold the new hospital license, is approved by a resolution of the Maple Grove City 
158.16 	Council as of March 1, 2006;
158.17 	(ii) the entity that will hold the new hospital license will be owned or controlled by one 
158.18 	or more not-for-profit hospitals or health systems that have previously submitted a plan or 
158.19 	plans for a project in Maple Grove as required under section 144.552, and the plan or plans 
158.20 	have been found to be in the public interest by the commissioner of health as of April 1, 
158.21 	2005;
158.22 	(iii) the new hospital's initial inpatient services must include, but are not limited to, 
158.23 	medical and surgical services, obstetrical and gynecological services, intensive care services, 
158.24 	orthopedic services, pediatric services, noninvasive cardiac diagnostics, behavioral health 
158.25 	services, and emergency room services;
158.26 	(iv) the new hospital:
158.27 	(A) will have the ability to provide and staff sufficient new beds to meet the growing 
158.28 	needs of the Maple Grove service area and the surrounding communities currently being 
158.29 	served by the hospital or health system that will own or control the entity that will hold the 
158.30 	new hospital license;
158.31 	(B) will provide uncompensated care;
158.32 	(C) will provide mental health services, including inpatient beds;
159.1 	(D) will be a site for workforce development for a broad spectrum of health-care-related 
159.2 	occupations and have a commitment to providing clinical training programs for physicians 
159.3 	and other health care providers;
159.4 	(E) will demonstrate a commitment to quality care and patient safety;
159.5 	(F) will have an electronic medical records system, including physician order entry;
159.6 	(G) will provide a broad range of senior services;
159.7 	(H) will provide emergency medical services that will coordinate care with regional 
159.8 	providers of trauma services and licensed emergency ambulance services in order to enhance 
159.9 	the continuity of care for emergency medical patients; and
159.10 	(I) will be completed by December 31, 2009, unless delayed by circumstances beyond 
159.11 	the control of the entity holding the new hospital license; and
159.12 	(v) as of 30 days following submission of a written plan, the commissioner of health 
159.13 	has not determined that the hospitals or health systems that will own or control the entity 
159.14 	that will hold the new hospital license are unable to meet the criteria of this clause;
159.15 	(21) a project approved under section 144.553;
159.16 	(22) a project for the construction of a hospital with up to 25 beds in Cass County within 
159.17 	a 20-mile radius of the state Ah-Gwah-Ching facility, provided the hospital's license holder 
159.18 	is approved by the Cass County Board;
159.19 	(23) a project for an acute care hospital in Fergus Falls that will increase the bed capacity 
159.20 	from 108 to 110 beds by increasing the rehabilitation bed capacity from 14 to 16 and closing 
159.21 	a separately licensed 13-bed skilled nursing facility;
159.22 	(24) notwithstanding section 144.552, a project for the construction and expansion of a 
159.23 	specialty psychiatric hospital in Hennepin County for up to 50 beds, exclusively for patients 
159.24 	who are under 21 years of age on the date of admission. The commissioner conducted a 
159.25 	public interest review of the mental health needs of Minnesota and the Twin Cities 
159.26 	metropolitan area in 2008. No further public interest review shall be conducted for the 
159.27 	construction or expansion project under this clause;
159.28 	(25) a project for a 16-bed psychiatric hospital in the city of Thief River Falls, if the 
159.29 	commissioner finds the project is in the public interest after the public interest review 
159.30 	conducted under section 144.552 is complete;
159.31 	(26)(i) a project for a 20-bed psychiatric hospital, within an existing facility in the city 
159.32 	of Maple Grove, exclusively for patients who are under 21 years of age on the date of 
160.1 	admission, if the commissioner finds the project is in the public interest after the public 
160.2 	interest review conducted under section 144.552 is complete;
160.3 	(ii) this project shall serve patients in the continuing care benefit program under section 
160.4 	256.9693. The project may also serve patients not in the continuing care benefit program; 
160.5 	and
160.6 	(iii) if the project ceases to participate in the continuing care benefit program, the 
160.7 	commissioner must complete a subsequent public interest review under section 144.552. If 
160.8 	the project is found not to be in the public interest, the license must be terminated six months 
160.9 	from the date of that finding. If the commissioner of human services terminates the contract 
160.10 	without cause or reduces per diem payment rates for patients under the continuing care 
160.11 	benefit program below the rates in effect for services provided on December 31, 2015, the 
160.12 	project may cease to participate in the continuing care benefit program and continue to 
160.13 	operate without a subsequent public interest review;
160.14 	(27) a project involving the addition of 21 new beds in an existing psychiatric hospital 
160.15 	in Hennepin County that is exclusively for patients who are under 21 years of age on the 
160.16 	date of admission;
160.17 	(28) a project to add 55 licensed beds in an existing safety net, level I trauma center 
160.18 	hospital in Ramsey County as designated under section 383A.91, subdivision 5, of which 
160.19 	15 beds are to be used for inpatient mental health and 40 are to be used for other services. 
160.20 	In addition, five unlicensed observation mental health beds shall be added;
160.21 	(29) upon submission of a plan to the commissioner for public interest review under 
160.22 	section 144.552 and the addition of the 15 inpatient mental health beds specified in clause 
160.23 	(28), to its bed capacity, a project to add 45 licensed beds in an existing safety net, level I 
160.24 	trauma center hospital in Ramsey County as designated under section 383A.91, subdivision 
160.25 	5. Five of the 45 additional beds authorized under this clause must be designated for use 
160.26 	for inpatient mental health and must be added to the hospital's bed capacity before the 
160.27 	remaining 40 beds are added. Notwithstanding section 144.552, the hospital may add licensed 
160.28 	beds under this clause prior to completion of the public interest review, provided the hospital 
160.29 	submits its plan by the 2021 deadline and adheres to the timelines for the public interest 
160.30 	review described in section 144.552;
160.31 	(30) upon submission of a plan to the commissioner for public interest review under 
160.32 	section 144.552, a project to add up to 30 licensed beds in an existing psychiatric hospital 
160.33 	in Hennepin County that exclusively provides care to patients who are under 21 years of 
160.34 	age on the date of admission. Notwithstanding section 144.552, the psychiatric hospital 
161.1 	may add licensed beds under this clause prior to completion of the public interest review, 
161.2 	provided the hospital submits its plan by the 2021 deadline and adheres to the timelines for 
161.3 	the public interest review described in section 144.552;
161.4 	(31) any project to add licensed beds in a hospital located in Cook County or Mahnomen 
161.5 	County that: (i) is designated as a critical access hospital under section 144.1483, clause 
161.6 	(9), and United States Code, title 42, section 1395i-4; (ii) has a licensed bed capacity of 
161.7 	fewer than 25 beds; and (iii) has an attached nursing home, so long as the total number of 
161.8 	licensed beds in the hospital after the bed addition does not exceed 25 beds. Notwithstanding 
161.9 	section 144.552, a public interest review is not required for a project authorized under this 
161.10 	clause;
161.11 	(32) upon submission of a plan to the commissioner for public interest review under 
161.12 	section 144.552, a project to add 22 licensed beds at a Minnesota freestanding children's 
161.13 	hospital in St. Paul that is part of an independent pediatric health system with freestanding 
161.14 	inpatient hospitals located in Minneapolis and St. Paul. The beds shall be utilized for pediatric 
161.15 	inpatient behavioral health services. Notwithstanding section 144.552, the hospital may add 
161.16 	licensed beds under this clause prior to completion of the public interest review, provided 
161.17 	the hospital submits its plan by the 2022 deadline and adheres to the timelines for the public 
161.18 	interest review described in section 144.552; or
161.19 	(33) a project for a 144-bed psychiatric hospital on the site of the former Bethesda 
161.20 	hospital in the city of Saint Paul, Ramsey County, if the commissioner finds the project is 
161.21 	in the public interest after the public interest review conducted under section 144.552 is 
161.22 	complete. Following the completion of the construction project, the commissioner of health 
161.23 	shall monitor the hospital, including by assessing the hospital's case mix and payer mix, 
161.24 	patient transfers, and patient diversions. The hospital must have an intake and assessment 
161.25 	area. The hospital must accommodate patients with acute mental health needs, whether they 
161.26 	walk up to the facility, are delivered by ambulances or law enforcement, or are transferred 
161.27 	from other facilities. The hospital must comply with subdivision 1a, paragraph (b). The 
161.28 	hospital must annually submit de-identified data to the department in the format and manner 
161.29 	defined by the commissioner.; or
161.30 	(34) a project involving the relocation of up to 26 licensed long-term acute care hospital 
161.31 	beds from an existing long-term care hospital located in Hennepin County with a licensed 
161.32 	capacity prior to the relocation of 92 beds to dedicated space on the campus of an existing 
161.33 	safety net, level I trauma center hospital in Ramsey County as designated under section 
161.34 	383A.91, subdivision 5, provided both the commissioner finds the project is in the public 
161.35 	interest after the public interest review conducted under section 144.552 is complete and 
162.1 	the relocated beds continue to be used as long-term acute care hospital beds after the 
162.2 	relocation.

162.3 	Sec. 30. Minnesota Statutes 2022, section 144.605, is amended by adding a subdivision 
162.4 	to read:
162.5 		Subd. 10.Chapter 16C waiver. Pursuant to subdivisions 4, paragraph (b), and 5, 
162.6 	paragraph (b), the commissioner of administration may waive provisions of chapter 16C 
162.7 	for the purposes of approving contracts for independent clinical teams.

162.8 	Sec. 31. Minnesota Statutes 2023 Supplement, section 144.651, subdivision 10a, is amended 
162.9 	to read:
162.10 		Subd. 10a.Designated support person for pregnant patient or other patient. (a) 
162.11 	Subject to paragraph (c), a health care provider and a health care facility must allow, at a 
162.12 	minimum, one designated support person of a pregnant patient's choosing chosen by a 
162.13 	patient, including but not limited to a pregnant patient, to be physically present while the 
162.14 	patient is receiving health care services including during a hospital stay.
162.15 	(b) For purposes of this subdivision, "designated support person" means any person 
162.16 	chosen by the patient to provide comfort to the patient including but not limited to the 
162.17 	patient's spouse, partner, family member, or another person related by affinity. Certified 
162.18 	doulas and traditional midwives may not be counted toward the limit of one designated 
162.19 	support person.
162.20 	(c) A facility may restrict or prohibit the presence of a designated support person in 
162.21 	treatment rooms, procedure rooms, and operating rooms when such a restriction or prohibition 
162.22 	is strictly necessary to meet the appropriate standard of care. A facility may also restrict or 
162.23 	prohibit the presence of a designated support person if the designated support person is 
162.24 	acting in a violent or threatening manner toward others. Any restriction or prohibition of a 
162.25 	designated support person by the facility is subject to the facility's written internal grievance 
162.26 	procedure required by subdivision 20.

162.27 	Sec. 32. [144.6985] COMMUNITY HEALTH NEEDS ASSESSMENT; COMMUNITY 
162.28 	HEALTH IMPROVEMENT SERVICES; IMPLEMENTATION.
162.29 		Subdivision 1.Community health needs assessment. A nonprofit hospital that is exempt 
162.30 	from taxation under section 501(c)(3) of the Internal Revenue Code must make available 
162.31 	to the public and submit to the commissioner of health, by January 15, 2026, the most recent 
162.32 	community health needs assessment submitted by the hospital to the Internal Revenue 
163.1 	Service. Each time the hospital conducts a subsequent community health needs assessment, 
163.2 	the hospital must, within 15 business days after submitting the subsequent community health 
163.3 	needs assessment to the Internal Revenue Service, make the subsequent assessment available 
163.4 	to the public and submit the subsequent assessment to the commissioner.
163.5 		Subd. 2.Description of community. A nonprofit hospital subject to subdivision 1 must 
163.6 	make available to the public and submit to the commissioner of health a description of the 
163.7 	community served by the hospital. The description must include a geographic description 
163.8 	of the area where the hospital is located, a description of the general population served by 
163.9 	the hospital, and demographic information about the community served by the hospital, 
163.10 	such as leading causes of death, levels of chronic illness, and descriptions of the medically 
163.11 	underserved, low-income, minority, or chronically ill populations in the community. A 
163.12 	hospital is not required to separately make the information available to the public or 
163.13 	separately submit the information to the commissioner if the information is included in the 
163.14 	hospital's community health needs assessment made available and submitted under 
163.15 	subdivision 1.
163.16 		Subd. 3.Addendum; community health improvement services. (a) A nonprofit hospital 
163.17 	subject to subdivision 1 must annually submit to the commissioner an addendum which 
163.18 	details information about hospital activities identified as community health improvement 
163.19 	services with a cost of $5,000 or more. The addendum must include the type of activity, the 
163.20 	method through which the activity was delivered, how the activity relates to an identified 
163.21 	community need in the community health needs assessment, the target population for the 
163.22 	activity, strategies to reach the target population, identified outcome metrics, the cost to the 
163.23 	hospital to provide the activity, the methodology used to calculate the hospital's costs, and 
163.24 	the number of people served by the activity. If a community health improvement service is 
163.25 	administered by an entity other than the hospital, the administering entity must be identified 
163.26 	in the addendum. This paragraph does not apply to hospitals required to submit an addendum 
163.27 	under paragraph (b).
163.28 	(b) A nonprofit hospital subject to subdivision 1 must annually submit to the 
163.29 	commissioner an addendum which details information about the ten highest-cost activities 
163.30 	of the hospital identified as community health improvement services if the nonprofit hospital:
163.31 	(1) is designated as a critical access hospital under section 144.1483, clause (9), and 
163.32 	United States Code, title 42, section 1395i-4;
163.33 	(2) meets the definition of sole community hospital in section 62Q.19, subdivision 1, 
163.34 	paragraph (a), clause (5); or
164.1 	(3) meets the definition of rural emergency hospital in United States Code, title 42, 
164.2 	section 1395x(kkk)(2).
164.3 	The addendum must include the type of activity, the method in which the activity was 
164.4 	delivered, how the activity relates to an identified community need in the community health 
164.5 	needs assessment, the target population for the activity, strategies to reach the target 
164.6 	population, identified outcome metrics, the cost to the hospital to provide the activity, the 
164.7 	methodology used to calculate the hospital's costs, and the number of people served by the 
164.8 	activity. If a community health improvement service is administered by an entity other than 
164.9 	the hospital, the administering entity must be identified in the addendum.
164.10 		Subd. 4.Community benefit implementation strategy. A nonprofit hospital subject 
164.11 	to subdivision 1 must make available to the public, within one year after completing each 
164.12 	community health needs assessment, a community benefit implementation strategy. In 
164.13 	developing the community benefit implementation strategy, the hospital must consult with 
164.14 	community-based organizations, stakeholders, local public health organizations, and others 
164.15 	as determined by the hospital. The implementation strategy must include how the hospital 
164.16 	shall address the top three community health priorities identified in the community health 
164.17 	needs assessment. Implementation strategies must be evidence-based, when available, and 
164.18 	development and implementation of innovative programs and strategies may be supported 
164.19 	by evaluation measures.
164.20 		Subd. 5.Information made available to the public. A nonprofit hospital required to 
164.21 	make information available to the public under this section may do so by posting the 
164.22 	information on the hospital's website in a consolidated location and with clear labeling.
164.23 	This section is effective January 1, 2026.

164.24 	Sec. 33. Minnesota Statutes 2022, section 144.7067, subdivision 2, is amended to read:
164.25 		Subd. 2.Duty to analyze reports; communicate findings. (a) The commissioner shall:
164.26 	(1) analyze adverse event reports, corrective action plans, and findings of the root cause 
164.27 	analyses to determine patterns of systemic failure in the health care system and successful 
164.28 	methods to correct these failures;
164.29 	(2) communicate to individual facilities the commissioner's conclusions, if any, regarding 
164.30 	an adverse event reported by the facility;
164.31 	(3) communicate with relevant health care facilities any recommendations for corrective 
164.32 	action resulting from the commissioner's analysis of submissions from facilities; and
165.1 	(4) publish an annual report:
165.2 	(i) describing, by institution, adverse events reported;
165.3 	(ii) outlining, in aggregate, corrective action plans and the findings of root cause analyses; 
165.4 	and
165.5 	(iii) making recommendations for modifications of state health care operations.
165.6 	(b) Notwithstanding section 144.05, subdivision 7, the mandate to publish an annual 
165.7 	report under this subdivision does not expire.

165.8 	EFFECTIVE DATE. This section is effective retroactively from January 1, 2023.

165.9 	Sec. 34. Minnesota Statutes 2022, section 144.99, subdivision 3, is amended to read:
165.10 		Subd. 3.Correction orders. (a) The commissioner may issue correction orders that 
165.11 	require a person to correct a violation of the statutes, rules, and other actions listed in 
165.12 	subdivision 1. The correction order must state the deficiencies that constitute the violation; 
165.13 	the specific statute, rule, or other action; and the time by which the violation must be 
165.14 	corrected.
165.15 	(b) If the person believes that the information contained in the commissioner's correction 
165.16 	order is in error, the person may ask the commissioner to reconsider the parts of the order 
165.17 	that are alleged to be in error. The request must be in writing, delivered to the commissioner 
165.18 	by certified mail within seven 15 calendar days after receipt of the order, and:
165.19 	(1) specify which parts of the order for corrective action are alleged to be in error;
165.20 	(2) explain why they are in error; and
165.21 	(3) provide documentation to support the allegation of error.
165.22 	The commissioner must respond to requests made under this paragraph within 15 calendar 
165.23 	days after receiving a request. A request for reconsideration does not stay the correction 
165.24 	order; however, after reviewing the request for reconsideration, the commissioner may 
165.25 	provide additional time to comply with the order if necessary. The commissioner's disposition 
165.26 	of a request for reconsideration is final.

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

165.28 	Sec. 35. Minnesota Statutes 2022, section 144A.10, subdivision 15, is amended to read:
165.29 		Subd. 15.Informal dispute resolution. The commissioner shall respond in writing to 
165.30 	a request from a nursing facility certified under the federal Medicare and Medicaid programs 
166.1 	for an informal dispute resolution within 30 days of the exit date of the facility's survey ten 
166.2 	calendar days of the facility's receipt of the notice of deficiencies. The commissioner's 
166.3 	response shall identify the commissioner's decision regarding the continuation of each 
166.4 	deficiency citation challenged by the nursing facility, as well as a statement of any changes 
166.5 	in findings, level of severity or scope, and proposed remedies or sanctions for each deficiency 
166.6 	citation.

166.7 	EFFECTIVE DATE. This section is effective August 1, 2024.

166.8 	Sec. 36. Minnesota Statutes 2022, section 144A.10, subdivision 16, is amended to read:
166.9 		Subd. 16.Independent informal dispute resolution. (a) Notwithstanding subdivision 
166.10 	15, a facility certified under the federal Medicare or Medicaid programs that has been 
166.11 	assessed a civil money penalty as provided by Code of Federal Regulations, title 42, section 
166.12 	488.430, may request from the commissioner, in writing, an independent informal dispute 
166.13 	resolution process regarding any deficiency citation issued to the facility. The facility must 
166.14 	specify in its written request each deficiency citation that it disputes. The commissioner 
166.15 	shall provide a hearing under sections 14.57 to 14.62. Upon the written request of the facility, 
166.16 	the parties must submit the issues raised to arbitration by an administrative law judge submit 
166.17 	its request in writing within ten calendar days of receiving notice that a civil money penalty 
166.18 	will be imposed.
166.19 	(b) The facility and commissioner have the right to be represented by an attorney at the 
166.20 	hearing.
166.21 	(c) An independent informal dispute resolution may not be requested for any deficiency 
166.22 	that is the subject of an active informal dispute resolution requested under subdivision 15. 
166.23 	The facility must withdraw its informal dispute resolution prior to requesting independent 
166.24 	informal dispute resolution.
166.25 	(b) Upon (d) Within five calendar days of receipt of a written request for an arbitration 
166.26 	proceeding independent informal dispute resolution, the commissioner shall file with the 
166.27 	Office of Administrative Hearings a request for the appointment of an arbitrator
166.28 	administrative law judge from the Office of Administrative Hearings and simultaneously 
166.29 	serve the facility with notice of the request. The arbitrator for the dispute shall be an 
166.30 	administrative law judge appointed by the Office of Administrative Hearings. The disclosure 
166.31 	provisions of section 572B.12 and the notice provisions of section 572B.15, subsection (c), 
166.32 	apply. The facility and the commissioner have the right to be represented by an attorney.
167.1 	(e) An independent informal dispute resolution proceeding shall be scheduled to occur 
167.2 	within 30 calendar days of the commissioner's request to the Office of Administrative 
167.3 	Hearings, unless the parties agree otherwise or the chief administrative law judge deems 
167.4 	the timing to be unreasonable. The independent informal dispute resolution process must 
167.5 	be completed within 60 calendar days of the facility's request.
167.6 	(c) (f) Five working days in advance of the scheduled proceeding, the commissioner 
167.7 	and the facility may present must submit written statements and arguments, documentary 
167.8 	evidence, depositions, and oral statements and arguments at the arbitration proceeding. Oral 
167.9 	statements and arguments may be made by telephone any other materials supporting their 
167.10 	position to the administrative law judge.
167.11 	(g) The independent informal dispute resolution proceeding shall be informal and 
167.12 	conducted in a manner so as to allow the parties to fully present their positions and respond 
167.13 	to the opposing party's positions. This may include presentation of oral statements and 
167.14 	arguments at the proceeding.
167.15 	(d) (h) Within ten working days of the close of the arbitration proceeding, the 
167.16 	administrative law judge shall issue findings and recommendations regarding each of the 
167.17 	deficiencies in dispute. The findings shall be one or more of the following:
167.18 	(1) Supported in full. The citation is supported in full, with no deletion of findings and 
167.19 	no change in the scope or severity assigned to the deficiency citation.
167.20 	(2) Supported in substance. The citation is supported, but one or more findings are 
167.21 	deleted without any change in the scope or severity assigned to the deficiency.
167.22 	(3) Deficient practice cited under wrong requirement of participation. The citation is 
167.23 	amended by moving it to the correct requirement of participation.
167.24 	(4) Scope not supported. The citation is amended through a change in the scope assigned 
167.25 	to the citation.
167.26 	(5) Severity not supported. The citation is amended through a change in the severity 
167.27 	assigned to the citation.
167.28 	(6) No deficient practice. The citation is deleted because the findings did not support 
167.29 	the citation or the negative resident outcome was unavoidable. The findings of the arbitrator 
167.30 	are not binding on the commissioner.
167.31 	(i) The findings and recommendations of the administrative law judge are not binding 
167.32 	on the commissioner.
168.1 	(j) Within ten calendar days of receiving the administrative law judge's findings and 
168.2 	recommendations, the commissioner shall issue a recommendation to the Center for Medicare 
168.3 	and Medicaid Services.
168.4 	(e) (k) The commissioner shall reimburse the Office of Administrative Hearings for the 
168.5 	costs incurred by that office for the arbitration proceeding. The facility shall reimburse the 
168.6 	commissioner for the proportion of the costs that represent the sum of deficiency citations 
168.7 	supported in full under paragraph (d), clause (1), or in substance under paragraph (d), clause 
168.8 	(2), divided by the total number of deficiencies disputed. A deficiency citation for which 
168.9 	the administrative law judge's sole finding is that the deficient practice was cited under the 
168.10 	wrong requirements of participation shall not be counted in the numerator or denominator 
168.11 	in the calculation of the proportion of costs.

168.12 	EFFECTIVE DATE. This section is effective October 1, 2024, or upon federal approval, 
168.13 	whichever is later, and applies to appeals of deficiencies which are issued after October 1, 
168.14 	2024, or on or after the date upon which federal approval is obtained, whichever is later. 
168.15 	The commissioner of health shall notify the revisor of statutes when federal approval is 
168.16 	obtained.

168.17 	Sec. 37. Minnesota Statutes 2022, section 144A.471, is amended by adding a subdivision 
168.18 	to read:
168.19 		Subd. 1a.Licensure under other law. A home care licensee must not provide sleeping 
168.20 	accommodations as a provision of home care services. For purposes of this subdivision, the 
168.21 	provision of sleeping accommodations and assisted living services under section 144G.08, 
168.22 	subdivision 9, requires assisted living facility licensure under chapter 144G. This subdivision 
168.23 	does not apply to those settings exempt from assisted living facility licensure under section 
168.24 	144G.08, subdivision 7.

168.25 	Sec. 38. Minnesota Statutes 2022, section 144A.474, subdivision 13, is amended to read:
168.26 		Subd. 13.Home care surveyor training. (a) Before conducting a home care survey, 
168.27 	each home care surveyor must receive training on the following topics:
168.28 	(1) Minnesota home care licensure requirements;
168.29 	(2) Minnesota home care bill of rights;
168.30 	(3) Minnesota Vulnerable Adults Act and reporting of maltreatment of minors;
168.31 	(4) principles of documentation;
169.1 	(5) survey protocol and processes;
169.2 	(6) Offices of the Ombudsman roles;
169.3 	(7) Office of Health Facility Complaints;
169.4 	(8) Minnesota landlord-tenant and housing with services laws;
169.5 	(9) types of payors for home care services; and
169.6 	(10) Minnesota Nurse Practice Act for nurse surveyors.
169.7 	(b) Materials used for the training in paragraph (a) shall be posted on the department 
169.8 	website. Requisite understanding of these topics will be reviewed as part of the quality 
169.9 	improvement plan in section 144A.483.

169.10 	Sec. 39. Minnesota Statutes 2023 Supplement, section 144A.4791, subdivision 10, is 
169.11 	amended to read:
169.12 		Subd. 10.Termination of service plan. (a) If a home care provider terminates a service 
169.13 	plan with a client, and the client continues to need home care services, the home care provider 
169.14 	shall provide the client and the client's representative, if any, with a written notice of 
169.15 	termination which includes the following information:
169.16 	(1) the effective date of termination;
169.17 	(2) the reason for termination;
169.18 	(3) for clients age 18 or older, a statement that the client may contact the Office of 
169.19 	Ombudsman for Long-Term Care to request an advocate to assist regarding the termination 
169.20 	and contact information for the office, including the office's central telephone number;
169.21 	(4) a list of known licensed home care providers in the client's immediate geographic 
169.22 	area;
169.23 	(5) a statement that the home care provider will participate in a coordinated transfer of 
169.24 	care of the client to another home care provider, health care provider, or caregiver, as 
169.25 	required by the home care bill of rights, section 144A.44, subdivision 1, clause (17); and
169.26 	(6) the name and contact information of a person employed by the home care provider 
169.27 	with whom the client may discuss the notice of termination; and.
169.28 	(7) if applicable, a statement that the notice of termination of home care services does 
169.29 	not constitute notice of termination of any housing contract.
170.1 	(b) When the home care provider voluntarily discontinues services to all clients, the 
170.2 	home care provider must notify the commissioner, lead agencies, and ombudsman for 
170.3 	long-term care about its clients and comply with the requirements in this subdivision.

170.4 	Sec. 40. Minnesota Statutes 2022, section 144E.16, subdivision 7, is amended to read:
170.5 		Subd. 7.Stroke transport protocols. Regional emergency medical services programs 
170.6 	and any ambulance service licensed under this chapter must develop stroke transport 
170.7 	protocols. The protocols must include standards of care for triage and transport of acute 
170.8 	stroke patients within a specific time frame from symptom onset until transport to the most 
170.9 	appropriate designated acute stroke ready hospital, primary stroke center, 
170.10 	thrombectomy-capable stroke center, or comprehensive stroke center.

170.11 	Sec. 41. Minnesota Statutes 2022, section 144G.08, subdivision 29, is amended to read:
170.12 		Subd. 29.Licensed health professional. "Licensed health professional" means a person 
170.13 	licensed in Minnesota to practice a profession described in section 214.01, subdivision 2, 
170.14 	other than a registered nurse or licensed practical nurse, who provides assisted living services 
170.15 	within the scope of practice of that person's health occupation license, registration, or 
170.16 	certification as a regulated person who is licensed by an appropriate Minnesota state board 
170.17 	or agency.

170.18 	Sec. 42. Minnesota Statutes 2022, section 144G.10, is amended by adding a subdivision 
170.19 	to read:
170.20 		Subd. 5.Protected title; restriction on use. (a) Effective January 1, 2026, no person 
170.21 	or entity may use the phrase "assisted living," whether alone or in combination with other 
170.22 	words and whether orally or in writing, to: advertise; market; or otherwise describe, offer, 
170.23 	or promote itself, or any housing, service, service package, or program that it provides 
170.24 	within this state, unless the person or entity is a licensed assisted living facility that meets 
170.25 	the requirements of this chapter. A person or entity entitled to use the phrase "assisted living" 
170.26 	shall use the phrase only in the context of its participation that meets the requirements of 
170.27 	this chapter.
170.28 	(b) Effective January 1, 2026, the licensee's name for a new assisted living facility may 
170.29 	not include the terms "home care" or "nursing home."

171.1 	Sec. 43. Minnesota Statutes 2022, section 144G.16, subdivision 6, is amended to read:
171.2 		Subd. 6.Requirements for notice and transfer. A provisional licensee whose license 
171.3 	is denied must comply with the requirements for notification and the coordinated move of 
171.4 	residents in sections 144G.52 and 144G.55. If the license denial is upheld by the 
171.5 	reconsideration process, the licensee must submit a draft closure plan as required by section 
171.6 	144G.57 within ten calendar days of receipt of the reconsideration decision, must work with 
171.7 	the commissioner on any revisions needed to the draft plan, and must have a final closure 
171.8 	plan submitted and approved within 30 calendar days of receipt of the reconsideration 
171.9 	decision.

171.10 	Sec. 44. Minnesota Statutes 2023 Supplement, section 145.561, subdivision 4, is amended 
171.11 	to read:
171.12 		Subd. 4.988 telecommunications fee. (a) In compliance with the National Suicide 
171.13 	Hotline Designation Act of 2020, the commissioner shall impose a monthly statewide fee 
171.14 	on each subscriber of a wireline, wireless, or IP-enabled voice service at a rate that provides
171.15 	must pay a monthly fee to provide for the robust creation, operation, and maintenance of a 
171.16 	statewide 988 suicide prevention and crisis system.
171.17 	(b) The commissioner shall annually recommend to the Public Utilities Commission an 
171.18 	adequate and appropriate fee to implement this section. The amount of the fee must comply 
171.19 	with the limits in paragraph (c). The commissioner shall provide telecommunication service 
171.20 	providers and carriers a minimum of 45 days' notice of each fee change.
171.21 	(c) (b) The amount of the 988 telecommunications fee must not be more than 25 is 12
171.22 	cents per month on or after January 1, 2024, for each consumer access line, including trunk 
171.23 	equivalents as designated by the commission Public Utilities Commission pursuant to section 
171.24 	403.11, subdivision 1. The 988 telecommunications fee must be the same for all subscribers.
171.25 	(d) (c) Each wireline, wireless, and IP-enabled voice telecommunication service provider 
171.26 	shall collect the 988 telecommunications fee and transfer the amounts collected to the 
171.27 	commissioner of public safety in the same manner as provided in section 403.11, subdivision 
171.28 	1, paragraph (d).
171.29 	(e) (d) The commissioner of public safety shall deposit the money collected from the 
171.30 	988 telecommunications fee to the 988 special revenue account established in subdivision 
171.31 	3.
171.32 	(f) (e) All 988 telecommunications fee revenue must be used to supplement, and not 
171.33 	supplant, federal, state, and local funding for suicide prevention.
172.1 	(g) (f) The 988 telecommunications fee amount shall be adjusted as needed to provide 
172.2 	for continuous operation of the lifeline centers and 988 hotline, volume increases, and 
172.3 	maintenance.
172.4 	(h) (g) The commissioner shall annually report to the Federal Communications 
172.5 	Commission on revenue generated by the 988 telecommunications fee.

172.6 	EFFECTIVE DATE. This section is effective September 1, 2024.

172.7 	Sec. 45. Minnesota Statutes 2022, section 146B.03, subdivision 7a, is amended to read:
172.8 		Subd. 7a.Supervisors. (a) A technician must have been licensed in Minnesota or in a 
172.9 	jurisdiction with which Minnesota has reciprocity for at least:
172.10 	(1) two years as a tattoo technician licensed under section 146B.03, subdivision 4, 6, or 
172.11 	8, in order to supervise a temporary tattoo technician; or
172.12 	(2) one year as a body piercing technician licensed under section 146B.03, subdivision 
172.13 	4, 6, or 8, or must have performed at least 500 body piercings, in order to supervise a 
172.14 	temporary body piercing technician.
172.15 	(b) Any technician who agrees to supervise more than two temporary tattoo technicians 
172.16 	during the same time period, or more than four body piercing technicians during the same 
172.17 	time period, must provide to the commissioner a supervisory plan that describes how the 
172.18 	technician will provide supervision to each temporary technician in accordance with section 
172.19 	146B.01, subdivision 28.
172.20 	(c) The supervisory plan must include, at a minimum:
172.21 	(1) the areas of practice under supervision;
172.22 	(2) the anticipated supervision hours per week;
172.23 	(3) the anticipated duration of the training period; and
172.24 	(4) the method of providing supervision if there are multiple technicians being supervised 
172.25 	during the same time period.
172.26 	(d) If the supervisory plan is terminated before completion of the technician's supervised 
172.27 	practice, the supervisor must notify the commissioner in writing within 14 days of the change 
172.28 	in supervision and include an explanation of why the plan was not completed.
172.29 	(e) The commissioner may refuse to approve as a supervisor a technician who has been 
172.30 	disciplined in Minnesota or in another jurisdiction after considering the criteria in section 
172.31 	146B.02, subdivision 10, paragraph (b).

173.1 	Sec. 46. Minnesota Statutes 2022, section 146B.10, subdivision 1, is amended to read:
173.2 		Subdivision 1. Licensing fees. (a) The fee for the initial technician licensure application
173.3 	and biennial licensure renewal application is $420.
173.4 	(b) The fee for temporary technician licensure application is $240.
173.5 	(c) The fee for the temporary guest artist license application is $140.
173.6 	(d) The fee for a dual body art technician license application is $420.
173.7 	(e) The fee for a provisional establishment license application required in section 146B.02, 
173.8 	subdivision 5, paragraph (c), is $1,500.
173.9 	(f) The fee for an initial establishment license application and the two-year license 
173.10 	renewal period application required in section 146B.02, subdivision 2, paragraph (b), is 
173.11 	$1,500.
173.12 	(g) The fee for a temporary body art establishment event permit application is $200.
173.13 	(h) The commissioner shall prorate the initial two-year technician license fee based on 
173.14 	the number of months in the initial licensure period. The commissioner shall prorate the 
173.15 	first renewal fee for the establishment license based on the number of months from issuance 
173.16 	of the provisional license to the first renewal.
173.17 	(i) The fee for verification of licensure to other states is $25.
173.18 	(j) The fee to reissue a provisional establishment license that relocates prior to inspection 
173.19 	and removal of provisional status is $350. The expiration date of the provisional license 
173.20 	does not change.
173.21 	(k) (j) The fee to change an establishment name or establishment type, such as tattoo, 
173.22 	piercing, or dual, is $50.

173.23 	Sec. 47. Minnesota Statutes 2022, section 146B.10, subdivision 3, is amended to read:
173.24 		Subd. 3.Deposit. Fees collected by the commissioner under this section must be deposited 
173.25 	in the state government special revenue fund. All fees are nonrefundable.

173.26 	Sec. 48. Minnesota Statutes 2022, section 149A.02, subdivision 3b, is amended to read:
173.27 		Subd. 3b.Burial site services. "Burial site services" means any services sold or offered 
173.28 	for sale directly to the public for use in connection with the final disposition of a dead human 
173.29 	body but does not include services provided under a transportation protection agreement.

174.1 	Sec. 49. Minnesota Statutes 2022, section 149A.02, subdivision 23, is amended to read:
174.2 		Subd. 23.Funeral services. (a) "Funeral services" means any services which may be 
174.3 	used to: (1) care for and prepare dead human bodies for burial, alkaline hydrolysis, cremation, 
174.4 	or other final disposition; and (2) arrange, supervise, or conduct the funeral ceremony or 
174.5 	the final disposition of dead human bodies.
174.6 	(b) Funeral service does not include a transportation protection agreement.

174.7 	Sec. 50. Minnesota Statutes 2022, section 149A.02, is amended by adding a subdivision 
174.8 	to read:
174.9 		Subd. 38a.Transportation protection agreement. "Transportation protection agreement" 
174.10 	means an agreement that is primarily for the purpose of transportation and subsequent 
174.11 	transportation of the remains of a dead human body.

174.12 	Sec. 51. Minnesota Statutes 2022, section 149A.65, is amended to read:
174.13 	149A.65 FEES.
174.14 		Subdivision 1.Generally. This section establishes the application fees for registrations, 
174.15 	examinations, initial and renewal licenses, and late fees authorized under the provisions of 
174.16 	this chapter.
174.17 		Subd. 2.Mortuary science fees. Fees for mortuary science are:
174.18 	(1) $75 for the initial and renewal registration of a mortuary science intern;
174.19 	(2) $125 for the mortuary science examination;
174.20 	(3) $200 for issuance of initial and renewal mortuary science licenses license applications;
174.21 	(4) $100 late fee charge for a license renewal application; and
174.22 	(5) $250 for issuing a an application for mortuary science license by endorsement.
174.23 		Subd. 3.Funeral directors. The license renewal application fee for funeral directors is 
174.24 	$200. The late fee charge for a license renewal is $100.
174.25 		Subd. 4.Funeral establishments. The initial and renewal application fee for funeral 
174.26 	establishments is $425. The late fee charge for a license renewal is $100.
174.27 		Subd. 5.Crematories. The initial and renewal application fee for a crematory is $425. 
174.28 	The late fee charge for a license renewal is $100.
175.1 		Subd. 6.Alkaline hydrolysis facilities. The initial and renewal application fee for an 
175.2 	alkaline hydrolysis facility is $425. The late fee charge for a license renewal is $100.
175.3 		Subd. 7.State government special revenue fund. Fees collected by the commissioner 
175.4 	under this section must be deposited in the state treasury and credited to the state government 
175.5 	special revenue fund. All fees are nonrefundable.

175.6 	Sec. 52. Minnesota Statutes 2022, section 149A.97, subdivision 2, is amended to read:
175.7 		Subd. 2.Scope and requirements. This section shall not apply to a transportation 
175.8 	protection agreement or to any funeral goods or burial site goods purchased and delivered, 
175.9 	either at purchase or within a commercially reasonable amount of time thereafter. When 
175.10 	prior to the death of any person, that person or another, on behalf of that person, enters into 
175.11 	any transaction, makes a contract, or any series or combination of transactions or contracts 
175.12 	with a funeral provider lawfully doing business in Minnesota, other than an insurance 
175.13 	company licensed to do business in Minnesota selling approved insurance or annuity 
175.14 	products, by the terms of which, goods or services related to the final disposition of that 
175.15 	person will be furnished at-need, then the total of all money paid by the terms of the 
175.16 	transaction, contract, or series or combination of transactions or contracts shall be held in 
175.17 	trust for the purpose for which it has been paid. The person for whose benefit the money 
175.18 	was paid shall be known as the beneficiary, the person or persons who paid the money shall 
175.19 	be known as the purchaser, and the funeral provider shall be known as the depositor.

175.20 	Sec. 53. Minnesota Statutes 2022, section 256R.02, subdivision 20, is amended to read:
175.21 		Subd. 20.Facility average case mix index. "Facility average case mix index" or "CMI" 
175.22 	means a numerical score that describes the relative resource use for all residents within the 
175.23 	case mix classifications under the resource utilization group (RUG) classification system 
175.24 	prescribed by the commissioner based on an assessment of each resident. The facility average 
175.25 	CMI shall be computed as the standardized days divided by the sum of the facility's resident 
175.26 	days. The case mix indices used shall be based on the system prescribed in section 256R.17.

175.27 	Sec. 54. Minnesota Statutes 2022, section 259.52, subdivision 2, is amended to read:
175.28 		Subd. 2.Requirement to search registry before adoption petition can be granted; 
175.29 	proof of search. No petition for adoption may be granted unless the agency supervising 
175.30 	the adoptive placement, the birth mother of the child, the putative father who registered or 
175.31 	the legal father, or, in the case of a stepparent or relative adoption, the county agency 
175.32 	responsible for the report required under section 259.53, subdivision 1, requests that the 
176.1 	commissioner of health search the registry to determine whether a putative father is registered 
176.2 	in relation to a child who is or may be the subject of an adoption petition. The search required 
176.3 	by this subdivision must be conducted no sooner than 31 days following the birth of the 
176.4 	child. A search of the registry may be proven by the production of a certified copy of the 
176.5 	registration form or by a certified statement of the commissioner of health that after a search 
176.6 	no registration of a putative father in relation to a child who is or may be the subject of an 
176.7 	adoption petition could be located. The filing of a certified copy of an order from a juvenile 
176.8 	protection matter under chapter 260C containing a finding that certification of the requisite 
176.9 	search of the Minnesota Fathers' Adoption Registry was filed with the court in that matter 
176.10 	shall also constitute proof of search. Certification that the Minnesota Fathers' Adoption 
176.11 	Registry has been searched must be filed with the court prior to entry of any final order of 
176.12 	adoption. In addition to the search required by this subdivision, the agency supervising the 
176.13 	adoptive placement, the birth mother of the child, or, in the case of a stepparent or relative 
176.14 	adoption, the social services agency responsible for the report under section 259.53, 
176.15 	subdivision 1, or the responsible social services agency that is a petitioner in a juvenile 
176.16 	protection matter under chapter 260C may request that the commissioner of health search 
176.17 	the registry at any time. Search requirements of this section do not apply when the responsible 
176.18 	social services agency is proceeding under Safe Place for Newborns, section 260C.139.

176.19 	Sec. 55. Minnesota Statutes 2022, section 259.52, subdivision 4, is amended to read:
176.20 		Subd. 4.Classification of registry data. (a) Data in the fathers' adoption registry, 
176.21 	including all data provided in requesting the search of the registry, are private data on 
176.22 	individuals, as defined in section 13.02, subdivision 2, and are nonpublic data with respect 
176.23 	to data not on individuals, as defined in section 13.02, subdivision 9. Data in the registry 
176.24 	may be released to:
176.25 	(1) a person who is required to search the registry under subdivision 2, if the data relate 
176.26 	to the child who is or may be the subject of the adoption petition;
176.27 	(2) the mother of the child listed on the putative father's registration form who the 
176.28 	commissioner of health is required to notify under subdivision 1, paragraph (c);
176.29 	(3) the putative father who registered himself or the legal father;
176.30 	(4) a public authority as provided in subdivision 3; or
176.31 	(4) (5) an attorney who has signed an affidavit from the commissioner of health attesting 
176.32 	that the attorney represents the birth mother, the putative or legal father, or the prospective 
176.33 	adoptive parents.
177.1 	(b) A person who receives data under this subdivision may use the data only for purposes 
177.2 	authorized under this section or other law.

177.3 	Sec. 56. REVISOR INSTRUCTION.
 177.4 	The revisor of statutes shall substitute the term "employee" with the term "staff" in the 
177.5 	following sections of Minnesota Statutes and make any grammatical changes needed without 
177.6 	changing the meaning of the sentence: Minnesota Statutes, sections 144G.08, subdivisions 
177.7 	18 and 36; 144G.13, subdivision 1, paragraph (c); 144G.20, subdivisions 1, 2, and 21; 
177.8 	144G.30, subdivision 5; 144G.42, subdivision 8; 144G.45, subdivision 2; 144G.60, 
177.9 	subdivisions 1, paragraph (c), and 3, paragraph (a); 144G.63, subdivision 2, paragraph (a), 
177.10 	clause (9); 144G.64, paragraphs (a), clauses (2), (3), and (5), and (c); 144G.70, subdivision 
177.11 	7; and 144G.92, subdivisions 1 and 3.

177.12 	Sec. 57. REPEALER.
 177.13 	(a) Minnesota Statutes 2022, sections 144.218, subdivision 3; 144.497; and 256R.02, 
177.14 	subdivision 46, are repealed.
177.15 	(b) Minnesota Statutes 2023 Supplement, section 62J.312, subdivision 6, is repealed.

177.16 	ARTICLE 7
177.17 	PHARMACY BOARD AND PRACTICE

177.18 	Section 1. Minnesota Statutes 2023 Supplement, section 62Q.46, subdivision 1, is amended 
177.19 	to read:
177.20 		Subdivision 1.Coverage for preventive items and services. (a) "Preventive items and 
177.21 	services" has the meaning specified in the Affordable Care Act. Preventive items and services 
177.22 	includes:
177.23 	(1) evidence-based items or services that have in effect a rating of A or B in the current 
177.24 	recommendations of the United States Preventive Services Task Force with respect to the 
177.25 	individual involved;
177.26 	(2) immunizations for routine use in children, adolescents, and adults that have in effect 
177.27 	a recommendation from the Advisory Committee on Immunization Practices of the Centers 
177.28 	for Disease Control and Prevention with respect to the individual involved. For purposes 
177.29 	of this clause, a recommendation from the Advisory Committee on Immunization Practices 
177.30 	of the Centers for Disease Control and Prevention is considered in effect after the 
177.31 	recommendation has been adopted by the Director of the Centers for Disease Control and 
178.1 	Prevention, and a recommendation is considered to be for routine use if the recommendation 
178.2 	is listed on the Immunization Schedules of the Centers for Disease Control and Prevention;
178.3 	(3) with respect to infants, children, and adolescents, evidence-informed preventive care 
178.4 	and screenings provided for in comprehensive guidelines supported by the Health Resources 
178.5 	and Services Administration;
178.6 	(4) with respect to women, additional preventive care and screenings that are not listed 
178.7 	with a rating of A or B by the United States Preventive Services Task Force but that are 
178.8 	provided for in comprehensive guidelines supported by the Health Resources and Services 
178.9 	Administration;
178.10 	(5) all contraceptive methods established in guidelines published by the United States 
178.11 	Food and Drug Administration;
178.12 	(6) screenings for human immunodeficiency virus for:
178.13 	(i) all individuals at least 15 years of age but less than 65 years of age; and
178.14 	(ii) all other individuals with increased risk of human immunodeficiency virus infection 
178.15 	according to guidance from the Centers for Disease Control;
178.16 	(7) all preexposure prophylaxis when used for the prevention or treatment of human 
178.17 	immunodeficiency virus, including but not limited to all preexposure prophylaxis, as defined 
178.18 	in any guidance by the United States Preventive Services Task Force or the Centers for 
178.19 	Disease Control, including the June 11, 2019, Preexposure Prophylaxis for the Prevention 
178.20 	of HIV Infection United States Preventive Services Task Force Recommendation Statement; 
178.21 	and
178.22 	(8) all postexposure prophylaxis when used for the prevention or treatment of human 
178.23 	immunodeficiency virus, including but not limited to all postexposure prophylaxis as defined 
178.24 	in any guidance by the United States Preventive Services Task Force or the Centers for 
178.25 	Disease Control.
178.26 	(b) A health plan company must provide coverage for preventive items and services at 
178.27 	a participating provider without imposing cost-sharing requirements, including a deductible, 
178.28 	coinsurance, or co-payment. Nothing in this section prohibits a health plan company that 
178.29 	has a network of providers from excluding coverage or imposing cost-sharing requirements 
178.30 	for preventive items or services that are delivered by an out-of-network provider.
178.31 	(c) A health plan company is not required to provide coverage for any items or services 
178.32 	specified in any recommendation or guideline described in paragraph (a) if the 
178.33 	recommendation or guideline is no longer included as a preventive item or service as defined 
179.1 	in paragraph (a). Annually, a health plan company must determine whether any additional 
179.2 	items or services must be covered without cost-sharing requirements or whether any items 
179.3 	or services are no longer required to be covered.
179.4 	(d) Nothing in this section prevents a health plan company from using reasonable medical 
179.5 	management techniques to determine the frequency, method, treatment, or setting for a 
179.6 	preventive item or service to the extent not specified in the recommendation or guideline.
179.7 	(e) A health plan shall not require prior authorization or step therapy for preexposure 
179.8 	prophylaxis or postexposure prophylaxis, except that: if the United States Food and Drug 
179.9 	Administration has approved one or more therapeutic equivalents of a drug, device, or 
179.10 	product for the prevention of HIV, this paragraph does not require a health plan to cover 
179.11 	all of the therapeutically equivalent versions without prior authorization or step therapy, if 
179.12 	at least one therapeutically equivalent version is covered without prior authorization or step 
179.13 	therapy.
179.14 	(e) (f) This section does not apply to grandfathered plans.
179.15 	(f) (g) This section does not apply to plans offered by the Minnesota Comprehensive 
179.16 	Health Association.

179.17 	EFFECTIVE DATE. This section is effective January 1, 2026, and applies to health 
179.18 	plans offered, issued, or renewed on or after that date.

179.19 	Sec. 2. Minnesota Statutes 2022, section 151.01, subdivision 23, is amended to read:
179.20 		Subd. 23.Practitioner. "Practitioner" means a licensed doctor of medicine, licensed 
179.21 	doctor of osteopathic medicine duly licensed to practice medicine, licensed doctor of 
179.22 	dentistry, licensed doctor of optometry, licensed podiatrist, licensed veterinarian, licensed 
179.23 	advanced practice registered nurse, or licensed physician assistant. For purposes of sections 
179.24 	151.15, subdivision 4; 151.211, subdivision 3; 151.252, subdivision 3; 151.37, subdivision 
179.25 	2, paragraph (b); and 151.461, "practitioner" also means a dental therapist authorized to 
179.26 	dispense and administer under chapter 150A. For purposes of sections 151.252, subdivision 
179.27 	3, and 151.461, "practitioner" also means a pharmacist authorized to prescribe 
179.28 	self-administered hormonal contraceptives, nicotine replacement medications, or opiate 
179.29 	antagonists under section 151.37, subdivision 14, 15, or 16, or authorized to prescribe drugs 
179.30 	to prevent the acquisition of human immunodeficiency virus (HIV) under section 151.37, 
179.31 	subdivision 17.

179.32 	EFFECTIVE DATE. This section is effective January 1, 2025.

180.1 	Sec. 3. Minnesota Statutes 2022, section 151.01, subdivision 27, is amended to read:
180.2 		Subd. 27.Practice of pharmacy. "Practice of pharmacy" means:
180.3 	(1) interpretation and evaluation of prescription drug orders;
180.4 	(2) compounding, labeling, and dispensing drugs and devices (except labeling by a 
180.5 	manufacturer or packager of nonprescription drugs or commercially packaged legend drugs 
180.6 	and devices);
180.7 	(3) participation in clinical interpretations and monitoring of drug therapy for assurance 
180.8 	of safe and effective use of drugs, including the performance of ordering and performing
180.9 	laboratory tests that are waived under the federal Clinical Laboratory Improvement Act of 
180.10 	1988, United States Code, title 42, section 263a et seq., provided that a pharmacist may 
180.11 	interpret the results of laboratory tests but may modify A pharmacist may collect specimens, 
180.12 	interpret results, notify the patient of results, and refer the patient to other health care 
180.13 	providers for follow-up care and may initiate, modify, or discontinue drug therapy only 
180.14 	pursuant to a protocol or collaborative practice agreement. A pharmacist may delegate the 
180.15 	authority to administer tests under this clause to a pharmacy technician or pharmacy intern. 
180.16 	A pharmacy technician or pharmacy intern may perform tests authorized under this clause 
180.17 	if the technician or intern is working under the direct supervision of a pharmacist;
180.18 	(4) participation in drug and therapeutic device selection; drug administration for first 
180.19 	dosage and medical emergencies; intramuscular and subcutaneous drug administration under 
180.20 	a prescription drug order; drug regimen reviews; and drug or drug-related research;
180.21 	(5) drug administration, through intramuscular and subcutaneous administration used 
180.22 	to treat mental illnesses as permitted under the following conditions:
180.23 	(i) upon the order of a prescriber and the prescriber is notified after administration is 
180.24 	complete; or
180.25 	(ii) pursuant to a protocol or collaborative practice agreement as defined by section 
180.26 	151.01, subdivisions 27b and 27c, and participation in the initiation, management, 
180.27 	modification, administration, and discontinuation of drug therapy is according to the protocol 
180.28 	or collaborative practice agreement between the pharmacist and a dentist, optometrist, 
180.29 	physician, physician assistant, podiatrist, or veterinarian, or an advanced practice registered 
180.30 	nurse authorized to prescribe, dispense, and administer under section 148.235. Any changes 
180.31 	in drug therapy or medication administration made pursuant to a protocol or collaborative 
180.32 	practice agreement must be documented by the pharmacist in the patient's medical record 
180.33 	or reported by the pharmacist to a practitioner responsible for the patient's care;
181.1 	(6) participation in administration of influenza vaccines andinitiating, ordering, and 
181.2 	administering influenza and COVID-19 or SARS-CoV-2 vaccines authorized or approved 
181.3 	by the United States Food and Drug Administration related to COVID-19 or SARS-CoV-2
181.4 	to all eligible individuals six three years of age and older and all other United States Food 
181.5 	and Drug Administration-approved vaccines to patients 13 six years of age and older by 
181.6 	written protocol with a physician licensed under chapter 147, a physician assistant authorized 
181.7 	to prescribe drugs under chapter 147A, or an advanced practice registered nurse authorized 
181.8 	to prescribe drugs under section 148.235, provided that according to the federal Advisory 
181.9 	Committee on Immunization Practices recommendations. A pharmacist may delegate the 
181.10 	authority to administer vaccines under this clause to a pharmacy technician or pharmacy 
181.11 	intern who has completed training in vaccine administration if:
181.12 	(i) the protocol includes, at a minimum:
181.13 	(A) the name, dose, and route of each vaccine that may be given;
181.14 	(B) the patient population for whom the vaccine may be given;
181.15 	(C) contraindications and precautions to the vaccine;
181.16 	(D) the procedure for handling an adverse reaction;
181.17 	(E) the name, signature, and address of the physician, physician assistant, or advanced 
181.18 	practice registered nurse;
181.19 	(F) a telephone number at which the physician, physician assistant, or advanced practice 
181.20 	registered nurse can be contacted; and
181.21 	(G) the date and time period for which the protocol is valid;
181.22 	(ii) (i) the pharmacist has and the pharmacy technician or pharmacy intern have
181.23 	successfully completed a program approved by the Accreditation Council for Pharmacy 
181.24 	Education (ACPE) specifically for the administration of immunizations or a program 
181.25 	approved by the board;
181.26 	(iii) (ii) the pharmacist utilizes the Minnesota Immunization Information Connection to 
181.27 	assess the immunization status of individuals prior to the administration of vaccines, except 
181.28 	when administering influenza vaccines to individuals age nine and older;
181.29 	(iv) (iii) the pharmacist reports the administration of the immunization to the Minnesota 
181.30 	Immunization Information Connection; and
181.31 	(v) the pharmacist complies with guidelines for vaccines and immunizations established 
181.32 	by the federal Advisory Committee on Immunization Practices, except that a pharmacist 
182.1 	does not need to comply with those portions of the guidelines that establish immunization 
182.2 	schedules when administering a vaccine pursuant to a valid, patient-specific order issued 
182.3 	by a physician licensed under chapter 147, a physician assistant authorized to prescribe 
182.4 	drugs under chapter 147A, or an advanced practice registered nurse authorized to prescribe 
182.5 	drugs under section 148.235, provided that the order is consistent with the United States 
182.6 	Food and Drug Administration approved labeling of the vaccine;
182.7 	(iv) if the patient is 18 years of age or younger, the pharmacist, pharmacy technician, 
182.8 	or pharmacy intern informs the patient and any adult caregiver accompanying the patient 
182.9 	of the importance of a well-child visit with a pediatrician or other licensed primary care 
182.10 	provider; and
182.11 	(v) in the case of a pharmacy technician administering vaccinations while being 
182.12 	supervised by a licensed pharmacist:
182.13 	(A) the supervision is in-person and must not be done through telehealth as defined 
182.14 	under section 62A.673, subdivision 2;
182.15 	(B) the pharmacist is readily and immediately available to the immunizing pharmacy 
182.16 	technician;
182.17 	(C) the pharmacy technician has a current certificate in basic cardiopulmonary 
182.18 	resuscitation;
182.19 	(D) the pharmacy technician has completed a minimum of two hours of ACPE-approved, 
182.20 	immunization-related continuing pharmacy education as part of the pharmacy technician's 
182.21 	two-year continuing education schedule; and
182.22 	(E) the pharmacy technician has completed one of two training programs listed under 
182.23 	Minnesota Rules, part 6800.3850, subpart 1h, item B;
182.24 	(7) participation in the initiation, management, modification, and discontinuation of 
182.25 	drug therapy according to a written protocol or collaborative practice agreement between: 
182.26 	(i) one or more pharmacists and one or more dentists, optometrists, physicians, physician 
182.27 	assistants, podiatrists, or veterinarians; or (ii) one or more pharmacists and one or more 
182.28 	physician assistants authorized to prescribe, dispense, and administer under chapter 147A, 
182.29 	or advanced practice registered nurses authorized to prescribe, dispense, and administer 
182.30 	under section 148.235. Any changes in drug therapy made pursuant to a protocol or 
182.31 	collaborative practice agreement must be documented by the pharmacist in the patient's 
182.32 	medical record or reported by the pharmacist to a practitioner responsible for the patient's 
182.33 	care;
183.1 	(8) participation in the storage of drugs and the maintenance of records;
183.2 	(9) patient counseling on therapeutic values, content, hazards, and uses of drugs and 
183.3 	devices;
183.4 	(10) offering or performing those acts, services, operations, or transactions necessary 
183.5 	in the conduct, operation, management, and control of a pharmacy;
183.6 	(11) participation in the initiation, management, modification, and discontinuation of 
183.7 	therapy with opiate antagonists, as defined in section 604A.04, subdivision 1, pursuant to:
183.8 	(i) a written protocol as allowed under clause (7); or
183.9 	(ii) a written protocol with a community health board medical consultant or a practitioner 
183.10 	designated by the commissioner of health, as allowed under section 151.37, subdivision 13;
183.11 	(12) prescribing self-administered hormonal contraceptives; nicotine replacement 
183.12 	medications; and opiate antagonists for the treatment of an acute opiate overdose pursuant 
183.13 	to section 151.37, subdivision 14, 15, or 16; and
183.14 	(13) participation in the placement of drug monitoring devices according to a prescription, 
183.15 	protocol, or collaborative practice agreement.;
183.16 	(14) prescribing, dispensing, and administering drugs for preventing the acquisition of 
183.17 	human immunodeficiency virus (HIV) if the pharmacist meets the requirements in section 
183.18 	151.37, subdivision 17; and
183.19 	(15) ordering, conducting, and interpreting laboratory tests necessary for therapies that 
183.20 	use drugs for preventing the acquisition of HIV, if the pharmacist meets the requirements 
183.21 	in section 151.37, subdivision 17.

183.22 	EFFECTIVE DATE. This section is effective July 1, 2024, except that clauses (14) 
183.23 	and (15) are effective January 1, 2026.

183.24 	Sec. 4. Minnesota Statutes 2022, section 151.065, is amended by adding a subdivision to 
183.25 	read:
183.26 		Subd. 4a.Application and fee; relocation. A person who is registered with or licensed 
183.27 	by the board must submit a new application to the board before relocating the physical 
183.28 	location of the person's business. An application must be submitted for each affected license. 
183.29 	The application must set forth the proposed change of location on a form established by the 
183.30 	board. If the licensee or registrant remitted payment for the full amount during the state's 
183.31 	fiscal year, the relocation application fee is the same as the application fee in subdivision 
183.32 	1, except that the fees in clauses (6) to (9) and (11) to (16) are reduced by $5,000 and the 
184.1 	fee in clause (16) is reduced by $55,000. If the application is made within 60 days before 
184.2 	the date of the original license or registration expiration, the applicant must pay the full 
184.3 	application fee provided in subdivision 1. Upon approval of an application for a relocation, 
184.4 	the board shall issue a new license or registration.

184.5 	Sec. 5. Minnesota Statutes 2022, section 151.065, is amended by adding a subdivision to 
184.6 	read:
184.7 		Subd. 4b.Application and fee; change of ownership. A person who is registered with 
184.8 	or licensed by the board must submit a new application to the board before changing the 
184.9 	ownership of the licensee or registrant. An application must be submitted for each affected 
184.10 	license. The application must set forth the proposed change of ownership on a form 
184.11 	established by the board. If the licensee or registrant remitted payment for the full amount 
184.12 	during the state's fiscal year, the application fee is the same as the application fee in 
184.13 	subdivision 1, except that the fees in clauses (6) to (9) and (11) to (16) are reduced by $5,000 
184.14 	and the fee in clause (16) is reduced by $55,000. If the application is made within 60 days 
184.15 	before the date of the original license or registration expiration, the applicant must pay the 
184.16 	full application fee provided in subdivision 1. Upon approval of an application for a change 
184.17 	of ownership, the board shall issue a new license or registration.

184.18 	Sec. 6. Minnesota Statutes 2022, section 151.065, is amended by adding a subdivision to 
184.19 	read:
184.20 		Subd. 8.Transfer of licenses. Licenses and registrations granted by the board are not 
184.21 	transferable.

184.22 	Sec. 7. Minnesota Statutes 2022, section 151.066, subdivision 1, is amended to read:
184.23 		Subdivision 1.Definitions. (a) For purposes of this section, the following terms have 
184.24 	the meanings given to them in this subdivision.
184.25 	(b) "Manufacturer" means a manufacturer licensed under section 151.252that is engaged 
184.26 	in the manufacturing of an opiate, excluding those exclusively licensed to manufacture 
184.27 	medical gas.
184.28 	(c) "Opiate" means any opiate-containing controlled substance listed in section 152.02, 
184.29 	subdivisions 3 to 5, that is distributed, delivered, sold, or dispensed into or within this state.
184.30 	(d) "Third-party logistics provider" means a third-party logistics provider licensed under 
184.31 	section 151.471.
185.1 	(e) "Wholesaler" means a wholesale drug distributor licensed under section 151.47that 
185.2 	is engaged in the wholesale drug distribution of an opiate, excluding those exclusively 
185.3 	licensed to distribute medical gas.

185.4 	Sec. 8. Minnesota Statutes 2022, section 151.066, subdivision 2, is amended to read:
185.5 		Subd. 2.Reporting requirements. (a) By March 1 of each year, beginning March 1, 
185.6 	2020, each manufacturer and each wholesaler must report to the board every sale, delivery, 
185.7 	or other distribution within or into this state of any opiate that is made to any practitioner, 
185.8 	pharmacy, hospital, veterinary hospital, or other person who is permitted by section 151.37 
185.9 	to possess controlled substances for administration or dispensing to patients that occurred 
185.10 	during the previous calendar year. Reporting must be in the automation of reports and 
185.11 	consolidated orders system format unless otherwise specified by the board. If no reportable 
185.12 	distributions occurred for a given year, notification must be provided to the board in a 
185.13 	manner specified by the board. If a manufacturer or wholesaler fails to provide information 
185.14 	required under this paragraph on a timely basis, the board may assess an administrative 
185.15 	penalty of $500 per day. This penalty shall not be considered a form of disciplinary action.
185.16 	(b) By March 1 of each year, beginning March 1, 2020, each owner of a pharmacy with 
185.17 	at least one location within this state must report to the board any intracompany delivery 
185.18 	or distribution into this state, of any opiate, to the extent that those deliveries and distributions 
185.19 	are not reported to the board by a licensed wholesaler owned by, under contract to, or 
185.20 	otherwise operating on behalf of the owner of the pharmacy. Reporting must be in the 
185.21 	manner and format specified by the board for deliveries and distributions that occurred 
185.22 	during the previous calendar year. The report must include the name of the manufacturer 
185.23 	or wholesaler from which the owner of the pharmacy ultimately purchased the opiate, and 
185.24 	the amount and date that the purchase occurred.
185.25 	(c) By March 1 of each year, beginning March 1, 2025, each third-party logistics provider 
185.26 	must report to the board any delivery or distribution into this state of any opiate, to the 
185.27 	extent that those deliveries and distributions are not reported to the board by a licensed 
185.28 	wholesaler or manufacturer. Reporting must be in the manner and format specified by the 
185.29 	board for deliveries and distributions that occurred during the previous calendar year.

185.30 	Sec. 9. Minnesota Statutes 2022, section 151.066, subdivision 3, is amended to read:
185.31 		Subd. 3.Determination of an opiate product registration fee. (a) The board shall 
185.32 	annually assess an opiate product registration fee on any manufacturer of an opiate that 
186.1 	annually sells, delivers, or distributes an opiate within or into the state in a quantity of 
186.2 	2,000,000 or more units as reported to the board under subdivision 2.
186.3 	(b) For purposes of assessing the annual registration fee under this section and 
186.4 	determining the number of opiate units a manufacturer sold, delivered, or distributed within 
186.5 	or into the state, the board shall not consider any opiate that is used for substance use disorder 
186.6 	treatment with medications for opioid use disorder.
186.7 	(c) The annual registration fee for each manufacturer meeting the requirement under 
186.8 	paragraph (a) is $250,000.
186.9 	(d) In conjunction with the data reported under this section, and notwithstanding section 
186.10 	152.126, subdivision 6, the board may use the data reported under section 152.126, 
186.11 	subdivision 4, to determine which manufacturers meet the requirement under paragraph (a) 
186.12 	and are required to pay the registration fees under this subdivision.
186.13 	(e) By April 1 of each year, beginning April 1, 2020, the board shall notify a manufacturer 
186.14 	that the manufacturer meets the requirement in paragraph (a) and is required to pay the 
186.15 	annual registration fee in accordance with section 151.252, subdivision 1, paragraph (b).
186.16 	(f) A manufacturer may dispute the board's determination that the manufacturer must 
186.17 	pay the registration fee no later than 30 days after the date of notification. However, the 
186.18 	manufacturer must still remit the fee as required by section 151.252, subdivision 1, paragraph 
186.19 	(b). The dispute must be filed with the board in the manner and using the forms specified 
186.20 	by the board. A manufacturer must submit, with the required forms, data satisfactory to the 
186.21 	board that demonstrates that the assessment of the registration fee was incorrect. The board 
186.22 	must make a decision concerning a dispute no later than 60 days after receiving the required 
186.23 	dispute forms. If the board determines that the manufacturer has satisfactorily demonstrated 
186.24 	that the fee was incorrectly assessed, the board must refund the amount paid in error.
186.25 	(g) For purposes of this subdivision, a unit means the individual dosage form of the 
186.26 	particular drug product that is prescribed to the patient. One unit equals one tablet, capsule, 
186.27 	patch, syringe, milliliter, or gram.
186.28 	(h) For the purposes of this subdivision, an opiate's units will be assigned to the 
186.29 	manufacturer holding the New Drug Application (NDA) or Abbreviated New Drug 
186.30 	Application (ANDA), as listed by the United States Food and Drug Administration.

186.31 	Sec. 10. Minnesota Statutes 2022, section 151.212, is amended by adding a subdivision 
186.32 	to read:
186.33 		Subd. 4.Accessible prescription drug container labels. (a) A pharmacy must:
187.1 	(1) make reasonable efforts to inform the public that an accessible prescription drug 
187.2 	container label is available at no additional cost, upon request of the patient or the patient's 
187.3 	representative, to any patient who has difficulty seeing or reading standard printed labels 
187.4 	on prescription drug containers; and
187.5 	(2) if the pharmacy knows that the patient has difficulty seeing or reading standard 
187.6 	printed labels on prescription drug containers, inform a patient that an accessible prescription 
187.7 	drug container label is available at no additional cost upon request of the patient or the 
187.8 	patient's representative.
187.9 	(b) Subject to paragraph (e), if a patient requests an accessible container label, the 
187.10 	pharmacy must provide the patient with a prescription drug container label in large print, 
187.11 	Braille, or may provide any other method included in the best practices for access to 
187.12 	prescription drug labeling information by the United States Access Board, or its successor 
187.13 	organization, depending on the need and preference of the patient. The pharmacy must make 
187.14 	reasonable efforts to ensure patient safety and access during the time it takes to provide the 
187.15 	requested method of accessibility.
187.16 	(c) The accessible container label must:
187.17 	(1) be affixed on the container in compliance with section 151.212, subdivision 1;
187.18 	(2) last for at least the duration of the prescription;
187.19 	(3) contain the information required under subdivisions 1 and 2;
187.20 	(4) be available in a timely manner relative to the industry standard time required to 
187.21 	produce the accessible container label; and
187.22 	(5) conform with the best practices established by the United States Access Board, or 
187.23 	its successor organization, for large print and Braille accessible container labels.
187.24 	(d) By January 1, 2025, the commissioner of health must publish a list of pharmacies 
187.25 	that have informed the commissioner that the pharmacy has the technological capacity to 
187.26 	provide an accessible container label to a patient in the timely manner required by paragraph 
187.27 	(c), clause (4). The commissioner must update this list on a quarterly basis until January 1, 
187.28 	2026.
187.29 	(e) Until January 1, 2026, if the pharmacy does not have the technological capacity to 
187.30 	provide an accessible container label to a patient in the timely manner required by paragraph 
187.31 	(c), clause (4), the pharmacy is not required to provide an accessible container label to a 
187.32 	patient requesting such a label, but the pharmacy must inform the patient of the list of 
187.33 	pharmacies with such capacity required pursuant to paragraph (d), if such list is published.
188.1 	(f) On and after January 1, 2026, all pharmacies must be able to provide an accessible 
188.2 	container label in the timely manner required by paragraph (c), clause (4).
188.3 	(g) This subdivision does not apply to prescription drugs dispensed and administered 
188.4 	by a correctional institution.

188.5 	EFFECTIVE DATE. This section is effective January 1, 2025.

188.6 	Sec. 11. Minnesota Statutes 2022, section 151.37, is amended by adding a subdivision to 
188.7 	read:
188.8 		Subd. 17.Drugs for preventing the acquisition of HIV. (a) A pharmacist is authorized 
188.9 	to prescribe and administer drugs to prevent the acquisition of human immunodeficiency 
188.10 	virus (HIV) in accordance with this subdivision.
188.11 	(b) By January 1, 2025, the Board of Pharmacy shall develop a standardized protocol 
188.12 	for a pharmacist to follow in prescribing the drugs described in paragraph (a). In developing 
188.13 	the protocol, the board may consult with community health advocacy groups, the Board of 
188.14 	Medical Practice, the Board of Nursing, the commissioner of health, professional pharmacy 
188.15 	associations, and professional associations for physicians, physician assistants, and advanced 
188.16 	practice registered nurses.
188.17 	(c) Before a pharmacist is authorized to prescribe a drug described in paragraph (a), the 
188.18 	pharmacist must successfully complete a training program specifically developed for 
188.19 	prescribing drugs for preventing the acquisition of HIV that is offered by a college of 
188.20 	pharmacy, a continuing education provider that is accredited by the Accreditation Council 
188.21 	for Pharmacy Education, or a program approved by the board. To maintain authorization 
188.22 	to prescribe, the pharmacist shall complete continuing education requirements as specified 
188.23 	by the board.
188.24 	(d) Before prescribing a drug described in paragraph (a), the pharmacist shall follow the 
188.25 	appropriate standardized protocol developed under paragraph (b) and, if appropriate, may 
188.26 	dispense to a patient a drug described in paragraph (a).
188.27 	(e) Before dispensing a drug described in paragraph (a) that is prescribed by the 
188.28 	pharmacist, the pharmacist must provide counseling to the patient on the use of the drugs 
188.29 	and must provide the patient with a fact sheet that includes the indications and 
188.30 	contraindications for the use of these drugs, the appropriate method for using these drugs, 
188.31 	the need for medical follow up, and any additional information listed in Minnesota Rules, 
188.32 	part 6800.0910, subpart 2, that is required to be provided to a patient during the counseling 
188.33 	process.
189.1 	(f) A pharmacist is prohibited from delegating the prescribing authority provided under 
189.2 	this subdivision to any other person. A pharmacist intern registered under section 151.101 
189.3 	may prepare the prescription, but before the prescription is processed or dispensed, a 
189.4 	pharmacist authorized to prescribe under this subdivision must review, approve, and sign 
189.5 	the prescription.
189.6 	(g) Nothing in this subdivision prohibits a pharmacist from participating in the initiation, 
189.7 	management, modification, and discontinuation of drug therapy according to a protocol as 
189.8 	authorized in this section and in section 151.01, subdivision 27.

189.9 	EFFECTIVE DATE. This section is effective January 1, 2025, except that paragraph 
189.10 	(b) is effective the day following final enactment.

189.11 	Sec. 12. Minnesota Statutes 2023 Supplement, section 151.555, subdivision 1, is amended 
189.12 	to read:
189.13 		Subdivision 1.Definitions. (a) For the purposes of this section, the terms defined in this 
189.14 	subdivision have the meanings given.
189.15 	(b) "Central repository" means a wholesale distributor that meets the requirements under 
189.16 	subdivision 3 and enters into a contract with the Board of Pharmacy in accordance with this 
189.17 	section.
189.18 	(c) "Distribute" means to deliver, other than by administering or dispensing.
189.19 	(d) "Donor" means:
189.20 	(1) a health care facility as defined in this subdivision an individual at least 18 years of 
189.21 	age, provided that the drug or medical supply that is donated was obtained legally and meets 
189.22 	the requirements of this section for donation; or
189.23 	(2) a skilled nursing facility licensed under chapter 144A; any entity legally authorized 
189.24 	to possess medicine with a license or permit in good standing in the state in which it is 
189.25 	located, without further restrictions, including but not limited to a health care facility, skilled 
189.26 	nursing facility, assisted living facility, pharmacy, wholesaler, and drug manufacturer.
189.27 	(3) an assisted living facility licensed under chapter 144G;
189.28 	(4) a pharmacy licensed under section 151.19, and located either in the state or outside 
189.29 	the state;
189.30 	(5) a drug wholesaler licensed under section 151.47;
189.31 	(6) a drug manufacturer licensed under section 151.252; or
190.1 	(7) an individual at least 18 years of age, provided that the drug or medical supply that 
190.2 	is donated was obtained legally and meets the requirements of this section for donation.
190.3 	(e) "Drug" means any prescription drug that has been approved for medical use in the 
190.4 	United States, is listed in the United States Pharmacopoeia or National Formulary, and 
190.5 	meets the criteria established under this section for donation; or any over-the-counter 
190.6 	medication that meets the criteria established under this section for donation. This definition 
190.7 	includes cancer drugs and antirejection drugs, but does not include controlled substances, 
190.8 	as defined in section 152.01, subdivision 4, or a prescription drug that can only be dispensed 
190.9 	to a patient registered with the drug's manufacturer in accordance with federal Food and 
190.10 	Drug Administration requirements.
190.11 	(f) "Health care facility" means:
190.12 	(1) a physician's office or health care clinic where licensed practitioners provide health 
190.13 	care to patients;
190.14 	(2) a hospital licensed under section 144.50;
190.15 	(3) a pharmacy licensed under section 151.19 and located in Minnesota; or
190.16 	(4) a nonprofit community clinic, including a federally qualified health center; a rural 
190.17 	health clinic; public health clinic; or other community clinic that provides health care utilizing 
190.18 	a sliding fee scale to patients who are low-income, uninsured, or underinsured.
190.19 	(g) "Local repository" means a health care facility that elects to accept donated drugs 
190.20 	and medical supplies and meets the requirements of subdivision 4.
190.21 	(h) "Medical supplies" or "supplies" means any prescription or nonprescription medical 
190.22 	supplies needed to administer a drug.
190.23 	(i) "Original, sealed, unopened, tamper-evident packaging" means packaging that is 
190.24 	sealed, unopened, and tamper-evident, including a manufacturer's original unit dose or 
190.25 	unit-of-use container, a repackager's original unit dose or unit-of-use container, or unit-dose 
190.26 	packaging prepared by a licensed pharmacy according to the standards of Minnesota Rules, 
190.27 	part 6800.3750.
190.28 	(j) "Practitioner" has the meaning given in section 151.01, subdivision 23, except that 
190.29 	it does not include a veterinarian.

191.1 	Sec. 13. Minnesota Statutes 2023 Supplement, section 151.555, subdivision 4, is amended 
191.2 	to read:
191.3 		Subd. 4.Local repository requirements. (a) To be eligible for participation in the 
191.4 	medication repository program, a health care facility must agree to comply with all applicable 
191.5 	federal and state laws, rules, and regulations pertaining to the medication repository program, 
191.6 	drug storage, and dispensing. The facility must also agree to maintain in good standing any 
191.7 	required state license or registration that may apply to the facility.
191.8 	(b) A local repository may elect to participate in the program by submitting the following 
191.9 	information to the central repository on a form developed by the board and made available 
191.10 	on the board's website:
191.11 	(1) the name, street address, and telephone number of the health care facility and any 
191.12 	state-issued license or registration number issued to the facility, including the issuing state 
191.13 	agency;
191.14 	(2) the name and telephone number of a responsible pharmacist or practitioner who is 
191.15 	employed by or under contract with the health care facility; and
191.16 	(3) a statement signed and dated by the responsible pharmacist or practitioner indicating 
191.17 	that the health care facility meets the eligibility requirements under this section and agrees 
191.18 	to comply with this section.
191.19 	(c) Participation in the medication repository program is voluntary. A local repository 
191.20 	may withdraw from participation in the medication repository program at any time by 
191.21 	providing written notice to the central repository on a form developed by the board and 
191.22 	made available on the board's website. The central repository shall provide the board with 
191.23 	a copy of the withdrawal notice within ten business days from the date of receipt of the 
191.24 	withdrawal notice.

191.25 	Sec. 14. Minnesota Statutes 2023 Supplement, section 151.555, subdivision 5, is amended 
191.26 	to read:
191.27 		Subd. 5.Individual eligibility and application requirements. (a) To be eligible for 
191.28 	the medication repository program At the time of or before receiving donated drugs or 
191.29 	supplies as a new eligible patient, an individual must submit to a local repository an electronic 
191.30 	or physical intake application form that is signed by the individual and attests that the 
191.31 	individual:
191.32 	(1) is a resident of Minnesota;
192.1 	(2) is uninsured and is not enrolled in the medical assistance program under chapter 
192.2 	256B or the MinnesotaCare program under chapter 256L, has no prescription drug coverage, 
192.3 	or is underinsured;
192.4 	(3) acknowledges that the drugs or medical supplies to be received through the program 
192.5 	may have been donated; and
192.6 	(4) consents to a waiver of the child-resistant packaging requirements of the federal 
192.7 	Poison Prevention Packaging Act.
192.8 	(b) Upon determining that an individual is eligible for the program, the local repository 
192.9 	shall furnish the individual with an identification card. The card shall be valid for one year 
192.10 	from the date of issuance and may be used at any local repository. A new identification card 
192.11 	may be issued upon expiration once the individual submits a new application form.
192.12 	(c) (b) The local repository shall send a copy of the intake application form to the central 
192.13 	repository by regular mail, facsimile, or secured email within ten days from the date the 
192.14 	application is approved by the local repository.
192.15 	(d) (c) The board shall develop and make available on the board's website an application 
192.16 	form and the format for the identification card.

192.17 	Sec. 15. Minnesota Statutes 2023 Supplement, section 151.555, subdivision 6, is amended 
192.18 	to read:
192.19 		Subd. 6.Standards and procedures for accepting donations of drugs and supplies. (a) 
192.20 	Notwithstanding any other law or rule, a donor may donate drugs or medical supplies to 
192.21 	the central repository or a local repository if the drug or supply meets the requirements of 
192.22 	this section as determined by a pharmacist or practitioner who is employed by or under 
192.23 	contract with the central repository or a local repository.
192.24 	(b) A drug is eligible for donation under the medication repository program if the 
192.25 	following requirements are met:
192.26 	(1) the donation is accompanied by a medication repository donor form described under 
192.27 	paragraph (d) that is signed by an individual who is authorized by the donor to attest to the 
192.28 	donor's knowledge in accordance with paragraph (d);
192.29 	(2) (1) the drug's expiration date is at least six months after the date the drug was donated. 
192.30 	If a donated drug bears an expiration date that is less than six months from the donation 
192.31 	date, the drug may be accepted and distributed if the drug is in high demand and can be 
192.32 	dispensed for use by a patient before the drug's expiration date;
193.1 	(3) (2) the drug is in its original, sealed, unopened, tamper-evident packaging that includes 
193.2 	the expiration date. Single-unit-dose drugs may be accepted if the single-unit-dose packaging 
193.3 	is unopened;
193.4 	(4) (3) the drug or the packaging does not have any physical signs of tampering, 
193.5 	misbranding, deterioration, compromised integrity, or adulteration;
193.6 	(5) (4) the drug does not require storage temperatures other than normal room temperature 
193.7 	as specified by the manufacturer or United States Pharmacopoeia, unless the drug is being 
193.8 	donated directly by its manufacturer, a wholesale drug distributor, or a pharmacy located 
193.9 	in Minnesota; and
193.10 	(6) (5) the drug is not a controlled substance.
193.11 	(c) A medical supply is eligible for donation under the medication repository program 
193.12 	if the following requirements are met:
193.13 	(1) the supply has no physical signs of tampering, misbranding, or alteration and there 
193.14 	is no reason to believe it has been adulterated, tampered with, or misbranded;
193.15 	(2) the supply is in its original, unopened, sealed packaging; and
193.16 	(3) the donation is accompanied by a medication repository donor form described under 
193.17 	paragraph (d) that is signed by an individual who is authorized by the donor to attest to the 
193.18 	donor's knowledge in accordance with paragraph (d); and
193.19 	(4) (3) if the supply bears an expiration date, the date is at least six months later than 
193.20 	the date the supply was donated. If the donated supply bears an expiration date that is less 
193.21 	than six months from the date the supply was donated, the supply may be accepted and 
193.22 	distributed if the supply is in high demand and can be dispensed for use by a patient before 
193.23 	the supply's expiration date.
193.24 	(d) The board shall develop the medication repository donor form and make it available 
193.25 	on the board's website. The form must state that to the best of the donor's knowledge the 
193.26 	donated drug or supply has been properly stored under appropriate temperature and humidity 
193.27 	conditions and that the drug or supply has never been opened, used, tampered with, 
193.28 	adulterated, or misbranded. Prior to the first donation from a new donor, a central repository 
193.29 	or local repository shall verify and record the following information on the donor form:
193.30 	(1) the donor's name, address, phone number, and license number, if applicable;
193.31 	(2) that the donor will only make donations in accordance with the program;
194.1 	(3) to the best of the donor's knowledge, only drugs or supplies that have been properly 
194.2 	stored under appropriate temperature and humidity conditions will be donated; and
194.3 	(4) to the best of the donor's knowledge, only drugs or supplies that have never been 
194.4 	opened, used, tampered with, adulterated, or misbranded will be donated.
194.5 	(e) Notwithstanding any other law or rule, a central repository or a local repository may 
194.6 	receive donated drugs from donors. Donated drugs and supplies may be shipped or delivered 
194.7 	to the premises of the central repository or a local repository, and shall be inspected by a 
194.8 	pharmacist or an authorized practitioner who is employed by or under contract with the 
194.9 	repository and who has been designated by the repository to accept donations prior to 
194.10 	dispensing. A drop box must not be used to deliver or accept donations.
194.11 	(f) The central repository and local repository shall maintain a written or electronic 
194.12 	inventory of all drugs and supplies donated to the repository upon acceptance of each drug 
194.13 	or supply. For each drug, the inventory must include the drug's name, strength, quantity, 
194.14 	manufacturer, expiration date, and the date the drug was donated. For each medical supply, 
194.15 	the inventory must include a description of the supply, its manufacturer, the date the supply 
194.16 	was donated, and, if applicable, the supply's brand name and expiration date. The board 
194.17 	may waive the requirement under this paragraph if an entity is under common ownership 
194.18 	or control with a central repository or local repository and either the entity or the repository 
194.19 	maintains an inventory containing all the information required under this paragraph.

194.20 	Sec. 16. Minnesota Statutes 2023 Supplement, section 151.555, subdivision 7, is amended 
194.21 	to read:
194.22 		Subd. 7.Standards and procedures for inspecting and storing donated drugs and 
194.23 	supplies. (a) A pharmacist or authorized practitioner who is employed by or under contract 
194.24 	with the central repository or a local repository shall inspect all donated drugs and supplies 
194.25 	before the drug or supply is dispensed to determine, to the extent reasonably possible in the 
194.26 	professional judgment of the pharmacist or practitioner, that the drug or supply is not 
194.27 	adulterated or misbranded, has not been tampered with, is safe and suitable for dispensing, 
194.28 	has not been subject to a recall, and meets the requirements for donation. The pharmacist 
194.29 	or practitioner who inspects the drugs or supplies shall sign an inspection record stating that 
194.30 	the requirements for donation have been met. If a local repository receives drugs and supplies 
194.31 	from the central repository, the local repository does not need to reinspect the drugs and 
194.32 	supplies.
195.1 	(b) The central repository and local repositories shall store donated drugs and supplies 
195.2 	in a secure storage area under environmental conditions appropriate for the drug or supply 
195.3 	being stored. Donated drugs and supplies may not be stored with nondonated inventory.
195.4 	(c) The central repository and local repositories shall dispose of all drugs and medical 
195.5 	supplies that are not suitable for donation in compliance with applicable federal and state 
195.6 	statutes, regulations, and rules concerning hazardous waste.
195.7 	(d) In the event that controlled substances or drugs that can only be dispensed to a patient 
195.8 	registered with the drug's manufacturer are shipped or delivered to a central or local repository 
195.9 	for donation, the shipment delivery must be documented by the repository and returned 
195.10 	immediately to the donor or the donor's representative that provided the drugs.
195.11 	(e) Each repository must develop drug and medical supply recall policies and procedures. 
195.12 	If a repository receives a recall notification, the repository shall destroy all of the drug or 
195.13 	medical supply in its inventory that is the subject of the recall and complete a record of 
195.14 	destruction form in accordance with paragraph (f). If a drug or medical supply that is the 
195.15 	subject of a Class I or Class II recall has been dispensed, the repository shall immediately 
195.16 	notify the recipient of the recalled drug or medical supply. A drug that potentially is subject 
195.17 	to a recall need not be destroyed if its packaging bears a lot number and that lot of the drug 
195.18 	is not subject to the recall. If no lot number is on the drug's packaging, it must be destroyed.
195.19 	(f) A record of destruction of donated drugs and supplies that are not dispensed under 
195.20 	subdivision 8, are subject to a recall under paragraph (e), or are not suitable for donation 
195.21 	shall be maintained by the repository for at least two years. For each drug or supply destroyed, 
195.22 	the record shall include the following information:
195.23 	(1) the date of destruction;
195.24 	(2) the name, strength, and quantity of the drug destroyed; and
195.25 	(3) the name of the person or firm that destroyed the drug.
195.26 	No other record of destruction is required.

195.27 	Sec. 17. Minnesota Statutes 2023 Supplement, section 151.555, subdivision 8, is amended 
195.28 	to read:
195.29 		Subd. 8.Dispensing requirements. (a) Donated prescription drugs and supplies may 
195.30 	be dispensed if the drugs or supplies are prescribed by a practitioner for use by an eligible 
195.31 	individual and are dispensed by a pharmacist or practitioner. A repository shall dispense 
195.32 	drugs and supplies to eligible individuals in the following priority order: (1) individuals 
196.1 	who are uninsured; (2) individuals with no prescription drug coverage; and (3) individuals 
196.2 	who are underinsured. A repository shall dispense donated drugs in compliance with 
196.3 	applicable federal and state laws and regulations for dispensing drugs, including all 
196.4 	requirements relating to packaging, labeling, record keeping, drug utilization review, and 
196.5 	patient counseling.
196.6 	(b) Before dispensing or administering a drug or supply, the pharmacist or practitioner 
196.7 	shall visually inspect the drug or supply for adulteration, misbranding, tampering, and date 
196.8 	of expiration. Drugs or supplies that have expired or appear upon visual inspection to be 
196.9 	adulterated, misbranded, or tampered with in any way must not be dispensed or administered.
196.10 	(c) Before a the first drug or supply is dispensed or administered to an individual, the 
196.11 	individual must sign a an electronic or physical drug repository recipient form acknowledging 
196.12 	that the individual understands the information stated on the form. The board shall develop 
196.13 	the form and make it available on the board's website. The form must include the following 
196.14 	information:
196.15 	(1) that the drug or supply being dispensed or administered has been donated and may 
196.16 	have been previously dispensed;
196.17 	(2) that a visual inspection has been conducted by the pharmacist or practitioner to ensure 
196.18 	that the drug or supply has not expired, has not been adulterated or misbranded, and is in 
196.19 	its original, unopened packaging; and
196.20 	(3) that the dispensing pharmacist, the dispensing or administering practitioner, the 
196.21 	central repository or local repository, the Board of Pharmacy, and any other participant of 
196.22 	the medication repository program cannot guarantee the safety of the drug or medical supply 
196.23 	being dispensed or administered and that the pharmacist or practitioner has determined that 
196.24 	the drug or supply is safe to dispense or administer based on the accuracy of the donor's 
196.25 	form submitted with the donated drug or medical supply and the visual inspection required 
196.26 	to be performed by the pharmacist or practitioner before dispensing or administering.

196.27 	Sec. 18. Minnesota Statutes 2023 Supplement, section 151.555, subdivision 9, is amended 
196.28 	to read:
196.29 		Subd. 9.Handling fees. (a) The central or local repository may charge the individual 
196.30 	receiving a drug or supply a handling fee of no more than 250 percent of the medical 
196.31 	assistance program dispensing fee for each drug or medical supply dispensed or administered 
196.32 	by that repository.
197.1 	(b) A repository that dispenses or administers a drug or medical supply through the 
197.2 	medication repository program shall not receive reimbursement under the medical assistance 
197.3 	program or the MinnesotaCare program for that dispensed or administered drug or supply.
197.4 	(c) A supply or handling fee must not be charged to an individual enrolled in the medical 
197.5 	assistance or MinnesotaCare program.

197.6 	Sec. 19. Minnesota Statutes 2023 Supplement, section 151.555, subdivision 11, is amended 
197.7 	to read:
197.8 		Subd. 11.Forms and record-keeping requirements. (a) The following forms developed 
197.9 	for the administration of this program shall be utilized by the participants of the program 
197.10 	and shall be available on the board's website:
197.11 	(1) intake application form described under subdivision 5;
197.12 	(2) local repository participation form described under subdivision 4;
197.13 	(3) local repository withdrawal form described under subdivision 4;
197.14 	(4) medication repository donor form described under subdivision 6;
197.15 	(5) record of destruction form described under subdivision 7; and
197.16 	(6) medication repository recipient form described under subdivision 8.
197.17 	Participants may use substantively similar electronic or physical forms.
197.18 	(b) All records, including drug inventory, inspection, and disposal of donated drugs and 
197.19 	medical supplies, must be maintained by a repository for a minimum of two years. Records 
197.20 	required as part of this program must be maintained pursuant to all applicable practice acts.
197.21 	(c) Data collected by the medication repository program from all local repositories shall 
197.22 	be submitted quarterly or upon request to the central repository. Data collected may consist 
197.23 	of the information, records, and forms required to be collected under this section.
197.24 	(d) The central repository shall submit reports to the board as required by the contract 
197.25 	or upon request of the board.

197.26 	Sec. 20. Minnesota Statutes 2023 Supplement, section 151.555, subdivision 12, is amended 
197.27 	to read:
197.28 		Subd. 12.Liability. (a) The manufacturer of a drug or supply is not subject to criminal 
197.29 	or civil liability for injury, death, or loss to a person or to property for causes of action 
197.30 	described in clauses (1) and (2). A manufacturer is not liable for:
198.1 	(1) the intentional or unintentional alteration of the drug or supply by a party not under 
198.2 	the control of the manufacturer; or
198.3 	(2) the failure of a party not under the control of the manufacturer to transfer or 
198.4 	communicate product or consumer information or the expiration date of the donated drug 
198.5 	or supply.
198.6 	(b) A health care facility participating in the program, a pharmacist dispensing a drug 
198.7 	or supply pursuant to the program, a practitioner dispensing or administering a drug or 
198.8 	supply pursuant to the program, or a donor of a drug or medical supply, or a person or entity 
198.9 	that facilitates any of the above is immune from civil liability for an act or omission that 
198.10 	causes injury to or the death of an individual to whom the drug or supply is dispensed and 
198.11 	no disciplinary action by a health-related licensing board shall be taken against a pharmacist 
198.12 	or practitioner person or entity so long as the drug or supply is donated, accepted, distributed, 
198.13 	and dispensed according to the requirements of this section. This immunity does not apply 
198.14 	if the act or omission involves reckless, wanton, or intentional misconduct, or malpractice 
198.15 	unrelated to the quality of the drug or medical supply.

198.16 	Sec. 21. Minnesota Statutes 2022, section 256B.0625, subdivision 10, is amended to read:
198.17 		Subd. 10.Laboratory, x-ray, and opioid testing services. (a) Medical assistance covers 
198.18 	laboratory and x-ray services.
198.19 	(b) Medical assistance covers screening and urinalysis tests for opioids without lifetime 
198.20 	or annual limits.
198.21 	(c) Medical assistance covers laboratory tests ordered and performed by a licensed 
198.22 	pharmacist, according to the requirements of section 151.01, subdivision 27, clause (3), at 
198.23 	no less than the rate for which the same services are covered when provided by any other 
198.24 	licensed practitioner.

198.25 	EFFECTIVE DATE. This section is effective January 1, 2025, or upon federal approval, 
198.26 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
198.27 	when federal approval is obtained.

198.28 	Sec. 22. Minnesota Statutes 2023 Supplement, section 256B.0625, subdivision 13f, is 
198.29 	amended to read:
198.30 		Subd. 13f.Prior authorization. (a) The Formulary Committee shall review and 
198.31 	recommend drugs which require prior authorization. The Formulary Committee shall 
198.32 	establish general criteria to be used for the prior authorization of brand-name drugs for 
199.1 	which generically equivalent drugs are available, but the committee is not required to review 
199.2 	each brand-name drug for which a generically equivalent drug is available.
199.3 	(b) Prior authorization may be required by the commissioner before certain formulary 
199.4 	drugs are eligible for payment. The Formulary Committee may recommend drugs for prior 
199.5 	authorization directly to the commissioner. The commissioner may also request that the 
199.6 	Formulary Committee review a drug for prior authorization. Before the commissioner may 
199.7 	require prior authorization for a drug:
199.8 	(1) the commissioner must provide information to the Formulary Committee on the 
199.9 	impact that placing the drug on prior authorization may have on the quality of patient care 
199.10 	and on program costs, information regarding whether the drug is subject to clinical abuse 
199.11 	or misuse, and relevant data from the state Medicaid program if such data is available;
199.12 	(2) the Formulary Committee must review the drug, taking into account medical and 
199.13 	clinical data and the information provided by the commissioner; and
199.14 	(3) the Formulary Committee must hold a public forum and receive public comment for 
199.15 	an additional 15 days.
199.16 	The commissioner must provide a 15-day notice period before implementing the prior 
199.17 	authorization.
199.18 	(c) Except as provided in subdivision 13j, prior authorization shall not be required or 
199.19 	utilized for any atypical antipsychotic drug prescribed for the treatment of mental illness 
199.20 	if:
199.21 	(1) there is no generically equivalent drug available; and
199.22 	(2) the drug was initially prescribed for the recipient prior to July 1, 2003; or
199.23 	(3) the drug is part of the recipient's current course of treatment.
199.24 	This paragraph applies to any multistate preferred drug list or supplemental drug rebate 
199.25 	program established or administered by the commissioner. Prior authorization shall 
199.26 	automatically be granted for 60 days for brand name drugs prescribed for treatment of mental 
199.27 	illness within 60 days of when a generically equivalent drug becomes available, provided 
199.28 	that the brand name drug was part of the recipient's course of treatment at the time the 
199.29 	generically equivalent drug became available.
199.30 	(d) Prior authorization must not be required for liquid methadone if only one version of 
199.31 	liquid methadone is available. If more than one version of liquid methadone is available, 
200.1 	the commissioner shall ensure that at least one version of liquid methadone is available 
200.2 	without prior authorization.
200.3 	(e) Prior authorization may be required for an oral liquid form of a drug, except as 
200.4 	described in paragraph (d). A prior authorization request under this paragraph must be 
200.5 	automatically approved within 24 hours if the drug is being prescribed for a Food and Drug 
200.6 	Administration-approved condition for a patient who utilizes an enteral tube for feedings 
200.7 	or medication administration, even if the patient has current or prior claims for pills for that 
200.8 	condition. If more than one version of the oral liquid form of a drug is available, the 
200.9 	commissioner may select the version that is able to be approved for a Food and Drug 
200.10 	Administration-approved condition for a patient who utilizes an enteral tube for feedings 
200.11 	or medication administration. This paragraph applies to any multistate preferred drug list 
200.12 	or supplemental drug rebate program established or administered by the commissioner. The 
200.13 	commissioner shall design and implement a streamlined prior authorization form for patients 
200.14 	who utilize an enteral tube for feedings or medication administration and are prescribed an 
200.15 	oral liquid form of a drug. The commissioner may require prior authorization for brand 
200.16 	name drugs whenever a generically equivalent product is available, even if the prescriber 
200.17 	specifically indicates "dispense as written-brand necessary" on the prescription as required 
200.18 	by section 151.21, subdivision 2.
200.19 	(f) Notwithstanding this subdivision, the commissioner may automatically require prior 
200.20 	authorization, for a period not to exceed 180 days, for any drug that is approved by the 
200.21 	United States Food and Drug Administration on or after July 1, 2005. The 180-day period 
200.22 	begins no later than the first day that a drug is available for shipment to pharmacies within 
200.23 	the state. The Formulary Committee shall recommend to the commissioner general criteria 
200.24 	to be used for the prior authorization of the drugs, but the committee is not required to 
200.25 	review each individual drug. In order to continue prior authorizations for a drug after the 
200.26 	180-day period has expired, the commissioner must follow the provisions of this subdivision.
200.27 	(g) Prior authorization under this subdivision shall comply with section 62Q.184.
200.28 	(h) Any step therapy protocol requirements established by the commissioner must comply 
200.29 	with section 62Q.1841.
200.30 	(i) Notwithstanding any law to the contrary, prior authorization or step therapy shall not 
200.31 	be required or utilized for any class of drugs that is approved by the United States Food and 
200.32 	Drug Administration for the treatment or prevention of HIV and AIDS.

200.33 	EFFECTIVE DATE. This section is effective January 1, 2026.

201.1 	Sec. 23. Minnesota Statutes 2022, section 256B.0625, subdivision 39, is amended to read:
201.2 		Subd. 39.Childhood immunizations. (a) Providers who administer pediatric vaccines 
201.3 	within the scope of their licensure, and who are enrolled as a medical assistance provider, 
201.4 	must enroll in the pediatric vaccine administration program established by section 13631 
201.5 	of the Omnibus Budget Reconciliation Act of 1993. Medical assistance shall pay for 
201.6 	administration of the vaccine to children eligible for medical assistance. Medical assistance 
201.7 	does not pay for vaccines that are available at no cost from the pediatric vaccine 
201.8 	administration program unless the vaccines qualify for 100 percent federal funding or are 
201.9 	mandated by the Centers for Medicare and Medicaid Services to be covered outside of the 
201.10 	Vaccines for Children program.
201.11 	(b) Medical assistance covers vaccines initiated, ordered, or administered by a licensed 
201.12 	pharmacist, according to the requirements of section 151.01, subdivision 27, clause (6), at 
201.13 	no less than the rate for which the same services are covered when provided by any other 
201.14 	licensed practitioner.

201.15 	EFFECTIVE DATE. The amendment to paragraph (a) is effective July 1, 2024. 
201.16 	Paragraph (b) is effective January 1, 2025, or upon federal approval, whichever is later. The 
201.17 	commissioner of human services shall notify the revisor of statutes when federal approval 
201.18 	is obtained.

201.19 	Sec. 24. DIRECTION TO THE COMMISSIONER; ASSESSMENT OF LICENSED 
201.20 	OUTPATIENT PHARMACIES; REPORT.
 201.21 	The commissioner of health, in consultation with the Board of Pharmacy, must conduct 
201.22 	an assessment of licensed outpatient pharmacies and vendors of audible container labels 
201.23 	and prescription readers to determine: (1) the approximate number of such pharmacies 
201.24 	currently providing accessible labels to individuals who cannot access large print or Braille 
201.25 	labels; and (2) the approximate cost to such pharmacies to provide accessible labels to 
201.26 	individuals who cannot access large print or Braille labels. By January 15, 2025, the 
201.27 	commissioner must submit a report to the chairs and ranking minority members of the 
201.28 	legislative committees with jurisdiction over health and human services finance and policy. 
201.29 	The report must include the assessment results and recommendations for providing accessible 
201.30 	labels to those who cannot access large print or Braille labels.

201.31 	EFFECTIVE DATE. This section is effective July 1, 2024.

202.1 	Sec. 25. RULEMAKING; BOARD OF PHARMACY.
 202.2 	The Board of Pharmacy must amend Minnesota Rules, part 6800.3400, to permit and 
202.3 	promote the inclusion of the following on a prescription label:
202.4 	(1) the complete and unabbreviated generic name of the drug; and
202.5 	(2) instructions written in plain language explaining the patient-specific indications for 
202.6 	the drug if the patient-specific indications are indicated on the prescription.
202.7 	The Board of Pharmacy must comply with Minnesota Statutes, section 14.389, in adopting 
202.8 	the amendment to the rule.

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

202.10 	ARTICLE 8
202.11 	BEHAVIORAL HEALTH

202.12 	Section 1. Minnesota Statutes 2022, section 245.462, subdivision 6, is amended to read:
202.13 		Subd. 6.Community support services program. "Community support services program" 
202.14 	means services, other than inpatient or residential treatment services, provided or coordinated 
202.15 	by an identified program and staff under the treatment supervision of a mental health 
202.16 	professional designed to help adults with serious and persistent mental illness to function 
202.17 	and remain in the community. A community support services program includes:
202.18 	(1) client outreach,
202.19 	(2) medication monitoring,
202.20 	(3) assistance in independent living skills,
202.21 	(4) development of employability and work-related opportunities,
202.22 	(5) crisis assistance,
202.23 	(6) psychosocial rehabilitation,
202.24 	(7) help in applying for government benefits, and
202.25 	(8) housing support services.
202.26 	The community support services program must be coordinated with the case management 
202.27 	services specified in section 245.4711. A program that meets the accreditation standards 
202.28 	for Clubhouse International model programs meets the requirements of this subdivision.

203.1 	Sec. 2. Minnesota Statutes 2022, section 245.4663, subdivision 2, is amended to read:
203.2 		Subd. 2.Eligible providers. In order to be eligible for a grant under this section, a mental 
203.3 	health provider must:
203.4 	(1) provide at least 25 percent of the provider's yearly patient encounters to state public 
203.5 	program enrollees or patients receiving sliding fee schedule discounts through a formal 
203.6 	sliding fee schedule meeting the standards established by the United States Department of 
203.7 	Health and Human Services under Code of Federal Regulations, title 42, section 51c.303; 
203.8 	or
203.9 	(2) primarily serve underrepresented communities as defined in section 148E.010, 
203.10 	subdivision 20.; or
203.11 	(3) provide services to people in a city or township that is not within the seven-county 
203.12 	metropolitan area as defined in section 473.121, subdivision 2, and is not the city of Duluth, 
203.13 	Mankato, Moorhead, Rochester, or St. Cloud.

203.14 	Sec. 3. Minnesota Statutes 2023 Supplement, section 245.4889, subdivision 1, is amended 
203.15 	to read:
203.16 		Subdivision 1.Establishment and authority. (a) The commissioner is authorized to 
203.17 	make grants from available appropriations to assist:
203.18 	(1) counties;
203.19 	(2) Indian tribes;
203.20 	(3) children's collaboratives under section 124D.23 or 245.493; or
203.21 	(4) mental health service providers.
203.22 	(b) The following services are eligible for grants under this section:
203.23 	(1) services to children with emotional disturbances as defined in section 245.4871, 
203.24 	subdivision 15, and their families;
203.25 	(2) transition services under section 245.4875, subdivision 8, for young adults under 
203.26 	age 21 and their families;
203.27 	(3) respite care services for children with emotional disturbances or severe emotional 
203.28 	disturbances who are at risk of out-of-home placement or residential treatment or 
203.29 	hospitalization, who are already in out-of-home placement in family foster settings as defined 
203.30 	in chapter 245A and at risk of change in out-of-home placement or placement in a residential 
203.31 	facility or other higher level of care, who have utilized crisis services or emergency room 
204.1 	services, or who have experienced a loss of in-home staffing support. Allowable activities 
204.2 	and expenses for respite care services are defined under subdivision 4. A child is not required 
204.3 	to have case management services to receive respite care services. Counties must work to 
204.4 	provide access to regularly scheduled respite care;
204.5 	(4) children's mental health crisis services;
204.6 	(5) child-, youth-, and family-specific mobile response and stabilization services models;
204.7 	(6) mental health services for people from cultural and ethnic minorities, including 
204.8 	supervision of clinical trainees who are Black, indigenous, or people of color;
204.9 	(7) children's mental health screening and follow-up diagnostic assessment and treatment;
204.10 	(8) services to promote and develop the capacity of providers to use evidence-based 
204.11 	practices in providing children's mental health services;
204.12 	(9) school-linked mental health services under section 245.4901;
204.13 	(10) building evidence-based mental health intervention capacity for children birth to 
204.14 	age five;
204.15 	(11) suicide prevention and counseling services that use text messaging statewide;
204.16 	(12) mental health first aid training;
204.17 	(13) training for parents, collaborative partners, and mental health providers on the 
204.18 	impact of adverse childhood experiences and trauma and development of an interactive 
204.19 	website to share information and strategies to promote resilience and prevent trauma;
204.20 	(14) transition age services to develop or expand mental health treatment and supports 
204.21 	for adolescents and young adults 26 years of age or younger;
204.22 	(15) early childhood mental health consultation;
204.23 	(16) evidence-based interventions for youth at risk of developing or experiencing a first 
204.24 	episode of psychosis, and a public awareness campaign on the signs and symptoms of 
204.25 	psychosis;
204.26 	(17) psychiatric consultation for primary care practitioners; and
204.27 	(18) providers to begin operations and meet program requirements when establishing a 
204.28 	new children's mental health program. These may be start-up grants.
204.29 	(c) Services under paragraph (b) must be designed to help each child to function and 
204.30 	remain with the child's family in the community and delivered consistent with the child's 
205.1 	treatment plan. Transition services to eligible young adults under this paragraph must be 
205.2 	designed to foster independent living in the community.
205.3 	(d) As a condition of receiving grant funds, a grantee shall obtain all available third-party 
205.4 	reimbursement sources, if applicable.
205.5 	(e) The commissioner may establish and design a pilot program to expand the mobile 
205.6 	response and stabilization services model for children, youth, and families. The commissioner 
205.7 	may use grant funding to consult with a qualified expert entity to assist in the formulation 
205.8 	of measurable outcomes and explore and position the state to submit a Medicaid state plan 
205.9 	amendment to scale the model statewide.

205.10 	Sec. 4. Minnesota Statutes 2023 Supplement, section 245.735, subdivision 3, is amended 
205.11 	to read:
205.12 		Subd. 3.Certified community behavioral health clinics. (a) The commissioner shall 
205.13 	establish state certification and recertification processes for certified community behavioral 
205.14 	health clinics (CCBHCs) that satisfy all federal requirements necessary for CCBHCs certified 
205.15 	under this section to be eligible for reimbursement under medical assistance, without service 
205.16 	area limits based on geographic area or region. The commissioner shall consult with CCBHC 
205.17 	stakeholders before establishing and implementing changes in the certification or 
205.18 	recertification process and requirements. Any changes to the certification or recertification 
205.19 	process or requirements must be consistent with the most recently issued Certified 
205.20 	Community Behavioral Health Clinic Certification Criteria published by the Substance 
205.21 	Abuse and Mental Health Services Administration. The commissioner must allow a transition 
205.22 	period for CCBHCs to meet the revised criteria prior to July 1, 2024 on or before January 
205.23 	1, 2025. The commissioner is authorized to amend the state's Medicaid state plan or the 
205.24 	terms of the demonstration to comply with federal requirements.
205.25 	(b) As part of the state CCBHC certification and recertification processes, the 
205.26 	commissioner shall provide to entities applying for certification or requesting recertification 
205.27 	the standard requirements of the community needs assessment and the staffing plan that are 
205.28 	consistent with the most recently issued Certified Community Behavioral Health Clinic 
205.29 	Certification Criteria published by the Substance Abuse and Mental Health Services 
205.30 	Administration.
205.31 	(c) The commissioner shall schedule a certification review that includes a site visit within 
205.32 	90 calendar days of receipt of an application for certification or recertification.
205.33 	(d) Entities that choose to be CCBHCs must:
206.1 	(1) complete a community needs assessment and complete a staffing plan that is 
206.2 	responsive to the needs identified in the community needs assessment and update both the 
206.3 	community needs assessment and the staffing plan no less frequently than every 36 months;
206.4 	(2) comply with state licensing requirements and other requirements issued by the 
206.5 	commissioner;
206.6 	(3) employ or contract with a medical director. A medical director must be a physician 
206.7 	licensed under chapter 147 and either certified by the American Board of Psychiatry and 
206.8 	Neurology, certified by the American Osteopathic Board of Neurology and Psychiatry, or 
206.9 	eligible for board certification in psychiatry. A registered nurse who is licensed under 
206.10 	sections 148.171 to 148.285 and is certified as a nurse practitioner in adult or family 
206.11 	psychiatric and mental health nursing by a national nurse certification organization may 
206.12 	serve as the medical director when a CCBHC is unable to employ or contract a qualified 
206.13 	physician;
206.14 	(4) employ or contract for clinic staff who have backgrounds in diverse disciplines, 
206.15 	including licensed mental health professionals and licensed alcohol and drug counselors, 
206.16 	and staff who are culturally and linguistically trained to meet the needs of the population 
206.17 	the clinic serves;
206.18 	(5) ensure that clinic services are available and accessible to individuals and families of 
206.19 	all ages and genders with access on evenings and weekends and that crisis management 
206.20 	services are available 24 hours per day;
206.21 	(6) establish fees for clinic services for individuals who are not enrolled in medical 
206.22 	assistance using a sliding fee scale that ensures that services to patients are not denied or 
206.23 	limited due to an individual's inability to pay for services;
206.24 	(7) comply with quality assurance reporting requirements and other reporting 
206.25 	requirements included in the most recently issued Certified Community Behavioral Health 
206.26 	Clinic Certification Criteria published by the Substance Abuse and Mental Health Services 
206.27 	Administration;
206.28 	(8) provide crisis mental health and substance use services, withdrawal management 
206.29 	services, emergency crisis intervention services, and stabilization services through existing 
206.30 	mobile crisis services; screening, assessment, and diagnosis services, including risk 
206.31 	assessments and level of care determinations; person- and family-centered treatment planning; 
206.32 	outpatient mental health and substance use services; targeted case management; psychiatric 
206.33 	rehabilitation services; peer support and counselor services and family support services; 
206.34 	and intensive community-based mental health services, including mental health services 
207.1 	for members of the armed forces and veterans. CCBHCs must directly provide the majority 
207.2 	of these services to enrollees, but may coordinate some services with another entity through 
207.3 	a collaboration or agreement, pursuant to subdivision 3a;
207.4 	(9) provide coordination of care across settings and providers to ensure seamless 
207.5 	transitions for individuals being served across the full spectrum of health services, including 
207.6 	acute, chronic, and behavioral needs;
207.7 	(10) be certified as a mental health clinic under section 245I.20;
207.8 	(11) comply with standards established by the commissioner relating to CCBHC 
207.9 	screenings, assessments, and evaluations that are consistent with this section;
207.10 	(12) be licensed to provide substance use disorder treatment under chapter 245G;
207.11 	(13) be certified to provide children's therapeutic services and supports under section 
207.12 	256B.0943;
207.13 	(14) be certified to provide adult rehabilitative mental health services under section 
207.14 	256B.0623;
207.15 	(15) be enrolled to provide mental health crisis response services under section 
207.16 	256B.0624;
207.17 	(16) be enrolled to provide mental health targeted case management under section 
207.18 	256B.0625, subdivision 20;
207.19 	(17) provide services that comply with the evidence-based practices described in 
207.20 	subdivision 3d;
207.21 	(18) provide peer services as defined in sections 256B.0615, 256B.0616, and 245G.07, 
207.22 	subdivision 2, clause (8), as applicable when peer services are provided; and
207.23 	(19) inform all clients upon initiation of care of the full array of services available under 
207.24 	the CCBHC model.

207.25 	EFFECTIVE DATE. This section is effective upon federal approval. The commissioner 
207.26 	of human services shall notify the revisor of statutes when federal approval is obtained.

207.27 	Sec. 5. Minnesota Statutes 2022, section 245I.02, subdivision 17, is amended to read:
207.28 		Subd. 17.Functional assessment. "Functional assessment" means the assessment of a 
207.29 	client's current level of functioning relative to functioning that is appropriate for someone 
207.30 	the client's age. For a client five years of age or younger, a functional assessment is the 
207.31 	Early Childhood Service Intensity Instrument (ESCII). For a client six to 17 years of age, 
208.1 	a functional assessment is the Child and Adolescent Service Intensity Instrument (CASII). 
208.2 	For a client 18 years of age or older, a functional assessment is the functional assessment 
208.3 	described in section 245I.10, subdivision 9.

208.4 	Sec. 6. Minnesota Statutes 2022, section 245I.02, subdivision 19, is amended to read:
208.5 		Subd. 19.Level of care assessment. "Level of care assessment" means the level of care 
208.6 	decision support tool appropriate to the client's age. For a client five years of age or younger, 
208.7 	a level of care assessment is the Early Childhood Service Intensity Instrument (ESCII). For 
208.8 	a client six to 17 years of age, a level of care assessment is the Child and Adolescent Service 
208.9 	Intensity Instrument (CASII). For a client 18 years of age or older, a level of care assessment 
208.10 	is the Level of Care Utilization System for Psychiatric and Addiction Services (LOCUS) 
208.11 	or another tool authorized by the commissioner.

208.12 	Sec. 7. Minnesota Statutes 2022, section 245I.04, subdivision 6, is amended to read:
208.13 		Subd. 6.Clinical trainee qualifications. (a) A clinical trainee is a staff person who: (1) 
208.14 	is enrolled in an accredited graduate program of study to prepare the staff person for 
208.15 	independent licensure as a mental health professional and who is participating in a practicum 
208.16 	or internship with the license holder through the individual's graduate program; or (2) has 
208.17 	completed an accredited graduate program of study to prepare the staff person for independent 
208.18 	licensure as a mental health professional and who is in compliance with the requirements 
208.19 	of the applicable health-related licensing board, including requirements for supervised 
208.20 	practice.; or (3) has completed an accredited graduate program of study to prepare the staff 
208.21 	person for independent licensure as a mental health professional, has completed a practicum 
208.22 	or internship and has not yet taken or received the results from the required test or is waiting 
208.23 	for the final licensure decision.
208.24 	(b) A clinical trainee is responsible for notifying and applying to a health-related licensing 
208.25 	board to ensure that the trainee meets the requirements of the health-related licensing board. 
208.26 	As permitted by a health-related licensing board, treatment supervision under this chapter 
208.27 	may be integrated into a plan to meet the supervisory requirements of the health-related 
208.28 	licensing board but does not supersede those requirements.

208.29 	Sec. 8. Minnesota Statutes 2022, section 245I.10, subdivision 9, is amended to read:
208.30 		Subd. 9.Functional assessment; required elements. (a) When a license holder is 
208.31 	completing a functional assessment for an adult client, the license holder must:
209.1 	(1) complete a functional assessment of the client after completing the client's diagnostic 
209.2 	assessment;
209.3 	(2) use a collaborative process that allows the client and the client's family and other 
209.4 	natural supports, the client's referral sources, and the client's providers to provide information 
209.5 	about how the client's symptoms of mental illness impact the client's functioning;
209.6 	(3) if applicable, document the reasons that the license holder did not contact the client's 
209.7 	family and other natural supports;
209.8 	(4) assess and document how the client's symptoms of mental illness impact the client's 
209.9 	functioning in the following areas:
209.10 	(i) the client's mental health symptoms;
209.11 	(ii) the client's mental health service needs;
209.12 	(iii) the client's substance use;
209.13 	(iv) the client's vocational and educational functioning;
209.14 	(v) the client's social functioning, including the use of leisure time;
209.15 	(vi) the client's interpersonal functioning, including relationships with the client's family 
209.16 	and other natural supports;
209.17 	(vii) the client's ability to provide self-care and live independently;
209.18 	(viii) the client's medical and dental health;
209.19 	(ix) the client's financial assistance needs; and
209.20 	(x) the client's housing and transportation needs;
209.21 	(5) include a narrative summarizing the client's strengths, resources, and all areas of 
209.22 	functional impairment;
209.23 	(6) (5) complete the client's functional assessment before the client's initial individual 
209.24 	treatment plan unless a service specifies otherwise; and
209.25 	(7) (6) update the client's functional assessment with the client's current functioning 
209.26 	whenever there is a significant change in the client's functioning or at least every 180 365
209.27 	days, unless a service specifies otherwise.
209.28 	(b) A license holder may use any available, validated measurement tool, including but 
209.29 	not limited to the Daily Living Activities-20, when completing the required elements of a 
209.30 	functional assessment under this subdivision.

210.1 	Sec. 9. Minnesota Statutes 2022, section 245I.11, subdivision 1, is amended to read:
210.2 		Subdivision 1.Generally. (a) If a license holder is licensed as a residential program, 
210.3 	stores or administers client medications, or observes clients self-administer medications, 
210.4 	the license holder must ensure that a staff person who is a registered nurse or licensed 
210.5 	prescriber is responsible for overseeing storage and administration of client medications 
210.6 	and observing as a client self-administers medications, including training according to 
210.7 	section 245I.05, subdivision 6, and documenting the occurrence according to section 245I.08, 
210.8 	subdivision 5.
210.9 	(b) For purposes of this section, "observed self-administration" means the preparation 
210.10 	and administration of a medication by a client to themselves under the direct supervision 
210.11 	of a registered nurse or a staff member to whom a registered nurse delegates supervision 
210.12 	duty. Observed self-administration does not include a client's use of a medication that they 
210.13 	keep in their own possession while participating in a program.

210.14 	Sec. 10. Minnesota Statutes 2022, section 245I.11, is amended by adding a subdivision 
210.15 	to read:
210.16 		Subd. 6.Medication administration in children's day treatment settings. (a) For a 
210.17 	program providing children's day treatment services under section 256B.0943, the license 
210.18 	holder must maintain policies and procedures that state whether the program will store 
210.19 	medication and administer or allow observed self-administration.
210.20 	(b) For a program providing children's day treatment services under section 256B.0943 
210.21 	that does not store medications but allows clients to use a medication that they keep in their 
210.22 	own possession while participating in a program, the license holder must maintain 
210.23 	documentation from a licensed prescriber regarding the safety of medications held by clients, 
210.24 	including:
210.25 	(1) an evaluation that the client is capable of holding and administering the medication 
210.26 	safely;
210.27 	(2) an evaluation of whether the medication is prone to diversion, misuse, or self-injury; 
210.28 	and
210.29 	(3) any conditions under which the license holder should no longer allow the client to 
210.30 	maintain the medication in their own possession.

211.1 	Sec. 11. Minnesota Statutes 2022, section 245I.20, subdivision 4, is amended to read:
211.2 		Subd. 4.Minimum staffing standards. (a) A certification holder's treatment team must 
211.3 	consist of at least four mental health professionals. At least two of the mental health 
211.4 	professionals must be employed by or under contract with the mental health clinic for a 
211.5 	minimum of 35 hours per week each. Each of the two mental health professionals must 
211.6 	specialize in a different mental health discipline.
211.7 	(b) The treatment team must include:
211.8 	(1) a physician qualified as a mental health professional according to section 245I.04, 
211.9 	subdivision 2, clause (4), or a nurse qualified as a mental health professional according to 
211.10 	section 245I.04, subdivision 2, clause (1); and
211.11 	(2) a psychologist qualified as a mental health professional according to section 245I.04, 
211.12 	subdivision 2, clause (3).
211.13 	(c) The staff persons fulfilling the requirement in paragraph (b) must provide clinical 
211.14 	services at least:
211.15 	(1) eight hours every two weeks if the mental health clinic has over 25.0 full-time 
211.16 	equivalent treatment team members;
211.17 	(2) eight hours each month if the mental health clinic has 15.1 to 25.0 full-time equivalent 
211.18 	treatment team members;
211.19 	(3) four hours each month if the mental health clinic has 5.1 to 15.0 full-time equivalent 
211.20 	treatment team members; or
211.21 	(4) two hours each month if the mental health clinic has 2.0 to 5.0 full-time equivalent 
211.22 	treatment team members or only provides in-home services to clients.
211.23 	(d) The certification holder must maintain a record that demonstrates compliance with 
211.24 	this subdivision.

211.25 	Sec. 12. Minnesota Statutes 2022, section 245I.23, subdivision 14, is amended to read:
211.26 		Subd. 14.Weekly team meetings. (a) The license holder must hold weekly team meetings 
211.27 	and ancillary meetings according to this subdivision.
211.28 	(b) A mental health professional or certified rehabilitation specialist must hold at least 
211.29 	one team meeting each calendar week and. The mental health professional or certified 
211.30 	rehabilitation specialist must lead and be physically present at the team meeting, except as 
211.31 	permitted under paragraph (e). All treatment team members, including treatment team 
212.1 	members who work on a part-time or intermittent basis, must participate in a minimum of 
212.2 	one team meeting during each calendar week when the treatment team member is working 
212.3 	for the license holder. The license holder must document all weekly team meetings, including 
212.4 	the names of meeting attendees, and indicate whether the meeting was conducted remotely 
212.5 	under paragraph (e).
212.6 	(c) If a treatment team member cannot participate in a weekly team meeting, the treatment 
212.7 	team member must participate in an ancillary meeting. A mental health professional, certified 
212.8 	rehabilitation specialist, clinical trainee, or mental health practitioner who participated in 
212.9 	the most recent weekly team meeting may lead the ancillary meeting. During the ancillary 
212.10 	meeting, the treatment team member leading the ancillary meeting must review the 
212.11 	information that was shared at the most recent weekly team meeting, including revisions 
212.12 	to client treatment plans and other information that the treatment supervisors exchanged 
212.13 	with treatment team members. The license holder must document all ancillary meetings, 
212.14 	including the names of meeting attendees.
212.15 	(d) If a treatment team member working only one shift during a week cannot participate 
212.16 	in a weekly team meeting or participate in an ancillary meeting, the treatment team member 
212.17 	must read the minutes of the weekly team meeting required to be documented in paragraph 
212.18 	(b). The treatment team member must sign to acknowledge receipt of this information, and 
212.19 	document pertinent information or questions. The mental health professional or certified 
212.20 	rehabilitation specialist must review any documented questions or pertinent information 
212.21 	before the next weekly team meeting.
212.22 	(e) A license holder may permit a mental health professional or certified rehabilitation 
212.23 	specialist to lead the weekly meeting remotely due to medical or weather conditions. If the 
212.24 	conditions that do not permit physical presence persist for longer than one week, the license 
212.25 	holder must request a variance to conduct additional meetings remotely.

212.26 	Sec. 13. Minnesota Statutes 2023 Supplement, section 254B.04, subdivision 1a, is amended 
212.27 	to read:
212.28 		Subd. 1a.Client eligibility. (a) Persons eligible for benefits under Code of Federal 
212.29 	Regulations, title 25, part 20, who meet the income standards of section 256B.056, 
212.30 	subdivision 4, and are not enrolled in medical assistance, are entitled to behavioral health 
212.31 	fund services. State money appropriated for this paragraph must be placed in a separate 
212.32 	account established for this purpose.
212.33 	(b) Persons with dependent children who are determined to be in need of substance use 
212.34 	disorder treatment pursuant to an assessment under section 260E.20, subdivision 1, or in 
213.1 	need of chemical dependency treatment pursuant to a case plan under section 260C.201, 
213.2 	subdivision 6, or 260C.212, shall be assisted by the local agency to access needed treatment 
213.3 	services. Treatment services must be appropriate for the individual or family, which may 
213.4 	include long-term care treatment or treatment in a facility that allows the dependent children 
213.5 	to stay in the treatment facility. The county shall pay for out-of-home placement costs, if 
213.6 	applicable.
213.7 	(c) Notwithstanding paragraph (a), persons any person enrolled in medical assistance 
213.8 	are or MinnesotaCare is eligible for room and board services under section 254B.05, 
213.9 	subdivision 5, paragraph (b), clause (12) (9).
213.10 	(d) A client is eligible to have substance use disorder treatment paid for with funds from 
213.11 	the behavioral health fund when the client:
213.12 	(1) is eligible for MFIP as determined under chapter 256J;
213.13 	(2) is eligible for medical assistance as determined under Minnesota Rules, parts 
213.14 	9505.0010 to 9505.0150;
213.15 	(3) is eligible for general assistance, general assistance medical care, or work readiness 
213.16 	as determined under Minnesota Rules, parts 9500.1200 to 9500.1318; or
213.17 	(4) has income that is within current household size and income guidelines for entitled 
213.18 	persons, as defined in this subdivision and subdivision 7.
213.19 	(e) Clients who meet the financial eligibility requirement in paragraph (a) and who have 
213.20 	a third-party payment source are eligible for the behavioral health fund if the third-party 
213.21 	payment source pays less than 100 percent of the cost of treatment services for eligible 
213.22 	clients.
213.23 	(f) A client is ineligible to have substance use disorder treatment services paid for with 
213.24 	behavioral health fund money if the client:
213.25 	(1) has an income that exceeds current household size and income guidelines for entitled 
213.26 	persons as defined in this subdivision and subdivision 7; or
213.27 	(2) has an available third-party payment source that will pay the total cost of the client's 
213.28 	treatment.
213.29 	(g) A client who is disenrolled from a state prepaid health plan during a treatment episode 
213.30 	is eligible for continued treatment service that is paid for by the behavioral health fund until 
213.31 	the treatment episode is completed or the client is re-enrolled in a state prepaid health plan 
213.32 	if the client:
214.1 	(1) continues to be enrolled in MinnesotaCare, medical assistance, or general assistance 
214.2 	medical care; or
214.3 	(2) is eligible according to paragraphs (a) and (b) and is determined eligible by a local 
214.4 	agency under section 254B.04.
214.5 	(h) When a county commits a client under chapter 253B to a regional treatment center 
214.6 	for substance use disorder services and the client is ineligible for the behavioral health fund, 
214.7 	the county is responsible for the payment to the regional treatment center according to 
214.8 	section 254B.05, subdivision 4.
214.9 	(i) Persons enrolled in MinnesotaCare are eligible for room and board services when 
214.10 	provided through intensive residential treatment services and residential crisis services under 
214.11 	section 256B.0622.

214.12 	EFFECTIVE DATE. This section is effective January 1, 2025.

214.13 	Sec. 14. [256B.0617] MENTAL HEALTH SERVICES PROVIDER 
214.14 	CERTIFICATION.
214.15 	(a) The commissioner of human services shall establish an initial provider entity 
214.16 	application and certification and recertification processes to determine whether a provider 
214.17 	entity has administrative and clinical infrastructures that meet the certification requirements. 
214.18 	This process applies to providers of the following services:
214.19 	(1) children's intensive behavioral health services under section 256B.0946; and
214.20 	(2) intensive nonresidential rehabilitative mental health services under section 256B.0947.
214.21 	(b) The commissioner shall recertify a provider entity every three years using the 
214.22 	individual provider's certification anniversary or the calendar year end. The commissioner 
214.23 	may approve a recertification extension in the interest of sustaining services when a certain 
214.24 	date for recertification is identified.
214.25 	(c) The commissioner shall establish a process for decertification of a provider entity 
214.26 	and shall require corrective action, medical assistance repayment, or decertification of a 
214.27 	provider entity that no longer meets the requirements in this section or that fails to meet the 
214.28 	clinical quality standards or administrative standards provided by the commissioner in the 
214.29 	application and certification process.
214.30 	(d) The commissioner must provide the following to provider entities for the certification, 
214.31 	recertification, and decertification processes:
214.32 	(1) a structured listing of required provider certification criteria;
215.1 	(2) a formal written letter with a determination of certification, recertification, or 
215.2 	decertification signed by the commissioner or the appropriate division director; and
215.3 	(3) a formal written communication outlining the process for necessary corrective action 
215.4 	and follow-up by the commissioner signed by the commissioner or their designee, if 
215.5 	applicable. In the case of corrective action, the commissioner may schedule interim 
215.6 	recertification site reviews to confirm certification or decertification.

215.7 	EFFECTIVE DATE. This section is effective July 1, 2024, and the commissioner of 
215.8 	human services must implement all requirements of this section by September 1, 2024.

215.9 	Sec. 15. Minnesota Statutes 2022, section 256B.0622, subdivision 2a, is amended to read:
215.10 		Subd. 2a.Eligibility for assertive community treatment. (a) An eligible client for 
215.11 	assertive community treatment is an individual who meets the following criteria as assessed 
215.12 	by an ACT team:
215.13 	(1) is age 18 or older. Individuals ages 16 and 17 may be eligible upon approval by the 
215.14 	commissioner;
215.15 	(2) has a primary diagnosis of schizophrenia, schizoaffective disorder, major depressive 
215.16 	disorder with psychotic features, other psychotic disorders, or bipolar disorder. Individuals 
215.17 	with other psychiatric illnesses may qualify for assertive community treatment if they have 
215.18 	a serious mental illness and meet the criteria outlined in clauses (3) and (4), but no more 
215.19 	than ten percent of an ACT team's clients may be eligible based on this criteria. Individuals 
215.20 	with a primary diagnosis of a substance use disorder, intellectual developmental disabilities, 
215.21 	borderline personality disorder, antisocial personality disorder, traumatic brain injury, or 
215.22 	an autism spectrum disorder are not eligible for assertive community treatment;
215.23 	(3) has significant functional impairment as demonstrated by at least one of the following 
215.24 	conditions:
215.25 	(i) significant difficulty consistently performing the range of routine tasks required for 
215.26 	basic adult functioning in the community or persistent difficulty performing daily living 
215.27 	tasks without significant support or assistance;
215.28 	(ii) significant difficulty maintaining employment at a self-sustaining level or significant 
215.29 	difficulty consistently carrying out the head-of-household responsibilities; or
215.30 	(iii) significant difficulty maintaining a safe living situation;
215.31 	(4) has a need for continuous high-intensity services as evidenced by at least two of the 
215.32 	following:
216.1 	(i) two or more psychiatric hospitalizations or residential crisis stabilization services in 
216.2 	the previous 12 months;
216.3 	(ii) frequent utilization of mental health crisis services in the previous six months;
216.4 	(iii) 30 or more consecutive days of psychiatric hospitalization in the previous 24 months;
216.5 	(iv) intractable, persistent, or prolonged severe psychiatric symptoms;
216.6 	(v) coexisting mental health and substance use disorders lasting at least six months;
216.7 	(vi) recent history of involvement with the criminal justice system or demonstrated risk 
216.8 	of future involvement;
216.9 	(vii) significant difficulty meeting basic survival needs;
216.10 	(viii) residing in substandard housing, experiencing homelessness, or facing imminent 
216.11 	risk of homelessness;
216.12 	(ix) significant impairment with social and interpersonal functioning such that basic 
216.13 	needs are in jeopardy;
216.14 	(x) coexisting mental health and physical health disorders lasting at least six months;
216.15 	(xi) residing in an inpatient or supervised community residence but clinically assessed 
216.16 	to be able to live in a more independent living situation if intensive services are provided;
216.17 	(xii) requiring a residential placement if more intensive services are not available; or
216.18 	(xiii) difficulty effectively using traditional office-based outpatient services;
216.19 	(5) there are no indications that other available community-based services would be 
216.20 	equally or more effective as evidenced by consistent and extensive efforts to treat the 
216.21 	individual; and
216.22 	(6) in the written opinion of a licensed mental health professional, has the need for mental 
216.23 	health services that cannot be met with other available community-based services, or is 
216.24 	likely to experience a mental health crisis or require a more restrictive setting if assertive 
216.25 	community treatment is not provided.
216.26 	(b) An individual meets the criteria for assertive community treatment under this section 
216.27 	if they have participated within the last year or are currently participating in a first episode 
216.28 	of psychosis program if the individual:
216.29 	(1) meets the eligibility requirements outlined in paragraph (a), clauses (1), (2), (5), and 
216.30 	(6); and
217.1 	(2) needs the level of intensity provided by an ACT team, in the opinion of the individual's 
217.2 	first episode of psychosis program, in order to prevent crisis services use, hospitalization, 
217.3 	homelessness, and involvement with the criminal justice system.

217.4 	Sec. 16. Minnesota Statutes 2022, section 256B.0622, subdivision 3a, is amended to read:
217.5 		Subd. 3a.Provider certification and contract requirements for assertive community 
217.6 	treatment. (a) The assertive community treatment provider must:
217.7 	(1) have a contract with the host county to provide assertive community treatment 
217.8 	services; and
217.9 	(2) have each ACT team be certified by the state following the certification process and 
217.10 	procedures developed by the commissioner. The certification process determines whether 
217.11 	the ACT team meets the standards for assertive community treatment under this section, 
217.12 	the standards in chapter 245I as required in section 245I.011, subdivision 5, and minimum 
217.13 	program fidelity standards as measured by a nationally recognized fidelity tool approved 
217.14 	by the commissioner. Recertification must occur at least every three years.
217.15 	(b) An ACT team certified under this subdivision must meet the following standards:
217.16 	(1) have capacity to recruit, hire, manage, and train required ACT team members;
217.17 	(2) have adequate administrative ability to ensure availability of services;
217.18 	(3) ensure flexibility in service delivery to respond to the changing and intermittent care 
217.19 	needs of a client as identified by the client and the individual treatment plan;
217.20 	(4) keep all necessary records required by law;
217.21 	(5) be an enrolled Medicaid provider; and
217.22 	(6) establish and maintain a quality assurance plan to determine specific service outcomes 
217.23 	and the client's satisfaction with services.
217.24 	(c) The commissioner may intervene at any time and decertify an ACT team with cause. 
217.25 	The commissioner shall establish a process for decertification of an ACT team and shall 
217.26 	require corrective action, medical assistance repayment, or decertification of an ACT team 
217.27 	that no longer meets the requirements in this section or that fails to meet the clinical quality 
217.28 	standards or administrative standards provided by the commissioner in the application and 
217.29 	certification process. The decertification is subject to appeal to the state.

218.1 	Sec. 17. Minnesota Statutes 2022, section 256B.0622, subdivision 7a, is amended to read:
218.2 		Subd. 7a.Assertive community treatment team staff requirements and roles. (a) 
218.3 	The required treatment staff qualifications and roles for an ACT team are:
218.4 	(1) the team leader:
218.5 	(i) shall be a mental health professional. Individuals who are not licensed but who are 
218.6 	eligible for licensure and are otherwise qualified may also fulfill this role but must obtain 
218.7 	full licensure within 24 months of assuming the role of team leader;
218.8 	(ii) must be an active member of the ACT team and provide some direct services to 
218.9 	clients;
218.10 	(iii) must be a single full-time staff member, dedicated to the ACT team, who is 
218.11 	responsible for overseeing the administrative operations of the team, providing treatment 
218.12 	supervision of services in conjunction with the psychiatrist or psychiatric care provider, and 
218.13 	supervising team members to ensure delivery of best and ethical practices; and
218.14 	(iv) must be available to provide ensure that overall treatment supervision to the ACT 
218.15 	team is available after regular business hours and on weekends and holidays. The team 
218.16 	leader may delegate this duty to another and is provided by a qualified member of the ACT 
218.17 	team;
218.18 	(2) the psychiatric care provider:
218.19 	(i) must be a mental health professional permitted to prescribe psychiatric medications 
218.20 	as part of the mental health professional's scope of practice. The psychiatric care provider 
218.21 	must have demonstrated clinical experience working with individuals with serious and 
218.22 	persistent mental illness;
218.23 	(ii) shall collaborate with the team leader in sharing overall clinical responsibility for 
218.24 	screening and admitting clients; monitoring clients' treatment and team member service 
218.25 	delivery; educating staff on psychiatric and nonpsychiatric medications, their side effects, 
218.26 	and health-related conditions; actively collaborating with nurses; and helping provide 
218.27 	treatment supervision to the team;
218.28 	(iii) shall fulfill the following functions for assertive community treatment clients: 
218.29 	provide assessment and treatment of clients' symptoms and response to medications, including 
218.30 	side effects; provide brief therapy to clients; provide diagnostic and medication education 
218.31 	to clients, with medication decisions based on shared decision making; monitor clients' 
218.32 	nonpsychiatric medical conditions and nonpsychiatric medications; and conduct home and 
218.33 	community visits;
219.1 	(iv) shall serve as the point of contact for psychiatric treatment if a client is hospitalized 
219.2 	for mental health treatment and shall communicate directly with the client's inpatient 
219.3 	psychiatric care providers to ensure continuity of care;
219.4 	(v) shall have a minimum full-time equivalency that is prorated at a rate of 16 hours per 
219.5 	50 clients. Part-time psychiatric care providers shall have designated hours to work on the 
219.6 	team, with sufficient blocks of time on consistent days to carry out the provider's clinical, 
219.7 	supervisory, and administrative responsibilities. No more than two psychiatric care providers 
219.8 	may share this role; and
219.9 	(vi) shall provide psychiatric backup to the program after regular business hours and on 
219.10 	weekends and holidays. The psychiatric care provider may delegate this duty to another 
219.11 	qualified psychiatric provider;
219.12 	(3) the nursing staff:
219.13 	(i) shall consist of one to three registered nurses or advanced practice registered nurses, 
219.14 	of whom at least one has a minimum of one-year experience working with adults with 
219.15 	serious mental illness and a working knowledge of psychiatric medications. No more than 
219.16 	two individuals can share a full-time equivalent position;
219.17 	(ii) are responsible for managing medication, administering and documenting medication 
219.18 	treatment, and managing a secure medication room; and
219.19 	(iii) shall develop strategies, in collaboration with clients, to maximize taking medications 
219.20 	as prescribed; screen and monitor clients' mental and physical health conditions and 
219.21 	medication side effects; engage in health promotion, prevention, and education activities; 
219.22 	communicate and coordinate services with other medical providers; facilitate the development 
219.23 	of the individual treatment plan for clients assigned; and educate the ACT team in monitoring 
219.24 	psychiatric and physical health symptoms and medication side effects;
219.25 	(4) the co-occurring disorder specialist:
219.26 	(i) shall be a full-time equivalent co-occurring disorder specialist who has received 
219.27 	specific training on co-occurring disorders that is consistent with national evidence-based 
219.28 	practices. The training must include practical knowledge of common substances and how 
219.29 	they affect mental illnesses, the ability to assess substance use disorders and the client's 
219.30 	stage of treatment, motivational interviewing, and skills necessary to provide counseling to 
219.31 	clients at all different stages of change and treatment. The co-occurring disorder specialist 
219.32 	may also be an individual who is a licensed alcohol and drug counselor as described in 
219.33 	section 148F.01, subdivision 5, or a counselor who otherwise meets the training, experience, 
220.1 	and other requirements in section 245G.11, subdivision 5. No more than two co-occurring 
220.2 	disorder specialists may occupy this role; and
220.3 	(ii) shall provide or facilitate the provision of co-occurring disorder treatment to clients. 
220.4 	The co-occurring disorder specialist shall serve as a consultant and educator to fellow ACT 
220.5 	team members on co-occurring disorders;
220.6 	(5) the vocational specialist:
220.7 	(i) shall be a full-time vocational specialist who has at least one-year experience providing 
220.8 	employment services or advanced education that involved field training in vocational services 
220.9 	to individuals with mental illness. An individual who does not meet these qualifications 
220.10 	may also serve as the vocational specialist upon completing a training plan approved by the 
220.11 	commissioner;
220.12 	(ii) shall provide or facilitate the provision of vocational services to clients. The vocational 
220.13 	specialist serves as a consultant and educator to fellow ACT team members on these services; 
220.14 	and
220.15 	(iii) must not refer individuals to receive any type of vocational services or linkage by 
220.16 	providers outside of the ACT team;
220.17 	(6) the mental health certified peer specialist:
220.18 	(i) shall be a full-time equivalent. No more than two individuals can share this position. 
220.19 	The mental health certified peer specialist is a fully integrated team member who provides 
220.20 	highly individualized services in the community and promotes the self-determination and 
220.21 	shared decision-making abilities of clients. This requirement may be waived due to workforce 
220.22 	shortages upon approval of the commissioner;
220.23 	(ii) must provide coaching, mentoring, and consultation to the clients to promote recovery, 
220.24 	self-advocacy, and self-direction, promote wellness management strategies, and assist clients 
220.25 	in developing advance directives; and
220.26 	(iii) must model recovery values, attitudes, beliefs, and personal action to encourage 
220.27 	wellness and resilience, provide consultation to team members, promote a culture where 
220.28 	the clients' points of view and preferences are recognized, understood, respected, and 
220.29 	integrated into treatment, and serve in a manner equivalent to other team members;
220.30 	(7) the program administrative assistant shall be a full-time office-based program 
220.31 	administrative assistant position assigned to solely work with the ACT team, providing a 
220.32 	range of supports to the team, clients, and families; and
221.1 	(8) additional staff:
221.2 	(i) shall be based on team size. Additional treatment team staff may include mental 
221.3 	health professionals; clinical trainees; certified rehabilitation specialists; mental health 
221.4 	practitioners; or mental health rehabilitation workers. These individuals shall have the 
221.5 	knowledge, skills, and abilities required by the population served to carry out rehabilitation 
221.6 	and support functions; and
221.7 	(ii) shall be selected based on specific program needs or the population served.
221.8 	(b) Each ACT team must clearly document schedules for all ACT team members.
221.9 	(c) Each ACT team member must serve as a primary team member for clients assigned 
221.10 	by the team leader and are responsible for facilitating the individual treatment plan process 
221.11 	for those clients. The primary team member for a client is the responsible team member 
221.12 	knowledgeable about the client's life and circumstances and writes the individual treatment 
221.13 	plan. The primary team member provides individual supportive therapy or counseling, and 
221.14 	provides primary support and education to the client's family and support system.
221.15 	(d) Members of the ACT team must have strong clinical skills, professional qualifications, 
221.16 	experience, and competency to provide a full breadth of rehabilitation services. Each staff 
221.17 	member shall be proficient in their respective discipline and be able to work collaboratively 
221.18 	as a member of a multidisciplinary team to deliver the majority of the treatment, 
221.19 	rehabilitation, and support services clients require to fully benefit from receiving assertive 
221.20 	community treatment.
221.21 	(e) Each ACT team member must fulfill training requirements established by the 
221.22 	commissioner.

221.23 	Sec. 18. Minnesota Statutes 2023 Supplement, section 256B.0622, subdivision 7b, is 
221.24 	amended to read:
221.25 		Subd. 7b.Assertive community treatment program size and opportunities scores. (a)
221.26 	Each ACT team shall maintain an annual average caseload that does not exceed 100 clients. 
221.27 	Staff-to-client ratios shall be based on team size as follows: must demonstrate that the team 
221.28 	attained a passing score according to the most recently issued Tool for Measurement of 
221.29 	Assertive Community Treatment (TMACT).
221.30 	(1) a small ACT team must:
221.31 	(i) employ at least six but no more than seven full-time treatment team staff, excluding 
221.32 	the program assistant and the psychiatric care provider;
222.1 	(ii) serve an annual average maximum of no more than 50 clients;
222.2 	(iii) ensure at least one full-time equivalent position for every eight clients served;
222.3 	(iv) schedule ACT team staff on weekdays and on-call duty to provide crisis services 
222.4 	and deliver services after hours when staff are not working;
222.5 	(v) provide crisis services during business hours if the small ACT team does not have 
222.6 	sufficient staff numbers to operate an after-hours on-call system. During all other hours, 
222.7 	the ACT team may arrange for coverage for crisis assessment and intervention services 
222.8 	through a reliable crisis-intervention provider as long as there is a mechanism by which the 
222.9 	ACT team communicates routinely with the crisis-intervention provider and the on-call 
222.10 	ACT team staff are available to see clients face-to-face when necessary or if requested by 
222.11 	the crisis-intervention services provider;
222.12 	(vi) adjust schedules and provide staff to carry out the needed service activities in the 
222.13 	evenings or on weekend days or holidays, when necessary;
222.14 	(vii) arrange for and provide psychiatric backup during all hours the psychiatric care 
222.15 	provider is not regularly scheduled to work. If availability of the ACT team's psychiatric 
222.16 	care provider during all hours is not feasible, alternative psychiatric prescriber backup must 
222.17 	be arranged and a mechanism of timely communication and coordination established in 
222.18 	writing; and
222.19 	(viii) be composed of, at minimum, one full-time team leader, at least 16 hours each 
222.20 	week per 50 clients of psychiatric provider time, or equivalent if fewer clients, one full-time 
222.21 	equivalent nursing, one full-time co-occurring disorder specialist, one full-time equivalent 
222.22 	mental health certified peer specialist, one full-time vocational specialist, one full-time 
222.23 	program assistant, and at least one additional full-time ACT team member who has mental 
222.24 	health professional, certified rehabilitation specialist, clinical trainee, or mental health 
222.25 	practitioner status; and
222.26 	(2) a midsize ACT team shall:
222.27 	(i) be composed of, at minimum, one full-time team leader, at least 16 hours of psychiatry 
222.28 	time for 51 clients, with an additional two hours for every six clients added to the team, 1.5 
222.29 	to two full-time equivalent nursing staff, one full-time co-occurring disorder specialist, one 
222.30 	full-time equivalent mental health certified peer specialist, one full-time vocational specialist, 
222.31 	one full-time program assistant, and at least 1.5 to two additional full-time equivalent ACT 
222.32 	members, with at least one dedicated full-time staff member with mental health professional 
223.1 	status. Remaining team members may have mental health professional, certified rehabilitation 
223.2 	specialist, clinical trainee, or mental health practitioner status;
223.3 	(ii) employ seven or more treatment team full-time equivalents, excluding the program 
223.4 	assistant and the psychiatric care provider;
223.5 	(iii) serve an annual average maximum caseload of 51 to 74 clients;
223.6 	(iv) ensure at least one full-time equivalent position for every nine clients served;
223.7 	(v) schedule ACT team staff for a minimum of ten-hour shift coverage on weekdays 
223.8 	and six- to eight-hour shift coverage on weekends and holidays. In addition to these minimum 
223.9 	specifications, staff are regularly scheduled to provide the necessary services on a 
223.10 	client-by-client basis in the evenings and on weekends and holidays;
223.11 	(vi) schedule ACT team staff on-call duty to provide crisis services and deliver services 
223.12 	when staff are not working;
223.13 	(vii) have the authority to arrange for coverage for crisis assessment and intervention 
223.14 	services through a reliable crisis-intervention provider as long as there is a mechanism by 
223.15 	which the ACT team communicates routinely with the crisis-intervention provider and the 
223.16 	on-call ACT team staff are available to see clients face-to-face when necessary or if requested 
223.17 	by the crisis-intervention services provider; and
223.18 	(viii) arrange for and provide psychiatric backup during all hours the psychiatric care 
223.19 	provider is not regularly scheduled to work. If availability of the psychiatric care provider 
223.20 	during all hours is not feasible, alternative psychiatric prescriber backup must be arranged 
223.21 	and a mechanism of timely communication and coordination established in writing;
223.22 	(3) a large ACT team must:
223.23 	(i) be composed of, at minimum, one full-time team leader, at least 32 hours each week 
223.24 	per 100 clients, or equivalent of psychiatry time, three full-time equivalent nursing staff, 
223.25 	one full-time co-occurring disorder specialist, one full-time equivalent mental health certified 
223.26 	peer specialist, one full-time vocational specialist, one full-time program assistant, and at 
223.27 	least two additional full-time equivalent ACT team members, with at least one dedicated 
223.28 	full-time staff member with mental health professional status. Remaining team members 
223.29 	may have mental health professional or mental health practitioner status;
223.30 	(ii) employ nine or more treatment team full-time equivalents, excluding the program 
223.31 	assistant and psychiatric care provider;
223.32 	(iii) serve an annual average maximum caseload of 75 to 100 clients;
224.1 	(iv) ensure at least one full-time equivalent position for every nine individuals served;
224.2 	(v) schedule staff to work two eight-hour shifts, with a minimum of two staff on the 
224.3 	second shift providing services at least 12 hours per day weekdays. For weekends and 
224.4 	holidays, the team must operate and schedule ACT team staff to work one eight-hour shift, 
224.5 	with a minimum of two staff each weekend day and every holiday;
224.6 	(vi) schedule ACT team staff on-call duty to provide crisis services and deliver services 
224.7 	when staff are not working; and
224.8 	(vii) arrange for and provide psychiatric backup during all hours the psychiatric care 
224.9 	provider is not regularly scheduled to work. If availability of the ACT team psychiatric care 
224.10 	provider during all hours is not feasible, alternative psychiatric backup must be arranged 
224.11 	and a mechanism of timely communication and coordination established in writing.
224.12 	(b) An ACT team of any size may have a staff-to-client ratio that is lower than the 
224.13 	requirements described in paragraph (a) upon approval by the commissioner, but may not 
224.14 	exceed a one-to-ten staff-to-client ratio.

224.15 	Sec. 19. Minnesota Statutes 2022, section 256B.0622, subdivision 7d, is amended to read:
224.16 		Subd. 7d.Assertive community treatment assessment and individual treatment 
224.17 	plan. (a) An initial assessment shall be completed the day of the client's admission to 
224.18 	assertive community treatment by the ACT team leader or the psychiatric care provider, 
224.19 	with participation by designated ACT team members and the client. The initial assessment 
224.20 	must include obtaining or completing a standard diagnostic assessment according to section 
224.21 	245I.10, subdivision 6, and completing a 30-day individual treatment plan. The team leader, 
224.22 	psychiatric care provider, or other mental health professional designated by the team leader 
224.23 	or psychiatric care provider, must update the client's diagnostic assessment at least annually
224.24 	as required under section 245I.10, subdivision 2, paragraphs (f) and (g).
224.25 	(b) A functional assessment must be completed according to section 245I.10, subdivision 
224.26 	9. Each part of the functional assessment areas shall be completed by each respective team 
224.27 	specialist or an ACT team member with skill and knowledge in the area being assessed.
224.28 	(c) Between 30 and 45 days after the client's admission to assertive community treatment, 
224.29 	the entire ACT team must hold a comprehensive case conference, where all team members, 
224.30 	including the psychiatric provider, present information discovered from the completed 
224.31 	assessments and provide treatment recommendations. The conference must serve as the 
224.32 	basis for the first individual treatment plan, which must be written by the primary team 
224.33 	member.
225.1 	(d) The client's psychiatric care provider, primary team member, and individual treatment 
225.2 	team members shall assume responsibility for preparing the written narrative of the results 
225.3 	from the psychiatric and social functioning history timeline and the comprehensive 
225.4 	assessment.
225.5 	(e) The primary team member and individual treatment team members shall be assigned 
225.6 	by the team leader in collaboration with the psychiatric care provider by the time of the first 
225.7 	treatment planning meeting or 30 days after admission, whichever occurs first.
225.8 	(f) Individual treatment plans must be developed through the following treatment planning 
225.9 	process:
225.10 	(1) The individual treatment plan shall be developed in collaboration with the client and 
225.11 	the client's preferred natural supports, and guardian, if applicable and appropriate. The ACT 
225.12 	team shall evaluate, together with each client, the client's needs, strengths, and preferences 
225.13 	and develop the individual treatment plan collaboratively. The ACT team shall make every 
225.14 	effort to ensure that the client and the client's family and natural supports, with the client's 
225.15 	consent, are in attendance at the treatment planning meeting, are involved in ongoing 
225.16 	meetings related to treatment, and have the necessary supports to fully participate. The 
225.17 	client's participation in the development of the individual treatment plan shall be documented.
225.18 	(2) The client and the ACT team shall work together to formulate and prioritize the 
225.19 	issues, set goals, research approaches and interventions, and establish the plan. The plan is 
225.20 	individually tailored so that the treatment, rehabilitation, and support approaches and 
225.21 	interventions achieve optimum symptom reduction, help fulfill the personal needs and 
225.22 	aspirations of the client, take into account the cultural beliefs and realities of the individual, 
225.23 	and improve all the aspects of psychosocial functioning that are important to the client. The 
225.24 	process supports strengths, rehabilitation, and recovery.
225.25 	(3) Each client's individual treatment plan shall identify service needs, strengths and 
225.26 	capacities, and barriers, and set specific and measurable short- and long-term goals for each 
225.27 	service need. The individual treatment plan must clearly specify the approaches and 
225.28 	interventions necessary for the client to achieve the individual goals, when the interventions 
225.29 	shall happen, and identify which ACT team member shall carry out the approaches and 
225.30 	interventions.
225.31 	(4) The primary team member and the individual treatment team, together with the client 
225.32 	and the client's family and natural supports with the client's consent, are responsible for 
225.33 	reviewing and rewriting the treatment goals and individual treatment plan whenever there 
225.34 	is a major decision point in the client's course of treatment or at least every six months.
226.1 	(5) The primary team member shall prepare a summary that thoroughly describes in 
226.2 	writing the client's and the individual treatment team's evaluation of the client's progress 
226.3 	and goal attainment, the effectiveness of the interventions, and the satisfaction with services 
226.4 	since the last individual treatment plan. The client's most recent diagnostic assessment must 
226.5 	be included with the treatment plan summary.
226.6 	(6) The individual treatment plan and review must be approved or acknowledged by the 
226.7 	client, the primary team member, the team leader, the psychiatric care provider, and all 
226.8 	individual treatment team members. A copy of the approved individual treatment plan must 
226.9 	be made available to the client.

226.10 	Sec. 20. Minnesota Statutes 2022, section 256B.0623, subdivision 5, is amended to read:
226.11 		Subd. 5.Qualifications of provider staff.  Adult rehabilitative mental health services 
226.12 	must be provided by qualified individual provider staff of a certified provider entity. 
226.13 	Individual provider staff must be qualified as:
226.14 	(1) a mental health professional who is qualified according to section 245I.04, subdivision 
226.15 	2;
226.16 	(2) a certified rehabilitation specialist who is qualified according to section 245I.04, 
226.17 	subdivision 8;
226.18 	(3) a clinical trainee who is qualified according to section 245I.04, subdivision 6;
226.19 	(4) a mental health practitioner qualified according to section 245I.04, subdivision 4;
226.20 	(5) a mental health certified peer specialist who is qualified according to section 245I.04, 
226.21 	subdivision 10; or
226.22 	(6) a mental health rehabilitation worker who is qualified according to section 245I.04, 
226.23 	subdivision 14.; or
226.24 	(7) a licensed occupational therapist, as defined in section 148.6402, subdivision 14.

226.25 	EFFECTIVE DATE. This section is effective upon federal approval. The commissioner 
226.26 	of human services must notify the revisor of statutes when federal approval is obtained.

226.27 	Sec. 21. Minnesota Statutes 2023 Supplement, section 256B.0625, subdivision 5m, is 
226.28 	amended to read:
226.29 		Subd. 5m.Certified community behavioral health clinic services. (a) Medical 
226.30 	assistance covers services provided by a not-for-profit certified community behavioral health 
226.31 	clinic (CCBHC) that meets the requirements of section 245.735, subdivision 3.
227.1 	(b) The commissioner shall reimburse CCBHCs on a per-day basis for each day that an 
227.2 	eligible service is delivered using the CCBHC daily bundled rate system for medical 
227.3 	assistance payments as described in paragraph (c). The commissioner shall include a quality 
227.4 	incentive payment in the CCBHC daily bundled rate system as described in paragraph (e). 
227.5 	There is no county share for medical assistance services when reimbursed through the 
227.6 	CCBHC daily bundled rate system.
227.7 	(c) The commissioner shall ensure that the CCBHC daily bundled rate system for CCBHC 
227.8 	payments under medical assistance meets the following requirements:
227.9 	(1) the CCBHC daily bundled rate shall be a provider-specific rate calculated for each 
227.10 	CCBHC, based on the daily cost of providing CCBHC services and the total annual allowable 
227.11 	CCBHC costs divided by the total annual number of CCBHC visits. For calculating the 
227.12 	payment rate, total annual visits include visits covered by medical assistance and visits not 
227.13 	covered by medical assistance. Allowable costs include but are not limited to the salaries 
227.14 	and benefits of medical assistance providers; the cost of CCBHC services provided under 
227.15 	section 245.735, subdivision 3, paragraph (a), clauses (6) and (7); and other costs such as 
227.16 	insurance or supplies needed to provide CCBHC services;
227.17 	(2) payment shall be limited to one payment per day per medical assistance enrollee 
227.18 	when an eligible CCBHC service is provided. A CCBHC visit is eligible for reimbursement 
227.19 	if at least one of the CCBHC services listed under section 245.735, subdivision 3, paragraph 
227.20 	(a), clause (6), is furnished to a medical assistance enrollee by a health care practitioner or 
227.21 	licensed agency employed by or under contract with a CCBHC;
227.22 	(3) initial CCBHC daily bundled rates for newly certified CCBHCs under section 245.735, 
227.23 	subdivision 3, shall be established by the commissioner using a provider-specific rate based 
227.24 	on the newly certified CCBHC's audited historical cost report data adjusted for the expected 
227.25 	cost of delivering CCBHC services. Estimates are subject to review by the commissioner 
227.26 	and must include the expected cost of providing the full scope of CCBHC services and the 
227.27 	expected number of visits for the rate period;
227.28 	(4) the commissioner shall rebase CCBHC rates once every two years following the last 
227.29 	rebasing and no less than 12 months following an initial rate or a rate change due to a change 
227.30 	in the scope of services. For CCBHCs certified after September 31, 2020, and before January 
227.31 	1, 2021, the commissioner shall rebase rates according to this clause for services provided 
227.32 	on or after January 1, 2024;
227.33 	(5) the commissioner shall provide for a 60-day appeals process after notice of the results 
227.34 	of the rebasing;
228.1 	(6) an entity that receives a CCBHC daily bundled rate that overlaps with another federal 
228.2 	Medicaid rate is not eligible for the CCBHC rate methodology;
228.3 	(7) payments for CCBHC services to individuals enrolled in managed care shall be 
228.4 	coordinated with the state's phase-out of CCBHC wrap payments. The commissioner shall 
228.5 	complete the phase-out of CCBHC wrap payments within 60 days of the implementation 
228.6 	of the CCBHC daily bundled rate system in the Medicaid Management Information System 
228.7 	(MMIS), for CCBHCs reimbursed under this chapter, with a final settlement of payments 
228.8 	due made payable to CCBHCs no later than 18 months thereafter;
228.9 	(8) the CCBHC daily bundled rate for each CCBHC shall be updated by trending each 
228.10 	provider-specific rate by the Medicare Economic Index for primary care services. This 
228.11 	update shall occur each year in between rebasing periods determined by the commissioner 
228.12 	in accordance with clause (4). CCBHCs must provide data on costs and visits to the state 
228.13 	annually using the CCBHC cost report established by the commissioner; and
228.14 	(9) a CCBHC may request a rate adjustment for changes in the CCBHC's scope of 
228.15 	services when such changes are expected to result in an adjustment to the CCBHC payment 
228.16 	rate by 2.5 percent or more. The CCBHC must provide the commissioner with information 
228.17 	regarding the changes in the scope of services, including the estimated cost of providing 
228.18 	the new or modified services and any projected increase or decrease in the number of visits 
228.19 	resulting from the change. Estimated costs are subject to review by the commissioner. Rate 
228.20 	adjustments for changes in scope shall occur no more than once per year in between rebasing 
228.21 	periods per CCBHC and are effective on the date of the annual CCBHC rate update.
228.22 	(d) Managed care plans and county-based purchasing plans shall reimburse CCBHC 
228.23 	providers at the CCBHC daily bundled rate. The commissioner shall monitor the effect of 
228.24 	this requirement on the rate of access to the services delivered by CCBHC providers. If, for 
228.25 	any contract year, federal approval is not received for this paragraph, the commissioner 
228.26 	must adjust the capitation rates paid to managed care plans and county-based purchasing 
228.27 	plans for that contract year to reflect the removal of this provision. Contracts between 
228.28 	managed care plans and county-based purchasing plans and providers to whom this paragraph 
228.29 	applies must allow recovery of payments from those providers if capitation rates are adjusted 
228.30 	in accordance with this paragraph. Payment recoveries must not exceed the amount equal 
228.31 	to any increase in rates that results from this provision. This paragraph expires if federal 
228.32 	approval is not received for this paragraph at any time.
228.33 	(e) The commissioner shall implement a quality incentive payment program for CCBHCs 
228.34 	that meets the following requirements:
229.1 	(1) a CCBHC shall receive a quality incentive payment upon meeting specific numeric 
229.2 	thresholds for performance metrics established by the commissioner, in addition to payments 
229.3 	for which the CCBHC is eligible under the CCBHC daily bundled rate system described in 
229.4 	paragraph (c);
229.5 	(2) a CCBHC must be certified and enrolled as a CCBHC for the entire measurement 
229.6 	year to be eligible for incentive payments;
229.7 	(3) each CCBHC shall receive written notice of the criteria that must be met in order to 
229.8 	receive quality incentive payments at least 90 days prior to the measurement year; and
229.9 	(4) a CCBHC must provide the commissioner with data needed to determine incentive 
229.10 	payment eligibility within six months following the measurement year. The commissioner 
229.11 	shall notify CCBHC providers of their performance on the required measures and the 
229.12 	incentive payment amount within 12 months following the measurement year.
229.13 	(f) All claims to managed care plans for CCBHC services as provided under this section 
229.14 	shall be submitted directly to, and paid by, the commissioner on the dates specified no later 
229.15 	than January 1 of the following calendar year, if:
229.16 	(1) one or more managed care plans does not comply with the federal requirement for 
229.17 	payment of clean claims to CCBHCs, as defined in Code of Federal Regulations, title 42, 
229.18 	section 447.45(b), and the managed care plan does not resolve the payment issue within 30 
229.19 	days of noncompliance; and
229.20 	(2) the total amount of clean claims not paid in accordance with federal requirements 
229.21 	by one or more managed care plans is 50 percent of, or greater than, the total CCBHC claims 
229.22 	eligible for payment by managed care plans.
229.23 	If the conditions in this paragraph are met between January 1 and June 30 of a calendar 
229.24 	year, claims shall be submitted to and paid by the commissioner beginning on January 1 of 
229.25 	the following year. If the conditions in this paragraph are met between July 1 and December 
229.26 	31 of a calendar year, claims shall be submitted to and paid by the commissioner beginning 
229.27 	on July 1 of the following year.
229.28 	(g) Peer services provided by a CCBHC certified under section 245.735 are a covered 
229.29 	service under medical assistance when a licensed mental health professional or alcohol and 
229.30 	drug counselor determines that peer services are medically necessary. Eligibility under this 
229.31 	subdivision for peer services provided by a CCBHC supersede eligibility standards under 
229.32 	sections 256B.0615, 256B.0616, and 245G.07, subdivision 2, clause (8).

230.1 	Sec. 22. Minnesota Statutes 2023 Supplement, section 256B.0671, subdivision 3, is 
230.2 	amended to read:
230.3 		Subd. 3.Adult day treatment services. (a) Medical assistance covers adult day treatment 
230.4 	(ADT) services that are provided under contract with the county board. Adult day treatment 
230.5 	payment is subject to the conditions in paragraphs (b) to (e). The provider must make 
230.6 	reasonable and good faith efforts to report individual client outcomes to the commissioner 
230.7 	using instruments, protocols, and forms approved by the commissioner.
230.8 	(b) Adult day treatment is an intensive psychotherapeutic treatment to reduce or relieve 
230.9 	the effects of mental illness on a client to enable the client to benefit from a lower level of 
230.10 	care and to live and function more independently in the community. Adult day treatment 
230.11 	services must be provided to a client to stabilize the client's mental health and to improve 
230.12 	the client's independent living and socialization skills. Adult day treatment must consist of 
230.13 	at least one hour of group psychotherapy and must include group time focused on 
230.14 	rehabilitative interventions or other therapeutic services that a multidisciplinary team provides 
230.15 	to each client. Adult day treatment services are not a part of inpatient or residential treatment 
230.16 	services. The following providers may apply to become adult day treatment providers:
230.17 	(1) a hospital accredited by the Joint Commission on Accreditation of Health 
230.18 	Organizations with Centers for Medicare and Medicaid Services approved hospital 
230.19 	accreditation and licensed under sections 144.50 to 144.55;
230.20 	(2) a community mental health center under section 256B.0625, subdivision 5; or
230.21 	(3) an entity that is under contract with the county board to operate a program that meets 
230.22 	the requirements of section 245.4712, subdivision 2, and Minnesota Rules, parts 9505.0170 
230.23 	to 9505.0475.
230.24 	(c) An adult day treatment services provider must:
230.25 	(1) ensure that the commissioner has approved of the organization as an adult day 
230.26 	treatment provider organization;
230.27 	(2) ensure that a multidisciplinary team provides ADT services to a group of clients. A 
230.28 	mental health professional must supervise each multidisciplinary staff person who provides 
230.29 	ADT services;
230.30 	(3) make ADT services available to the client at least two days a week for at least three 
230.31 	consecutive hours per day. ADT services may be longer than three hours per day, but medical 
230.32 	assistance may not reimburse a provider for more than 15 hours per week;
231.1 	(4) provide ADT services to each client that includes group psychotherapy by a mental 
231.2 	health professional or clinical trainee and daily rehabilitative interventions by a mental 
231.3 	health professional, clinical trainee, or mental health practitioner; and
231.4 	(5) include ADT services in the client's individual treatment plan, when appropriate. 
231.5 	The adult day treatment provider must:
231.6 	(i) complete a functional assessment of each client under section 245I.10, subdivision 
231.7 	9;
231.8 	(ii) notwithstanding section 245I.10, subdivision 8, review the client's progress and 
231.9 	update the individual treatment plan at least every 90 days until the client is discharged 
231.10 	from the program; and
231.11 	(iii) include a discharge plan for the client in the client's individual treatment plan.
231.12 	(d) To be eligible for adult day treatment, a client must:
231.13 	(1) be 18 years of age or older;
231.14 	(2) not reside in a nursing facility, hospital, institute of mental disease, or state-operated 
231.15 	treatment center unless the client has an active discharge plan that indicates a move to an 
231.16 	independent living setting within 180 days;
231.17 	(3) have the capacity to engage in rehabilitative programming, skills activities, and 
231.18 	psychotherapy in the structured, therapeutic setting of an adult day treatment program and 
231.19 	demonstrate measurable improvements in functioning resulting from participation in the 
231.20 	adult day treatment program;
231.21 	(4) have a level of care assessment under section 245I.02, subdivision 19, recommending 
231.22 	that the client participate in services with the level of intensity and duration of an adult day 
231.23 	treatment program; and
231.24 	(5) have the recommendation of a mental health professional for adult day treatment 
231.25 	services. The mental health professional must find that adult day treatment services are 
231.26 	medically necessary for the client.
231.27 	(e) Medical assistance does not cover the following services as adult day treatment 
231.28 	services:
231.29 	(1) services that are primarily recreational or that are provided in a setting that is not 
231.30 	under medical supervision, including sports activities, exercise groups, craft hours, leisure 
231.31 	time, social hours, meal or snack time, trips to community activities, and tours;
232.1 	(2) social or educational services that do not have or cannot reasonably be expected to 
232.2 	have a therapeutic outcome related to the client's mental illness;
232.3 	(3) consultations with other providers or service agency staff persons about the care or 
232.4 	progress of a client;
232.5 	(4) prevention or education programs that are provided to the community;
232.6 	(5) day treatment for clients with a primary diagnosis of a substance use disorder;
232.7 	(6) day treatment provided in the client's home;
232.8 	(7) psychotherapy for more than two hours per day; and
232.9 	(8) participation in meal preparation and eating that is not part of a clinical treatment 
232.10 	plan to address the client's eating disorder.

232.11 	Sec. 23. Minnesota Statutes 2023 Supplement, section 256B.0671, subdivision 5, is 
232.12 	amended to read:
232.13 		Subd. 5.Child and family psychoeducation services. (a) Medical assistance covers
232.14 	child and family psychoeducation services provided to a child up tounder age 21 with and 
232.15 	the child's family members, when determined to be medically necessary due to a diagnosed
232.16 	mental health condition when or diagnosed mental illness identified in the child's individual 
232.17 	treatment plan and provided by a mental health professional who is qualified under section 
232.18 	245I.04, subdivision 2, and practicing within the scope of practice under section 245I.04, 
232.19 	subdivision 3; a mental health practitioner who is qualified under section 245I.04, subdivision 
232.20 	4, and practicing within the scope of practice under section 245I.04, subdivision 5; or a 
232.21 	clinical trainee who has determined it medically necessary to involve family members in 
232.22 	the child's care is qualified under section 245I.04, subdivision 6, and practicing within the 
232.23 	scope of practice under section 245I.04, subdivision 7.
232.24 	(b) "Child and family psychoeducation services" means information or demonstration 
232.25 	provided to an individual or family as part of an individual, family, multifamily group, or 
232.26 	peer group session to explain, educate, and support the child and family in understanding 
232.27 	a child's symptoms of mental illness, the impact on the child's development, and needed 
232.28 	components of treatment and skill development so that the individual, family, or group can 
232.29 	help the child to prevent relapse, prevent the acquisition of comorbid disorders, and achieve 
232.30 	optimal mental health and long-term resilience.
232.31 	(c) Child and family psychoeducation services include individual, family, or group skills 
232.32 	development or training to:
233.1 	(1) support the development of psychosocial skills that are medically necessary to 
233.2 	rehabilitate the child to an age-appropriate developmental trajectory when the child's 
233.3 	development was disrupted by a mental health condition or diagnosed mental illness; or
233.4 	(2) enable the child to self-monitor, compensate for, cope with, counteract, or replace 
233.5 	skills deficits or maladaptive skills acquired over the course of the child's mental health 
233.6 	condition or mental illness.
233.7 	(d) Skills development or training delivered to a child or the child's family under this 
233.8 	subdivision must be targeted to the specific deficits related to the child's mental health 
233.9 	condition or mental illness and must be prescribed in the child's individual treatment plan. 
233.10 	Group skills training may be provided to multiple recipients who, because of the nature of 
233.11 	their emotional, behavioral, or social functional ability, may benefit from interaction in a 
233.12 	group setting.

233.13 	EFFECTIVE DATE. This section is effective January 1, 2025, or upon federal approval, 
233.14 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
233.15 	when federal approval is obtained.

233.16 	Sec. 24. Minnesota Statutes 2022, section 256B.0943, subdivision 3, is amended to read:
233.17 		Subd. 3.Determination of client eligibility. (a) A client's eligibility to receive children's 
233.18 	therapeutic services and supports under this section shall be determined based on a standard 
233.19 	diagnostic assessment by a mental health professional or a clinical trainee that is performed 
233.20 	within one year before the initial start of service and updated as required under section 
233.21 	245I.10, subdivision 2. The standard diagnostic assessment must:
233.22 	(1) determine whether a child under age 18 has a diagnosis of emotional disturbance or, 
233.23 	if the person is between the ages of 18 and 21, whether the person has a mental illness;
233.24 	(2) document children's therapeutic services and supports as medically necessary to 
233.25 	address an identified disability, functional impairment, and the individual client's needs and 
233.26 	goals; and
233.27 	(3) be used in the development of the individual treatment plan.
233.28 	(b) Notwithstanding paragraph (a), a client may be determined to be eligible for up to 
233.29 	five days of day treatment under this section based on a hospital's medical history and 
233.30 	presentation examination of the client.
233.31 	(c) Children's therapeutic services and supports include development and rehabilitative 
233.32 	services that support a child's developmental treatment needs.

234.1 	Sec. 25. Minnesota Statutes 2022, section 256B.0943, subdivision 12, is amended to read:
234.2 		Subd. 12.Excluded services. The following services are not eligible for medical 
234.3 	assistance payment as children's therapeutic services and supports:
234.4 	(1) service components of children's therapeutic services and supports simultaneously 
234.5 	provided by more than one provider entity unless prior authorization is obtained;
234.6 	(2) treatment by multiple providers within the same agency at the same clock time, 
234.7 	unless one service is delivered to the child and the other service is delivered to the child's 
234.8 	family or treatment team without the child present;
234.9 	(3) children's therapeutic services and supports provided in violation of medical assistance 
234.10 	policy in Minnesota Rules, part 9505.0220;
234.11 	(4) mental health behavioral aide services provided by a personal care assistant who is 
234.12 	not qualified as a mental health behavioral aide and employed by a certified children's 
234.13 	therapeutic services and supports provider entity;
234.14 	(5) service components of CTSS that are the responsibility of a residential or program 
234.15 	license holder, including foster care providers under the terms of a service agreement or 
234.16 	administrative rules governing licensure; and
234.17 	(6) adjunctive activities that may be offered by a provider entity but are not otherwise 
234.18 	covered by medical assistance, including:
234.19 	(i) a service that is primarily recreation oriented or that is provided in a setting that is 
234.20 	not medically supervised. This includes sports activities, exercise groups, activities such as 
234.21 	craft hours, leisure time, social hours, meal or snack time, trips to community activities, 
234.22 	and tours;
234.23 	(ii) a social or educational service that does not have or cannot reasonably be expected 
234.24 	to have a therapeutic outcome related to the client's emotional disturbance;
234.25 	(iii) prevention or education programs provided to the community; and
234.26 	(iv) treatment for clients with primary diagnoses of alcohol or other drug abuse.

234.27 	Sec. 26. Minnesota Statutes 2022, section 256B.0947, subdivision 5, is amended to read:
234.28 		Subd. 5.Standards for intensive nonresidential rehabilitative providers. (a) Services 
234.29 	must meet the standards in this section and chapter 245I as required in section 245I.011, 
234.30 	subdivision 5.
235.1 	(b) The treatment team must have specialized training in providing services to the specific 
235.2 	age group of youth that the team serves. An individual treatment team must serve youth 
235.3 	who are: (1) at least eight years of age or older and under 16 years of age, or (2) at least 14 
235.4 	years of age or older and under 21 years of age.
235.5 	(c) The treatment team for intensive nonresidential rehabilitative mental health services 
235.6 	comprises both permanently employed core team members and client-specific team members 
235.7 	as follows:
235.8 	(1) Based on professional qualifications and client needs, clinically qualified core team 
235.9 	members are assigned on a rotating basis as the client's lead worker to coordinate a client's 
235.10 	care. The core team must comprise at least four full-time equivalent direct care staff and 
235.11 	must minimally include:
235.12 	(i) a mental health professional who serves as team leader to provide administrative 
235.13 	direction and treatment supervision to the team;
235.14 	(ii) an advanced-practice registered nurse with certification in psychiatric or mental 
235.15 	health care or a board-certified child and adolescent psychiatrist, either of which must be 
235.16 	credentialed to prescribe medications;
235.17 	(iii) a licensed alcohol and drug counselor who is also trained in mental health 
235.18 	interventions; and
235.19 	(iv)(iii) a mental health certified peer specialist who is qualified according to section 
235.20 	245I.04, subdivision 10, and is also a former children's mental health consumer.; and
235.21 	(iv) a co-occurring disorder specialist who meets the requirements under section 
235.22 	256B.0622, subdivision 7a, paragraph (a), clause (4), who will provide or facilitate the 
235.23 	provision of co-occurring disorder treatment to clients.
235.24 	(2) The core team may also include any of the following:
235.25 	(i) additional mental health professionals;
235.26 	(ii) a vocational specialist;
235.27 	(iii) an educational specialist with knowledge and experience working with youth 
235.28 	regarding special education requirements and goals, special education plans, and coordination 
235.29 	of educational activities with health care activities;
235.30 	(iv) a child and adolescent psychiatrist who may be retained on a consultant basis;
235.31 	(v) a clinical trainee qualified according to section 245I.04, subdivision 6;
236.1 	(vi) a mental health practitioner qualified according to section 245I.04, subdivision 4;
236.2 	(vii) a case management service provider, as defined in section 245.4871, subdivision 
236.3 	4;
236.4 	(viii) a housing access specialist; and
236.5 	(ix) a family peer specialist as defined in subdivision 2, paragraph (j).
236.6 	(3) A treatment team may include, in addition to those in clause (1) or (2), ad hoc 
236.7 	members not employed by the team who consult on a specific client and who must accept 
236.8 	overall clinical direction from the treatment team for the duration of the client's placement 
236.9 	with the treatment team and must be paid by the provider agency at the rate for a typical 
236.10 	session by that provider with that client or at a rate negotiated with the client-specific 
236.11 	member. Client-specific treatment team members may include:
236.12 	(i) the mental health professional treating the client prior to placement with the treatment 
236.13 	team;
236.14 	(ii) the client's current substance use counselor, if applicable;
236.15 	(iii) a lead member of the client's individualized education program team or school-based 
236.16 	mental health provider, if applicable;
236.17 	(iv) a representative from the client's health care home or primary care clinic, as needed 
236.18 	to ensure integration of medical and behavioral health care;
236.19 	(v) the client's probation officer or other juvenile justice representative, if applicable; 
236.20 	and
236.21 	(vi) the client's current vocational or employment counselor, if applicable.
236.22 	(d) The treatment supervisor shall be an active member of the treatment team and shall 
236.23 	function as a practicing clinician at least on a part-time basis. The treatment team shall meet 
236.24 	with the treatment supervisor at least weekly to discuss recipients' progress and make rapid 
236.25 	adjustments to meet recipients' needs. The team meeting must include client-specific case 
236.26 	reviews and general treatment discussions among team members. Client-specific case 
236.27 	reviews and planning must be documented in the individual client's treatment record.
236.28 	(e) The staffing ratio must not exceed ten clients to one full-time equivalent treatment 
236.29 	team position.
236.30 	(f) The treatment team shall serve no more than 80 clients at any one time. Should local 
236.31 	demand exceed the team's capacity, an additional team must be established rather than 
236.32 	exceed this limit.
237.1 	(g) Nonclinical staff shall have prompt access in person or by telephone to a mental 
237.2 	health practitioner, clinical trainee, or mental health professional. The provider shall have 
237.3 	the capacity to promptly and appropriately respond to emergent needs and make any 
237.4 	necessary staffing adjustments to ensure the health and safety of clients.
237.5 	(h) The intensive nonresidential rehabilitative mental health services provider shall 
237.6 	participate in evaluation of the assertive community treatment for youth (Youth ACT) model 
237.7 	as conducted by the commissioner, including the collection and reporting of data and the 
237.8 	reporting of performance measures as specified by contract with the commissioner.
237.9 	(i) A regional treatment team may serve multiple counties.

237.10 	Sec. 27. Minnesota Statutes 2022, section 256B.76, subdivision 6, is amended to read:
237.11 		Subd. 6.Medicare relative value units.  (a) Effective for services rendered on or after 
237.12 	January 1, 2007, the commissioner shall make payments for physician and professional 
237.13 	services based on the Medicare relative value units (RVU's) (RVUs). This change shall be 
237.14 	budget neutral and the cost of implementing RVU's RVUs will be incorporated in the 
237.15 	established conversion factor.
237.16 	(b) Effective for services rendered on or after January 1, 2025, rates for mental health 
237.17 	services reimbursed under the resource-based relative value scale (RBRVS) must be equal 
237.18 	to 83 percent of the Medicare Physician Fee Schedule.
237.19 	(c) Effective for services rendered on or after January 1, 2025, the commissioner shall 
237.20 	increase capitation payments made to managed care plans and county-based purchasing 
237.21 	plans to reflect the rate increases provided under this subdivision. Managed care plans and 
237.22 	county-based purchasing plans must use the capitation rate increase provided under this 
237.23 	paragraph to increase payment rates to the providers corresponding to the rate increases. 
237.24 	The commissioner must monitor the effect of this rate increase on enrollee access to services 
237.25 	under this subdivision. If for any contract year federal approval is not received for this 
237.26 	paragraph, the commissioner must adjust the capitation rates paid to managed care plans 
237.27 	and county-based purchasing plans for that contract year to reflect the removal of this 
237.28 	paragraph. Contracts between managed care plans and county-based purchasing plans and 
237.29 	providers to whom this paragraph applies must allow recovery of payments from those 
237.30 	providers if capitation rates are adjusted in accordance with this paragraph. Payment 
237.31 	recoveries must not exceed the amount equal to any increase in rates that results from this 
237.32 	paragraph.

238.1 	EFFECTIVE DATE. This section is effective January 1, 2025, or upon federal approval, 
238.2 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
238.3 	when federal approval is obtained.

238.4 	Sec. 28. Laws 2023, chapter 70, article 1, section 35, is amended to read:
238.5 	Sec. 35. Minnesota Statutes 2022, section 256B.761, is amended to read:
238.6 	256B.761 REIMBURSEMENT FOR MENTAL HEALTH SERVICES.
238.7 	(a) Effective for services rendered on or after July 1, 2001, payment for medication 
238.8 	management provided to psychiatric patients, outpatient mental health services, day treatment 
238.9 	services, home-based mental health services, and family community support services shall 
238.10 	be paid at the lower of (1) submitted charges, or (2) 75.6 percent of the 50th percentile of 
238.11 	1999 charges.
238.12 	(b) Effective July 1, 2001, the medical assistance rates for outpatient mental health 
238.13 	services provided by an entity that operates: (1) a Medicare-certified comprehensive 
238.14 	outpatient rehabilitation facility; and (2) a facility that was certified prior to January 1, 1993, 
238.15 	with at least 33 percent of the clients receiving rehabilitation services in the most recent 
238.16 	calendar year who are medical assistance recipients, will be increased by 38 percent, when 
238.17 	those services are provided within the comprehensive outpatient rehabilitation facility and 
238.18 	provided to residents of nursing facilities owned by the entity.
238.19 	(c) In addition to rate increases otherwise provided, the commissioner may restructure 
238.20 	coverage policy and rates to improve access to adult rehabilitative mental health services 
238.21 	under section 256B.0623 and related mental health support services under section 256B.021, 
238.22 	subdivision 4, paragraph (f), clause (2). For state fiscal years 2015 and 2016, the projected 
238.23 	state share of increased costs due to this paragraph is transferred from adult mental health 
238.24 	grants under sections 245.4661 and 256E.12. The transfer for fiscal year 2016 is a permanent 
238.25 	base adjustment for subsequent fiscal years. Payments made to managed care plans and 
238.26 	county-based purchasing plans under sections 256B.69, 256B.692, and 256L.12 shall reflect 
238.27 	the rate changes described in this paragraph.
238.28 	(d) Any ratables effective before July 1, 2015, do not apply to early intensive 
238.29 	developmental and behavioral intervention (EIDBI) benefits described in section 256B.0949.
238.30 	(e) Effective for services rendered on or after January 1, 2024, payment rates for 
238.31 	behavioral health services included in the rate analysis required by Laws 2021, First Special 
238.32 	Session chapter 7, article 17, section 18, except for adult day treatment services under section 
239.1 	256B.0671, subdivision 3; early intensive developmental and behavioral intervention services 
239.2 	under section 256B.0949; and substance use disorder services under chapter 254B, must be 
239.3 	increased by three percent from the rates in effect on December 31, 2023. Effective for 
239.4 	services rendered on or after January 1, 2025, payment rates for behavioral health services 
239.5 	included in the rate analysis required by Laws 2021, First Special Session chapter 7, article 
239.6 	17, section 18, except for adult day treatment services under section 256B.0671, subdivision 
239.7 	3; early intensive developmental behavioral intervention services under section 256B.0949; 
239.8 	and substance use disorder services under chapter 254B, must be annually adjusted according 
239.9 	to the change from the midpoint of the previous rate year to the midpoint of the rate year 
239.10 	for which the rate is being determined using the Centers for Medicare and Medicaid Services 
239.11 	Medicare Economic Index as forecasted in the fourth quarter of the calendar year before 
239.12 	the rate year. For payments made in accordance with this paragraph, if and to the extent 
239.13 	that the commissioner identifies that the state has received federal financial participation 
239.14 	for behavioral health services in excess of the amount allowed under United States Code, 
239.15 	title 42, section 447.321, the state shall repay the excess amount to the Centers for Medicare 
239.16 	and Medicaid Services with state money and maintain the full payment rate under this 
239.17 	paragraph. This paragraph does not apply to federally qualified health centers, rural health 
239.18 	centers, Indian health services, certified community behavioral health clinics, cost-based 
239.19 	rates, and rates that are negotiated with the county. This paragraph expires upon legislative 
239.20 	implementation of the new rate methodology resulting from the rate analysis required by 
239.21 	Laws 2021, First Special Session chapter 7, article 17, section 18.
239.22 	(f) Effective January 1, 2024, the commissioner shall increase capitation payments made 
239.23 	to managed care plans and county-based purchasing plans to reflect the behavioral health 
239.24 	service rate increase provided in paragraph (e). Managed care and county-based purchasing 
239.25 	plans must use the capitation rate increase provided under this paragraph to increase payment 
239.26 	rates to behavioral health services providers. The commissioner must monitor the effect of 
239.27 	this rate increase on enrollee access to behavioral health services. If for any contract year 
239.28 	federal approval is not received for this paragraph, the commissioner must adjust the 
239.29 	capitation rates paid to managed care plans and county-based purchasing plans for that 
239.30 	contract year to reflect the removal of this provision. Contracts between managed care plans 
239.31 	and county-based purchasing plans and providers to whom this paragraph applies must 
239.32 	allow recovery of payments from those providers if capitation rates are adjusted in accordance 
239.33 	with this paragraph. Payment recoveries must not exceed the amount equal to any increase 
239.34 	in rates that results from this provision.

240.1 	EFFECTIVE DATE. This section is effective January 1, 2025, or upon federal approval, 
240.2 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
240.3 	when federal approval is obtained.

240.4 	Sec. 29. FIRST EPISODE PSYCHOSIS COORDINATED SPECIALITY CARE 
240.5 	MEDICAL ASSISTANCE BENEFIT.
 240.6 	(a) The commissioner of human services must develop a First Episode Psychosis 
240.7 	Coordinated Specialty Care (FEP-CSC) medical assistance benefit.
240.8 	(b) The benefit must cover medically necessary treatment. Services must include:
240.9 	(1) assertive outreach and engagement strategies encouraging individuals' involvement;
240.10 	(2) person-centered care, delivered in the home and community, extending beyond 
240.11 	typical hours of operation, such as evenings and weekends;
240.12 	(3) crisis planning and intervention;
240.13 	(4) team leadership from a mental health professional who provides ongoing consultation 
240.14 	to the team members, coordinates admission screening, and leads the weekly team meetings 
240.15 	to facilitate case review and entry to the program;
240.16 	(5) employment and education services that enable individuals to function in workplace 
240.17 	and educational settings that support individual preferences;
240.18 	(6) family education and support that builds on an individual's identified family and 
240.19 	natural support systems;
240.20 	(7) individual and group psychotherapy that include but are not limited to cognitive 
240.21 	behavioral therapies;
240.22 	(8) care coordination services in clinic, community, and home settings to assist individuals 
240.23 	with practical problem solving, such as securing transportation, addressing housing and 
240.24 	other basic needs, managing money, obtaining medical care, and coordinating care with 
240.25 	other providers; and
240.26 	(9) pharmacotherapy, medication management, and primary care coordination provided 
240.27 	by a mental health professional who is permitted to prescribe psychiatric medications.
240.28 	(c) An eligible recipient is an individual who:
240.29 	(1) is between the ages of 15 and 40;
240.30 	(2) is experiencing early signs of psychosis with the duration of onset being less than 
240.31 	two years; and
241.1 	(3) has been on antipsychotic medications for less than a total of 12 months.
241.2 	(d) By December 1, 2026, the commissioner must submit a report to the chairs and 
241.3 	ranking minority members of the legislative committees with jurisdiction over human 
241.4 	services policy and finance. The report must include:
241.5 	(1) an overview of the recommended benefit;
241.6 	(2) eligibility requirements;
241.7 	(3) program standards;
241.8 	(4) a reimbursement methodology that covers team-based bundled costs;
241.9 	(5) performance evaluation criteria for programs; and
241.10 	(6) draft legislation with the statutory changes necessary to implement the benefit.

241.11 	EFFECTIVE DATE. This section is effective July 1, 2024.

241.12 	Sec. 30. MEDICAL ASSISTANCE CHILDREN'S RESIDENTIAL MENTAL 
241.13 	HEALTH CRISIS STABILIZATION.
 241.14 	(a) The commissioner of human services must consult with providers, advocates, Tribal 
241.15 	Nations, counties, people with lived experience as or with a child in a mental health crisis, 
241.16 	and other interested community members to develop a covered benefit under medical 
241.17 	assistance to provide residential mental health crisis stabilization for children. The benefit 
241.18 	must:
241.19 	(1) consist of evidence-based promising practices, or culturally responsive treatment 
241.20 	services for children under the age of 21 experiencing a mental health crisis;
241.21 	(2) embody an integrative care model that supports individuals experiencing a mental 
241.22 	health crisis who may also be experiencing co-occurring conditions;
241.23 	(3) qualify for federal financial participation; and
241.24 	(4) include services that support children and families, including but not limited to:
241.25 	(i) an assessment of the child's immediate needs and factors that led to the mental health 
241.26 	crisis;
241.27 	(ii) individualized care to address immediate needs and restore the child to a precrisis 
241.28 	level of functioning;
241.29 	(iii) 24-hour on-site staff and assistance;
241.30 	(iv) supportive counseling and clinical services;
242.1 	(v) skills training and positive support services, as identified in the child's individual 
242.2 	crisis stabilization plan;
242.3 	(vi) referrals to other service providers in the community as needed and to support the 
242.4 	child's transition from residential crisis stabilization services;
242.5 	(vii) development of an individualized and culturally responsive crisis response action 
242.6 	plan; and
242.7 	(viii) assistance to access and store medication.
242.8 	(b) When developing the new benefit, the commissioner must make recommendations 
242.9 	for providers to be reimbursed for room and board.
242.10 	(c) The commissioner must consult with or contract with rate-setting experts to develop 
242.11 	a prospective data-based rate methodology for the children's residential mental health crisis 
242.12 	stabilization benefit.
242.13 	(d) No later than October 1, 2025, the commissioner must submit to the chairs and 
242.14 	ranking minority members of the legislative committees with jurisdiction over human 
242.15 	services policy and finance a report detailing the children's residential mental health crisis 
242.16 	stabilization benefit and must include:
242.17 	(1) eligibility criteria, clinical and service requirements, provider standards, licensing 
242.18 	requirements, and reimbursement rates;
242.19 	(2) the process for community engagement, community input, and crisis models studied 
242.20 	in other states;
242.21 	(3) a deadline for the commissioner to submit a state plan amendment to the Centers for 
242.22 	Medicare and Medicaid Services; and
242.23 	(4) draft legislation with the statutory changes necessary to implement the benefit.

242.24 	EFFECTIVE DATE. This section is effective July 1, 2024.

242.25 	Sec. 31. MEDICAL ASSISTANCE CLUBHOUSE BENEFIT ANALYSIS.
 242.26 	The commissioner of human services must conduct an analysis to identify existing or 
242.27 	pending Medicaid Clubhouse benefits in other states, federal authorities used, populations 
242.28 	served, service and reimbursement design, and accreditation standards. By December 1, 
242.29 	2025, the commissioner must submit a report to the chairs and ranking minority members 
242.30 	of the legislative committees with jurisdiction over health and human services finance and 
243.1 	policy. The report must include a comparative analysis of Medicaid Clubhouse programs 
243.2 	and recommendations for designing a medical assistance benefit in Minnesota.

243.3 	Sec. 32. DIRECTION TO COMMISSIONER OF HUMAN SERVICES; MENTAL 
243.4 	HEALTH PROCEDURE CODES.
 243.5 	The commissioner of human services must develop recommendations, in consultation 
243.6 	with external partners and medical coding and compliance experts, on simplifying mental 
243.7 	health procedure codes and the feasibility of converting mental health procedure codes to 
243.8 	the current procedural terminology (CPT) code structure. By October 1, 2025, the 
243.9 	commissioner must submit a report to the chairs and ranking minority members of the 
243.10 	legislative committees with jurisdiction over mental health on the recommendations and 
243.11 	methodology to simplify and restructure mental health procedure codes with corresponding 
243.12 	resource-based relative value scale (RBRVS) values.

243.13 	EFFECTIVE DATE. This section is effective July 1, 2024.

243.14 	Sec. 33. MENTAL HEALTH SERVICES FORMULA-BASED ALLOCATION.
 243.15 	The commissioner of human services shall consult with the commissioner of management 
243.16 	and budget, counties, Tribes, mental health providers, and advocacy organizations to develop 
243.17 	recommendations for moving from the children's and adult mental health grant funding 
243.18 	structure to a formula-based allocation structure for mental health services. The 
243.19 	recommendations must consider formula-based allocations for grants for respite care, 
243.20 	school-linked behavioral health, mobile crisis teams, and first episode of psychosis programs.

243.21 	Sec. 34. REVISOR INSTRUCTION.
 243.22 	The revisor of statutes, in consultation with the Office of Senate Counsel, Research and 
243.23 	Fiscal Analysis; the House Research Department; and the commissioner of human services 
243.24 	shall prepare legislation for the 2025 legislative session to recodify Minnesota Statutes, 
243.25 	section 256B.0622, to move provisions related to assertive community treatment and intensive 
243.26 	residential treatment services into separate sections of statute. The revisor shall correct any 
243.27 	cross-references made necessary by this recodification.

244.1 	ARTICLE 9
244.2 	DEPARTMENT OF HUMAN SERVICES POLICY

244.3 	Section 1. Minnesota Statutes 2023 Supplement, section 245A.03, subdivision 2, as 
244.4 	amended by Laws 2024, chapter 85, section 52, and Laws 2024, chapter 80, article 2, section 
244.5 	35, is amended to read:
244.6 		Subd. 2.Exclusion from licensure. (a) This chapter does not apply to:
244.7 	(1) residential or nonresidential programs that are provided to a person by an individual 
244.8 	who is related;
244.9 	(2) nonresidential programs that are provided by an unrelated individual to persons from 
244.10 	a single related family;
244.11 	(3) residential or nonresidential programs that are provided to adults who do not misuse 
244.12 	substances or have a substance use disorder, a mental illness, a developmental disability, a 
244.13 	functional impairment, or a physical disability;
244.14 	(4) sheltered workshops or work activity programs that are certified by the commissioner 
244.15 	of employment and economic development;
244.16 	(5) programs operated by a public school for children 33 months or older;
244.17 	(6) nonresidential programs primarily for children that provide care or supervision for 
244.18 	periods of less than three hours a day while the child's parent or legal guardian is in the 
244.19 	same building as the nonresidential program or present within another building that is 
244.20 	directly contiguous to the building in which the nonresidential program is located;
244.21 	(7) nursing homes or hospitals licensed by the commissioner of health except as specified 
244.22 	under section 245A.02;
244.23 	(8) board and lodge facilities licensed by the commissioner of health that do not provide 
244.24 	children's residential services under Minnesota Rules, chapter 2960, mental health or 
244.25 	substance use disorder treatment;
244.26 	(9) programs licensed by the commissioner of corrections;
244.27 	(10) recreation programs for children or adults that are operated or approved by a park 
244.28 	and recreation board whose primary purpose is to provide social and recreational activities;
244.29 	(11) noncertified boarding care homes unless they provide services for five or more 
244.30 	persons whose primary diagnosis is mental illness or a developmental disability;
245.1 	(12) programs for children such as scouting, boys clubs, girls clubs, and sports and art 
245.2 	programs, and nonresidential programs for children provided for a cumulative total of less 
245.3 	than 30 days in any 12-month period;
245.4 	(13) residential programs for persons with mental illness, that are located in hospitals;
245.5 	(14) camps licensed by the commissioner of health under Minnesota Rules, chapter 
245.6 	4630;
245.7 	(15) mental health outpatient services for adults with mental illness or children with 
245.8 	emotional disturbance;
245.9 	(16) residential programs serving school-age children whose sole purpose is cultural or 
245.10 	educational exchange, until the commissioner adopts appropriate rules;
245.11 	(17) community support services programs as defined in section 245.462, subdivision 
245.12 	6, and family community support services as defined in section 245.4871, subdivision 17;
245.13 	(18) settings registered under chapter 144D which provide home care services licensed 
245.14 	by the commissioner of health to fewer than seven adults assisted living facilities licensed 
245.15 	by the commissioner of health under chapter 144G;
245.16 	(19) substance use disorder treatment activities of licensed professionals in private 
245.17 	practice as defined in section 245G.01, subdivision 17;
245.18 	(20) consumer-directed community support service funded under the Medicaid waiver 
245.19 	for persons with developmental disabilities when the individual who provided the service 
245.20 	is:
245.21 	(i) the same individual who is the direct payee of these specific waiver funds or paid by 
245.22 	a fiscal agent, fiscal intermediary, or employer of record; and
245.23 	(ii) not otherwise under the control of a residential or nonresidential program that is 
245.24 	required to be licensed under this chapter when providing the service;
245.25 	(21) a county that is an eligible vendor under section 254B.05 to provide care coordination 
245.26 	and comprehensive assessment services;
245.27 	(22) a recovery community organization that is an eligible vendor under section 254B.05 
245.28 	to provide peer recovery support services; or
245.29 	(23) programs licensed by the commissioner of children, youth, and families in chapter 
245.30 	142B.
246.1 	(b) For purposes of paragraph (a), clause (6), a building is directly contiguous to a 
246.2 	building in which a nonresidential program is located if it shares a common wall with the 
246.3 	building in which the nonresidential program is located or is attached to that building by 
246.4 	skyway, tunnel, atrium, or common roof.
246.5 	(b) (c) Except for the home and community-based services identified in section 245D.03, 
246.6 	subdivision 1, nothing in this chapter shall be construed to require licensure for any services 
246.7 	provided and funded according to an approved federal waiver plan where licensure is 
246.8 	specifically identified as not being a condition for the services and funding.

246.9 	Sec. 3. Minnesota Statutes 2022, section 245A.04, is amended by adding a subdivision to 
246.10 	read:
246.11 		Subd. 7b.Notification to commissioner of changes in key staff positions; children's 
246.12 	residential facilities and detoxification programs. (a) A license holder must notify the 
246.13 	commissioner within five business days of a change or vacancy in a key staff position under 
246.14 	paragraph (b) or (c). The license holder must notify the commissioner of the staffing change 
246.15 	on a form approved by the commissioner and include the name of the staff person now 
246.16 	assigned to the key staff position and the staff person's qualifications for the position. The 
246.17 	license holder must notify the program licensor of a vacancy to discuss how the duties of 
246.18 	the key staff position will be fulfilled during the vacancy.
246.19 	(b) The key staff position for a children's residential facility licensed according to 
246.20 	Minnesota Rules, parts 2960.0130 to 2960.0220, is a program director; and
246.21 	(c) The key staff positions for a detoxification program licensed according to Minnesota 
246.22 	Rules, parts 9530.6510 to 9530.6590, are:
246.23 	(1) a program director as required by Minnesota Rules, part 9530.6560, subpart 1;
246.24 	(2) a registered nurse as required by Minnesota Rules, part 9530.6560, subpart 4; and
246.25 	(3) a medical director as required by Minnesota Rules, part 9530.6560, subpart 5.

246.26 	EFFECTIVE DATE. This section is effective January 1, 2025.

246.27 	Sec. 2. Minnesota Statutes 2022, section 245A.043, subdivision 2, is amended to read:
246.28 		Subd. 2.Change in ownership. (a) If the commissioner determines that there is a change 
246.29 	in ownership, the commissioner shall require submission of a new license application. This 
246.30 	subdivision does not apply to a licensed program or service located in a home where the 
246.31 	license holder resides. A change in ownership occurs when:
247.1 	(1) except as provided in paragraph (b), the license holder sells or transfers 100 percent 
247.2 	of the property, stock, or assets;
247.3 	(2) the license holder merges with another organization;
247.4 	(3) the license holder consolidates with two or more organizations, resulting in the 
247.5 	creation of a new organization;
247.6 	(4) there is a change to the federal tax identification number associated with the license 
247.7 	holder; or
247.8 	(5) except as provided in paragraph (b), all controlling individuals associated with for
247.9 	the original application license have changed.
247.10 	(b) Notwithstanding For changes under paragraph (a), clauses (1) and or (5), no change 
247.11 	in ownership has occurred and a new license application is not required if at least one 
247.12 	controlling individual has been listed affiliated as a controlling individual for the license 
247.13 	for at least the previous 12 months immediately preceding the change.

247.14 	EFFECTIVE DATE. This section is effective January 1, 2025.

247.15 	Sec. 3. Minnesota Statutes 2023 Supplement, section 245A.043, subdivision 3, is amended 
247.16 	to read:
247.17 		Subd. 3.Standard change of ownership process. (a) When a change in ownership is 
247.18 	proposed and the party intends to assume operation without an interruption in service longer 
247.19 	than 60 days after acquiring the program or service, the license holder must provide the 
247.20 	commissioner with written notice of the proposed change on a form provided by the 
247.21 	commissioner at least 60 90 days before the anticipated date of the change in ownership. 
247.22 	For purposes of this subdivision and subdivision 4 section, "party" means the party that 
247.23 	intends to operate the service or program.
247.24 	(b) The party must submit a license application under this chapter on the form and in 
247.25 	the manner prescribed by the commissioner at least 30 90 days before the change in 
247.26 	ownership is anticipated to be complete, and must include documentation to support the 
247.27 	upcoming change. The party must comply with background study requirements under chapter 
247.28 	245C and shall pay the application fee required under section 245A.10.
247.29 	(c) A party that intends to assume operation without an interruption in service longer 
247.30 	than 60 days after acquiring the program or service is exempt from the requirements of 
247.31 	sections 245G.03, subdivision 2, paragraph (b), and 254B.03, subdivision 2, paragraphs (c) 
247.32 	and (d).
248.1 	(c) (d) The commissioner may streamline application procedures when the party is an 
248.2 	existing license holder under this chapter and is acquiring a program licensed under this 
248.3 	chapter or service in the same service class as one or more licensed programs or services 
248.4 	the party operates and those licenses are in substantial compliance. For purposes of this 
248.5 	subdivision, "substantial compliance" means within the previous 12 months the commissioner 
248.6 	did not (1) issue a sanction under section 245A.07 against a license held by the party, or 
248.7 	(2) make a license held by the party conditional according to section 245A.06.
248.8 	(d) Except when a temporary change in ownership license is issued pursuant to 
248.9 	subdivision 4 (e) While the standard change of ownership process is pending, the existing 
248.10 	license holder is solely remains responsible for operating the program according to applicable 
248.11 	laws and rules until a license under this chapter is issued to the party.
248.12 	(e) (f) If a licensing inspection of the program or service was conducted within the 
248.13 	previous 12 months and the existing license holder's license record demonstrates substantial 
248.14 	compliance with the applicable licensing requirements, the commissioner may waive the 
248.15 	party's inspection required by section 245A.04, subdivision 4. The party must submit to the 
248.16 	commissioner (1) proof that the premises was inspected by a fire marshal or that the fire 
248.17 	marshal deemed that an inspection was not warranted, and (2) proof that the premises was 
248.18 	inspected for compliance with the building code or that no inspection was deemed warranted.
248.19 	(f) (g) If the party is seeking a license for a program or service that has an outstanding 
248.20 	action under section 245A.06 or 245A.07, the party must submit a letter written plan as part 
248.21 	of the application process identifying how the party has or will come into full compliance 
248.22 	with the licensing requirements.
248.23 	(g) (h) The commissioner shall evaluate the party's application according to section 
248.24 	245A.04, subdivision 6. If the commissioner determines that the party has remedied or 
248.25 	demonstrates the ability to remedy the outstanding actions under section 245A.06 or 245A.07
248.26 	and has determined that the program otherwise complies with all applicable laws and rules, 
248.27 	the commissioner shall issue a license or conditional license under this chapter. A conditional 
248.28 	license issued under this section is final and not subject to reconsideration under section 
248.29 	245A.06, subdivision 4. The conditional license remains in effect until the commissioner 
248.30 	determines that the grounds for the action are corrected or no longer exist.
248.31 	(h) (i) The commissioner may deny an application as provided in section 245A.05. An 
248.32 	applicant whose application was denied by the commissioner may appeal the denial according 
248.33 	to section 245A.05.
249.1 	(i) (j) This subdivision does not apply to a licensed program or service located in a home 
249.2 	where the license holder resides.

249.3 	EFFECTIVE DATE. This section is effective January 1, 2025.

249.4 	Sec. 4. Minnesota Statutes 2022, section 245A.043, is amended by adding a subdivision 
249.5 	to read:
249.6 		Subd. 3a.Emergency change in ownership process. (a) In the event of a death of a 
249.7 	license holder or sole controlling individual or a court order or other event that results in 
249.8 	the license holder being inaccessible or unable to operate the program or service, a party 
249.9 	may submit a request to the commissioner to allow the party to assume operation of the 
249.10 	program or service under an emergency change in ownership process to ensure persons 
249.11 	continue to receive services while the commissioner evaluates the party's license application.
249.12 	(b) To request the emergency change of ownership process, the party must immediately:
249.13 	(1) notify the commissioner of the event resulting in the inability of the license holder 
249.14 	to operate the program and of the party's intent to assume operations; and
249.15 	(2) provide the commissioner with documentation that demonstrates the party has a legal 
249.16 	or legitimate ownership interest in the program or service if applicable and is able to operate 
249.17 	the program or service.
249.18 	(c) If the commissioner approves the party to continue operating the program or service 
249.19 	under an emergency change in ownership process, the party must:
249.20 	(1) request to be added as a controlling individual or license holder to the existing license;
249.21 	(2) notify persons receiving services of the emergency change in ownership in a manner 
249.22 	approved by the commissioner;
249.23 	(3) submit an application for a new license within 30 days of approval;
249.24 	(4) comply with the background study requirements under chapter 245C; and
249.25 	(5) pay the application fee required under section 245A.10.
249.26 	(d) While the emergency change of ownership process is pending, a party approved 
249.27 	under this subdivision is responsible for operating the program under the existing license 
249.28 	according to applicable laws and rules until a new license under this chapter is issued.
249.29 	(e) The provisions in subdivision 3, paragraphs (c), (d), and (f) to (i) apply to this 
249.30 	subdivision.
250.1 	(f) Once a party is issued a new license or has decided not to seek a new license, the 
250.2 	commissioner must close the existing license.
250.3 	(g) This subdivision applies to any program or service licensed under this chapter.

250.4 	EFFECTIVE DATE. This section is effective January 1, 2025.

250.5 	Sec. 5. Minnesota Statutes 2022, section 245A.043, subdivision 4, is amended to read:
250.6 		Subd. 4.Temporary change in ownership transitional license. (a) After receiving the 
250.7 	party's application pursuant to subdivision 3, upon the written request of the existing license 
250.8 	holder and the party, the commissioner may issue a temporary change in ownership license 
250.9 	to the party while the commissioner evaluates the party's application. Until a decision is 
250.10 	made to grant or deny a license under this chapter, the existing license holder and the party 
250.11 	shall both be responsible for operating the program or service according to applicable laws 
250.12 	and rules, and the sale or transfer of the existing license holder's ownership interest in the 
250.13 	licensed program or service does not terminate the existing license.
250.14 	(b) The commissioner may issue a temporary change in ownership license when a license 
250.15 	holder's death, divorce, or other event affects the ownership of the program and an applicant 
250.16 	seeks to assume operation of the program or service to ensure continuity of the program or 
250.17 	service while a license application is evaluated.
250.18 	(c) This subdivision applies to any program or service licensed under this chapter.
250.19 	If a party's application under subdivision 2 is for a satellite license for a community 
250.20 	residential setting under section 245D.23 or day services facility under 245D.27 and if the 
250.21 	party already holds an active license to provide services under chapter 245D, the 
250.22 	commissioner may issue a temporary transitional license to the party for the community 
250.23 	residential setting or day services facility while the commissioner evaluates the party's 
250.24 	application. Until a decision is made to grant or deny a community residential setting or 
250.25 	day services facility satellite license, the party must be solely responsible for operating the 
250.26 	program according to applicable laws and rules, and the existing license must be closed. 
250.27 	The temporary transitional license expires after 12 months from the date it was issued or 
250.28 	upon issuance of the community residential setting or day services facility satellite license, 
250.29 	whichever occurs first.

250.30 	EFFECTIVE DATE. This section is effective January 1, 2025.

251.1 	Sec. 6. Minnesota Statutes 2022, section 245A.043, is amended by adding a subdivision 
251.2 	to read:
251.3 		Subd. 5.Failure to comply. If the commissioner finds that the applicant or license holder 
251.4 	has not fully complied with this section, the commissioner may impose a licensing sanction 
251.5 	under section 245A.05, 245A.06, or 245A.07.

251.6 	EFFECTIVE DATE. This section is effective January 1, 2025.

251.7 	Sec. 7. Minnesota Statutes 2023 Supplement, section 245A.07, subdivision 1, as amended 
251.8 	by Laws 2024, chapter 80, article 2, section 44, is amended to read:
251.9 		Subdivision 1.Sanctions; appeals; license. (a) In addition to making a license conditional 
251.10 	under section 245A.06, the commissioner may suspend or revoke the license, impose a fine, 
251.11 	or secure an injunction against the continuing operation of the program of a license holder 
251.12 	who does not comply with applicable law or rule.
251.13 	When applying sanctions authorized under this section, the commissioner shall consider 
251.14 	the nature, chronicity, or severity of the violation of law or rule and the effect of the violation 
251.15 	on the health, safety, or rights of persons served by the program.
251.16 	(b) If a license holder appeals the suspension or revocation of a license and the license 
251.17 	holder continues to operate the program pending a final order on the appeal, the commissioner 
251.18 	shall issue the license holder a temporary provisional license. The commissioner may include 
251.19 	terms the license holder must follow pending a final order on the appeal.Unless otherwise 
251.20 	specified by the commissioner, variances in effect on the date of the license sanction under 
251.21 	appeal continue under the temporary provisional license. If a license holder fails to comply 
251.22 	with applicable law or rule while operating under a temporary provisional license, the 
251.23 	commissioner may impose additional sanctions under this section and section 245A.06, and 
251.24 	may terminate any prior variance. If a temporary provisional license is set to expire, a new 
251.25 	temporary provisional license shall be issued to the license holder upon payment of any fee 
251.26 	required under section 245A.10. The temporary provisional license shall expire on the date 
251.27 	the final order is issued. If the license holder prevails on the appeal, a new nonprovisional 
251.28 	license shall be issued for the remainder of the current license period.
251.29 	(c) If a license holder is under investigation and the license issued under this chapter is 
251.30 	due to expire before completion of the investigation, the program shall be issued a new 
251.31 	license upon completion of the reapplication requirements and payment of any applicable 
251.32 	license fee. Upon completion of the investigation, a licensing sanction may be imposed 
251.33 	against the new license under this section, section 245A.06, or 245A.08.
252.1 	(d) Failure to reapply or closure of a license issued under this chapter by the license 
252.2 	holder prior to the completion of any investigation shall not preclude the commissioner 
252.3 	from issuing a licensing sanction under this section or section 245A.06 at the conclusion 
252.4 	of the investigation.

252.5 	EFFECTIVE DATE. This section is effective January 1, 2025.

252.6 	Sec. 8. Minnesota Statutes 2022, section 245A.07, subdivision 6, is amended to read:
252.7 		Subd. 6.Appeal of multiple sanctions. (a) When the license holder appeals more than 
252.8 	one licensing action or sanction that were simultaneously issued by the commissioner, the 
252.9 	license holder shall specify the actions or sanctions that are being appealed.
252.10 	(b) If there are different timelines prescribed in statutes for the licensing actions or 
252.11 	sanctions being appealed, the license holder must submit the appeal within the longest of 
252.12 	those timelines specified in statutes.
252.13 	(c) The appeal must be made in writing by certified mail or, by personal service, or 
252.14 	through the provider licensing and reporting hub. If mailed, the appeal must be postmarked 
252.15 	and sent to the commissioner within the prescribed timeline with the first day beginning 
252.16 	the day after the license holder receives the certified letter. If a request is made by personal 
252.17 	service, it must be received by the commissioner within the prescribed timeline with the 
252.18 	first day beginning the day after the license holder receives the certified letter. If the appeal 
252.19 	is made through the provider licensing and reporting hub, it must be received by the 
252.20 	commissioner within the prescribed timeline with the first day beginning the day after the 
252.21 	commissioner issued the order through the hub.
252.22 	(d) When there are different timelines prescribed in statutes for the appeal of licensing 
252.23 	actions or sanctions simultaneously issued by the commissioner, the commissioner shall 
252.24 	specify in the notice to the license holder the timeline for appeal as specified under paragraph 
252.25 	(b).

252.26 	Sec. 9. Minnesota Statutes 2023 Supplement, section 245A.11, subdivision 7, is amended 
252.27 	to read:
252.28 		Subd. 7.Adult foster care and community residential setting; variance for alternate 
252.29 	overnight supervision. (a) The commissioner may grant a variance under section 245A.04, 
252.30 	subdivision 9, to statute or rule parts requiring a caregiver to be present in an adult foster 
252.31 	care home or a community residential setting during normal sleeping hours to allow for 
252.32 	alternative methods of overnight supervision. The commissioner may grant the variance if 
253.1 	the local county licensing agency recommends the variance and the county recommendation 
253.2 	includes documentation verifying that:
253.3 	(1) the county has approved the license holder's plan for alternative methods of providing 
253.4 	overnight supervision and determined the plan protects the residents' health, safety, and 
253.5 	rights;
253.6 	(2) the license holder has obtained written and signed informed consent from each 
253.7 	resident or each resident's legal representative documenting the resident's or legal 
253.8 	representative's agreement with the alternative method of overnight supervision; and
253.9 	(3) the alternative method of providing overnight supervision, which may include the 
253.10 	use of technology, is specified for each resident in the resident's: (i) individualized plan of 
253.11 	care; (ii) individual service support plan under section 256B.092, subdivision 1b, if required; 
253.12 	or (iii) individual resident placement agreement under Minnesota Rules, part 9555.5105, 
253.13 	subpart 19, if required.
253.14 	(b) To be eligible for a variance under paragraph (a), the adult foster care or community 
253.15 	residential setting license holder must not have had a conditional license issued under section 
253.16 	245A.06, or any other licensing sanction issued under section 245A.07 during the prior 24 
253.17 	months based on failure to provide adequate supervision, health care services, or resident 
253.18 	safety in the adult foster care home or a community residential setting.
253.19 	(c) A license holder requesting a variance under this subdivision to utilize technology 
253.20 	as a component of a plan for alternative overnight supervision may request the commissioner's 
253.21 	review in the absence of a county recommendation. Upon receipt of such a request from a 
253.22 	license holder, the commissioner shall review the variance request with the county.
253.23 	(d) The variance requirements under this subdivision for alternative overnight supervision 
253.24 	do not apply to community residential settings licensed under chapter 245D.

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

253.26 	Sec. 10. Minnesota Statutes 2023 Supplement, section 245A.16, subdivision 1, as amended 
253.27 	by Laws 2024, chapter 80, article 2, section 65, is amended to read:
253.28 		Subdivision 1.Delegation of authority to agencies. (a) County agencies that have been 
253.29 	designated by the commissioner to perform licensing functions and activities under section 
253.30 	245A.04; to recommend denial of applicants under section 245A.05; to issue correction 
253.31 	orders, to issue variances, and recommend a conditional license under section 245A.06; or 
253.32 	to recommend suspending or revoking a license or issuing a fine under section 245A.07, 
253.33 	shall comply with rules and directives of the commissioner governing those functions and 
254.1 	with this section. The following variances are excluded from the delegation of variance 
254.2 	authority and may be issued only by the commissioner:
254.3 	(1) dual licensure of family child foster care and family adult foster care, dual licensure 
254.4 	of child foster residence setting and community residential setting, and dual licensure of 
254.5 	family adult foster care and family child care;
254.6 	(2) adult foster care or community residential settingmaximum capacity;
254.7 	(3) adult foster care or community residential settingminimum age requirement;
254.8 	(4) child foster care maximum age requirement;
254.9 	(5) variances regarding disqualified individuals;
254.10 	(6) the required presence of a caregiver in the adult foster care residence during normal 
254.11 	sleeping hours;
254.12 	(7) variances to requirements relating to chemical use problems of a license holder or a 
254.13 	household member of a license holder; and
254.14 	(8) variances to section 142B.46 for the use of a cradleboard for a cultural 
254.15 	accommodation.
254.16 	(b) For family adult day services programs, the commissioner may authorize licensing 
254.17 	reviews every two years after a licensee has had at least one annual review.
254.18 	(c) A license issued under this section may be issued for up to two years.
254.19 	(d) During implementation of chapter 245D, the commissioner shall consider:
254.20 	(1) the role of counties in quality assurance;
254.21 	(2) the duties of county licensing staff; and
254.22 	(3) the possible use of joint powers agreements, according to section 471.59, with counties 
254.23 	through which some licensing duties under chapter 245D may be delegated by the 
254.24 	commissioner to the counties.
254.25 	Any consideration related to this paragraph must meet all of the requirements of the corrective 
254.26 	action plan ordered by the federal Centers for Medicare and Medicaid Services.
254.27 	(e) Licensing authority specific to section 245D.06, subdivisions 5, 6, 7, and 8, or 
254.28 	successor provisions; and section 245D.061 or successor provisions, for family child foster 
254.29 	care programs providing out-of-home respite, as identified in section 245D.03, subdivision 
254.30 	1, paragraph (b), clause (1), is excluded from the delegation of authority to county agencies.

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

255.2 	Sec. 11. Minnesota Statutes 2023 Supplement, section 245A.211, subdivision 4, is amended 
255.3 	to read:
255.4 		Subd. 4.Contraindicated physical restraints. A license or certification holder must 
255.5 	not implement a restraint on a person receiving services in a program in a way that is 
255.6 	contraindicated for any of the person's known medical or psychological conditions. Prior 
255.7 	to using restraints on a person, the license or certification holder must assess and document 
255.8 	a determination of any with a known medical or psychological conditions that restraints are 
255.9 	contraindicated for, the license or certification holder must document the contraindication
255.10 	and the type of restraints that will not be used on the person based on this determination.

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

255.12 	Sec. 12. Minnesota Statutes 2023 Supplement, section 245A.242, subdivision 2, is amended 
255.13 	to read:
255.14 		Subd. 2.Emergency overdose treatment. (a) A license holder must maintain a supply 
255.15 	of opiate antagonists as defined in section 604A.04, subdivision 1, available for emergency 
255.16 	treatment of opioid overdose and must have a written standing order protocol by a physician 
255.17 	who is licensed under chapter 147, advanced practice registered nurse who is licensed under 
255.18 	chapter 148, or physician assistant who is licensed under chapter 147A, that permits the 
255.19 	license holder to maintain a supply of opiate antagonists on site. A license holder must 
255.20 	require staff to undergo training in the specific mode of administration used at the program, 
255.21 	which may include intranasal administration, intramuscular injection, or both.
255.22 	(b) Notwithstanding any requirements to the contrary in Minnesota Rules, chapters 2960 
255.23 	and 9530, and Minnesota Statutes, chapters 245F, 245G, and 245I:
255.24 	(1) emergency opiate antagonist medications are not required to be stored in a locked 
255.25 	area and staff and adult clients may carry this medication on them and store it in an unlocked 
255.26 	location;
255.27 	(2) staff persons who only administer emergency opiate antagonist medications only 
255.28 	require the training required by paragraph (a), which any knowledgeable trainer may provide. 
255.29 	The trainer is not required to be a registered nurse or part of an accredited educational 
255.30 	institution; and
255.31 	(3) nonresidential substance use disorder treatment programs that do not administer 
255.32 	client medications beyond emergency opiate antagonist medications are not required to 
256.1 	have the policies and procedures required in section 245G.08, subdivisions 5 and 6, and 
256.2 	must instead describe the program's procedures for administering opiate antagonist 
256.3 	medications in the license holder's description of health care services under section 245G.08, 
256.4 	subdivision 1.

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

256.6 	Sec. 13. Minnesota Statutes 2023 Supplement, section 245C.02, subdivision 13e, is 
256.7 	amended to read:
256.8 		Subd. 13e.NETStudy 2.0. (a) "NETStudy 2.0" means the commissioner's system that 
256.9 	replaces both NETStudy and the department's internal background study processing system. 
256.10 	NETStudy 2.0 is designed to enhance protection of children and vulnerable adults by 
256.11 	improving the accuracy of background studies through fingerprint-based criminal record 
256.12 	checks and expanding the background studies to include a review of information from the 
256.13 	Minnesota Court Information System and the national crime information database. NETStudy 
256.14 	2.0 is also designed to increase efficiencies in and the speed of the hiring process by:
256.15 	(1) providing access to and updates from public web-based data related to employment 
256.16 	eligibility;
256.17 	(2) decreasing the need for repeat studies through electronic updates of background 
256.18 	study subjects' criminal records;
256.19 	(3) supporting identity verification using subjects' Social Security numbers and 
256.20 	photographs;
256.21 	(4) using electronic employer notifications;
256.22 	(5) issuing immediate verification of subjects' eligibility to provide services as more 
256.23 	studies are completed under the NETStudy 2.0 system; and
256.24 	(6) providing electronic access to certain notices for entities and background study 
256.25 	subjects.
256.26 	(b) Information obtained by entities from public web-based data through NETStudy 2.0 
256.27 	under paragraph (a), clause (1), or any other source that is not direct correspondence from 
256.28 	the commissioner is not a notice of disqualification from the commissioner under this 
256.29 	chapter.

257.1 	Sec. 14. [245C.041] EMERGENCY WAIVER TO TEMPORARILY MODIFY 
257.2 	BACKGROUND STUDY REQUIREMENTS.
257.3 	(a) In the event of an emergency identified by the commissioner, the commissioner may 
257.4 	temporarily waive or modify provisions in this chapter, except that the commissioner shall 
257.5 	not waive or modify:
257.6 	(1) disqualification standards in section 245C.14 or 245C.15; or
257.7 	(2) any provision regarding the scope of individuals required to be subject to a background 
257.8 	study conducted under this chapter.
257.9 	(b) For the purposes of this section, an emergency may include, but is not limited to a 
257.10 	public health emergency, environmental emergency, natural disaster, or other unplanned 
257.11 	event that the commissioner has determined prevents the requirements in this chapter from 
257.12 	being met. This authority shall not exceed the amount of time needed to respond to the 
257.13 	emergency and reinstate the requirements of this chapter. The commissioner has the authority 
257.14 	to establish the process and time frame for returning to full compliance with this chapter. 
257.15 	The commissioner shall determine the length of time an emergency study is valid.
257.16 	(c) At the conclusion of the emergency, entities must submit a new, compliant background 
257.17 	study application and fee for each individual who was the subject of background study 
257.18 	affected by the powers created in this section, referred to as an "emergency study" to have 
257.19 	a new study that fully complies with this chapter within a time frame and notice period 
257.20 	established by the commissioner.

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

257.22 	Sec. 15. Minnesota Statutes 2022, section 245C.05, subdivision 5, is amended to read:
257.23 		Subd. 5.Fingerprints and photograph. (a) Notwithstanding paragraph (b) (c), for 
257.24 	background studies conducted by the commissioner for child foster care, children's residential 
257.25 	facilities, adoptions, or a transfer of permanent legal and physical custody of a child, the 
257.26 	subject of the background study, who is 18 years of age or older, shall provide the 
257.27 	commissioner with a set of classifiable fingerprints obtained from an authorized agency for 
257.28 	a national criminal history record check.
257.29 	(b) Notwithstanding paragraph (c), for background studies conducted by the commissioner 
257.30 	for Head Start programs, the subject of the background study shall provide the commissioner 
257.31 	with a set of classifiable fingerprints obtained from an authorized agency for a national 
257.32 	criminal history record check.
258.1 	(b) (c) For background studies initiated on or after the implementation of NETStudy 
258.2 	2.0, except as provided under subdivision 5a, every subject of a background study must 
258.3 	provide the commissioner with a set of the background study subject's classifiable fingerprints 
258.4 	and photograph. The photograph and fingerprints must be recorded at the same time by the 
258.5 	authorized fingerprint collection vendor or vendors and sent to the commissioner through 
258.6 	the commissioner's secure data system described in section 245C.32, subdivision 1a, 
258.7 	paragraph (b).
258.8 	(c) (d) The fingerprints shall be submitted by the commissioner to the Bureau of Criminal 
258.9 	Apprehension and, when specifically required by law, submitted to the Federal Bureau of 
258.10 	Investigation for a national criminal history record check.
258.11 	(d) (e) The fingerprints must not be retained by the Department of Public Safety, Bureau 
258.12 	of Criminal Apprehension, or the commissioner. The Federal Bureau of Investigation will 
258.13 	not retain background study subjects' fingerprints.
258.14 	(e) (f) The authorized fingerprint collection vendor or vendors shall, for purposes of 
258.15 	verifying the identity of the background study subject, be able to view the identifying 
258.16 	information entered into NETStudy 2.0 by the entity that initiated the background study, 
258.17 	but shall not retain the subject's fingerprints, photograph, or information from NETStudy 
258.18 	2.0. The authorized fingerprint collection vendor or vendors shall retain no more than the 
258.19 	name and date and time the subject's fingerprints were recorded and sent, only as necessary 
258.20 	for auditing and billing activities.
258.21 	(f) (g) For any background study conducted under this chapter, the subject shall provide 
258.22 	the commissioner with a set of classifiable fingerprints when the commissioner has reasonable 
258.23 	cause to require a national criminal history record check as defined in section 245C.02, 
258.24 	subdivision 15a.

258.25 	Sec. 16. Minnesota Statutes 2023 Supplement, section 245C.08, subdivision 1, is amended 
258.26 	to read:
258.27 		Subdivision 1.Background studies conducted by Department of Human Services. (a) 
258.28 	For a background study conducted by the Department of Human Services, the commissioner 
258.29 	shall review:
258.30 	(1) information related to names of substantiated perpetrators of maltreatment of 
258.31 	vulnerable adults that has been received by the commissioner as required under section 
258.32 	626.557, subdivision 9c, paragraph (j);
259.1 	(2) the commissioner's records relating to the maltreatment of minors in licensed 
259.2 	programs, and from findings of maltreatment of minors as indicated through the social 
259.3 	service information system;
259.4 	(3) information from juvenile courts as required in subdivision 4 for individuals listed 
259.5 	in section 245C.03, subdivision 1, paragraph (a), for studies under this chapter when there 
259.6 	is reasonable cause;
259.7 	(4) information from the Bureau of Criminal Apprehension, including information 
259.8 	regarding a background study subject's registration in Minnesota as a predatory offender 
259.9 	under section 243.166;
259.10 	(5) except as provided in clause (6), information received as a result of submission of 
259.11 	fingerprints for a national criminal history record check, as defined in section 245C.02, 
259.12 	subdivision 13c, when the commissioner has reasonable cause for a national criminal history 
259.13 	record check as defined under section 245C.02, subdivision 15a, or as required under section 
259.14 	144.057, subdivision 1, clause (2);
259.15 	(6) for a background study related to a child foster family setting application for licensure, 
259.16 	foster residence settings, children's residential facilities, a transfer of permanent legal and 
259.17 	physical custody of a child under sections 260C.503 to 260C.515, or adoptions, and for a 
259.18 	background study required for family child care, certified license-exempt child care, child 
259.19 	care centers, and legal nonlicensed child care authorized under chapter 119B, the 
259.20 	commissioner shall also review:
259.21 	(i) information from the child abuse and neglect registry for any state in which the 
259.22 	background study subject has resided for the past five years;
259.23 	(ii) when the background study subject is 18 years of age or older, or a minor under 
259.24 	section 245C.05, subdivision 5a, paragraph (c), information received following submission 
259.25 	of fingerprints for a national criminal history record check; and
259.26 	(iii) when the background study subject is 18 years of age or older or a minor under 
259.27 	section 245C.05, subdivision 5a, paragraph (d), for licensed family child care, certified 
259.28 	license-exempt child care, licensed child care centers, and legal nonlicensed child care 
259.29 	authorized under chapter 119B, information obtained using non-fingerprint-based data 
259.30 	including information from the criminal and sex offender registries for any state in which 
259.31 	the background study subject resided for the past five years and information from the national 
259.32 	crime information database and the national sex offender registry;
260.1 	(7) for a background study required for family child care, certified license-exempt child 
260.2 	care centers, licensed child care centers, and legal nonlicensed child care authorized under 
260.3 	chapter 119B, the background study shall also include, to the extent practicable, a name 
260.4 	and date-of-birth search of the National Sex Offender Public website; and
260.5 	(8) for a background study required for treatment programs for sexual psychopathic 
260.6 	personalities or sexually dangerous persons, the background study shall only include a 
260.7 	review of the information required under paragraph (a), clauses (1) to (4).
260.8 	(b) Except as otherwise provided in this paragraph, notwithstanding expungement by a 
260.9 	court, the commissioner may consider information obtained under paragraph (a), clauses 
260.10 	(3) and (4), unless:
260.11 	(1) the commissioner received notice of the petition for expungement and the court order 
260.12 	for expungement is directed specifically to the commissioner; or
260.13 	(2) the commissioner received notice of the expungement order issued pursuant to section 
260.14 	609A.017, 609A.025, or 609A.035, and the order for expungement is directed specifically 
260.15 	to the commissioner.
260.16 	The commissioner may not consider information obtained under paragraph (a), clauses (3) 
260.17 	and (4), or from any other source that identifies a violation of chapter 152 without 
260.18 	determining if the offense involved the possession of marijuana or tetrahydrocannabinol 
260.19 	and, if so, whether the person received a grant of expungement or order of expungement, 
260.20 	or the person was resentenced to a lesser offense. If the person received a grant of 
260.21 	expungement or order of expungement, the commissioner may not consider information 
260.22 	related to that violation but may consider any other relevant information arising out of the 
260.23 	same incident.
260.24 	(c) The commissioner shall also review criminal case information received according 
260.25 	to section 245C.04, subdivision 4a, from the Minnesota court information system that relates 
260.26 	to individuals who have already been studied under this chapter and who remain affiliated 
260.27 	with the agency that initiated the background study.
260.28 	(d) When the commissioner has reasonable cause to believe that the identity of a 
260.29 	background study subject is uncertain, the commissioner may require the subject to provide 
260.30 	a set of classifiable fingerprints for purposes of completing a fingerprint-based record check 
260.31 	with the Bureau of Criminal Apprehension. Fingerprints collected under this paragraph 
260.32 	shall not be saved by the commissioner after they have been used to verify the identity of 
260.33 	the background study subject against the particular criminal record in question.
261.1 	(e) The commissioner may inform the entity that initiated a background study under 
261.2 	NETStudy 2.0 of the status of processing of the subject's fingerprints.

261.3 	Sec. 17. Minnesota Statutes 2022, section 245C.10, subdivision 18, is amended to read:
261.4 		Subd. 18.Applicants, licensees, and other occupations regulated by commissioner 
261.5 	of health. The applicant or license holder is responsible for paying to the Department of 
261.6 	Human Services all fees associated with the preparation of the fingerprints, the criminal 
261.7 	records check consent form, and, through a fee of no more than $44 per study, the criminal 
261.8 	background check.

261.9 	Sec. 18. Minnesota Statutes 2022, section 245C.14, subdivision 1, is amended to read:
261.10 		Subdivision 1.Disqualification from direct contact. (a) The commissioner shall 
261.11 	disqualify an individual who is the subject of a background study from any position allowing 
261.12 	direct contact with persons receiving services from the license holder or entity identified in 
261.13 	section 245C.03, upon receipt of information showing, or when a background study 
261.14 	completed under this chapter shows any of the following:
261.15 	(1) a conviction of, admission to, or Alford plea to one or more crimes listed in section 
261.16 	245C.15, regardless of whether the conviction or admission is a felony, gross misdemeanor, 
261.17 	or misdemeanor level crime;
261.18 	(2) a preponderance of the evidence indicates the individual has committed an act or 
261.19 	acts that meet the definition of any of the crimes listed in section 245C.15, regardless of 
261.20 	whether the preponderance of the evidence is for a felony, gross misdemeanor, or 
261.21 	misdemeanor level crime; or
261.22 	(3) an investigation results in an administrative determination listed under section 
261.23 	245C.15, subdivision 4, paragraph (b).; or
261.24 	(4) the individual's parental rights have been terminated under section 260C.301, 
261.25 	subdivision 1, paragraph (b), or section 260C.301, subdivision 3.
261.26 	(b) No individual who is disqualified following a background study under section 
261.27 	245C.03, subdivisions 1 and 2, may be retained in a position involving direct contact with 
261.28 	persons served by a program or entity identified in section 245C.03, unless the commissioner 
261.29 	has provided written notice under section 245C.17 stating that:
261.30 	(1) the individual may remain in direct contact during the period in which the individual 
261.31 	may request reconsideration as provided in section 245C.21, subdivision 2;
262.1 	(2) the commissioner has set aside the individual's disqualification for that program or 
262.2 	entity identified in section 245C.03, as provided in section 245C.22, subdivision 4; or
262.3 	(3) the license holder has been granted a variance for the disqualified individual under 
262.4 	section 245C.30.
262.5 	(c) Notwithstanding paragraph (a), for the purposes of a background study affiliated 
262.6 	with a licensed family foster setting, the commissioner shall disqualify an individual who 
262.7 	is the subject of a background study from any position allowing direct contact with persons 
262.8 	receiving services from the license holder or entity identified in section 245C.03, upon 
262.9 	receipt of information showing or when a background study completed under this chapter 
262.10 	shows reason for disqualification under section 245C.15, subdivision 4a.

262.11 	Sec. 19. Minnesota Statutes 2022, section 245C.14, is amended by adding a subdivision 
262.12 	to read:
262.13 		Subd. 5.Basis for disqualification. Information obtained by entities from public 
262.14 	web-based data through NETStudy 2.0 or any other source that is not direct correspondence 
262.15 	from the commissioner is not a notice of disqualification from the commissioner under this 
262.16 	chapter.

262.17 	Sec. 20. Minnesota Statutes 2023 Supplement, section 245C.15, subdivision 2, is amended 
262.18 	to read:
262.19 		Subd. 2.15-year disqualification. (a) An individual is disqualified under section 245C.14 
262.20 	if: (1) less than 15 years have passed since the discharge of the sentence imposed, if any, 
262.21 	for the offense; and (2) the individual has committed a felony-level violation of any of the 
262.22 	following offenses: sections 152.021, subdivision 1 or 2b, (aggravated controlled substance 
262.23 	crime in the first degree; sale crimes); 152.022, subdivision 1 (controlled substance crime 
262.24 	in the second degree; sale crimes); 152.023, subdivision 1 (controlled substance crime in 
262.25 	the third degree; sale crimes); 152.024, subdivision 1 (controlled substance crime in the 
262.26 	fourth degree; sale crimes); 256.98 (wrongfully obtaining assistance); 268.182 (fraud); 
262.27 	393.07, subdivision 10, paragraph (c) (federal SNAP fraud); 518B.01, subdivision 14 
262.28 	(violation of an order for protection); 609.165 (felon ineligible to possess firearm); 609.2112, 
262.29 	609.2113, or 609.2114 (criminal vehicular homicide or injury); 609.215 (suicide); 609.223
262.30 	or 609.2231 (assault in the third or fourth degree); repeat offenses under 609.224 (assault 
262.31 	in the fifth degree); 609.229 (crimes committed for benefit of a gang); 609.2325 (criminal 
262.32 	abuse of a vulnerable adult); 609.2335 (financial exploitation of a vulnerable adult); 609.235
262.33 	(use of drugs to injure or facilitate crime); 609.24 (simple robbery); 609.247, subdivision 
263.1 	4 (carjacking in the third degree); 609.255 (false imprisonment); 609.2664 (manslaughter 
263.2 	of an unborn child in the first degree); 609.2665 (manslaughter of an unborn child in the 
263.3 	second degree); 609.267 (assault of an unborn child in the first degree); 609.2671 (assault 
263.4 	of an unborn child in the second degree); 609.268 (injury or death of an unborn child in the 
263.5 	commission of a crime); 609.27 (coercion); 609.275 (attempt to coerce); 609.466 (medical 
263.6 	assistance fraud); 609.495 (aiding an offender); 609.498, subdivision 1 or 1b (aggravated 
263.7 	first-degree or first-degree tampering with a witness); 609.52 (theft); 609.521 (possession 
263.8 	of shoplifting gear); 609.522 (organized retail theft); 609.525 (bringing stolen goods into 
263.9 	Minnesota); 609.527 (identity theft); 609.53 (receiving stolen property); 609.535 (issuance 
263.10 	of dishonored checks); 609.562 (arson in the second degree); 609.563 (arson in the third 
263.11 	degree); 609.582 (burglary); 609.59 (possession of burglary tools); 609.611 (insurance 
263.12 	fraud); 609.625 (aggravated forgery); 609.63 (forgery); 609.631 (check forgery; offering a 
263.13 	forged check); 609.635 (obtaining signature by false pretense); 609.66 (dangerous weapons); 
263.14 	609.67 (machine guns and short-barreled shotguns); 609.687 (adulteration); 609.71 (riot); 
263.15 	609.713 (terroristic threats); 609.746 (interference with privacy); 609.82 (fraud in obtaining 
263.16 	credit); 609.821 (financial transaction card fraud); 617.23 (indecent exposure), not involving 
263.17 	a minor; repeat offenses under 617.241 (obscene materials and performances; distribution 
263.18 	and exhibition prohibited; penalty); or 624.713 (certain persons not to possess firearms).
263.19 	(b) An individual is disqualified under section 245C.14 if less than 15 years has passed 
263.20 	since the individual's aiding and abetting, attempt, or conspiracy to commit any of the 
263.21 	offenses listed in paragraph (a), as each of these offenses is defined in Minnesota Statutes.
263.22 	(c) An individual is disqualified under section 245C.14 if less than 15 years has passed 
263.23 	since the termination of the individual's parental rights under section 260C.301, subdivision 
263.24 	1, paragraph (b), or subdivision 3.
263.25 	(d) An individual is disqualified under section 245C.14 if less than 15 years has passed 
263.26 	since the discharge of the sentence imposed for an offense in any other state or country, the 
263.27 	elements of which are substantially similar to the elements of the offenses listed in paragraph 
263.28 	(a) or since the termination of parental rights in any other state or country, the elements of 
263.29 	which are substantially similar to the elements listed in paragraph (c).
263.30 	(e) If the individual studied commits one of the offenses listed in paragraph (a), but the 
263.31 	sentence or level of offense is a gross misdemeanor or misdemeanor, the individual is 
263.32 	disqualified but the disqualification look-back period for the offense is the period applicable 
263.33 	to the gross misdemeanor or misdemeanor disposition.
264.1 	(f) When a disqualification is based on a judicial determination other than a conviction, 
264.2 	the disqualification period begins from the date of the court order. When a disqualification 
264.3 	is based on an admission, the disqualification period begins from the date of an admission 
264.4 	in court. When a disqualification is based on an Alford Plea, the disqualification period 
264.5 	begins from the date the Alford Plea is entered in court. When a disqualification is based 
264.6 	on a preponderance of evidence of a disqualifying act, the disqualification date begins from 
264.7 	the date of the dismissal, the date of discharge of the sentence imposed for a conviction for 
264.8 	a disqualifying crime of similar elements, or the date of the incident, whichever occurs last.

264.9 	Sec. 21. Minnesota Statutes 2022, section 245C.15, subdivision 3, is amended to read:
264.10 		Subd. 3.Ten-year disqualification. (a) An individual is disqualified under section 
264.11 	245C.14 if: (1) less than ten years have passed since the discharge of the sentence imposed, 
264.12 	if any, for the offense; and (2) the individual has committed a gross misdemeanor-level 
264.13 	violation of any of the following offenses: sections 256.98 (wrongfully obtaining assistance); 
264.14 	260B.425 (criminal jurisdiction for contributing to status as a juvenile petty offender or 
264.15 	delinquency); 260C.425 (criminal jurisdiction for contributing to need for protection or 
264.16 	services); 268.182 (fraud); 393.07, subdivision 10, paragraph (c) (federal SNAP fraud); 
264.17 	609.2112, 609.2113, or 609.2114 (criminal vehicular homicide or injury); 609.221 or 609.222
264.18 	(assault in the first or second degree); 609.223 or 609.2231 (assault in the third or fourth 
264.19 	degree); 609.224 (assault in the fifth degree); 609.224, subdivision 2, paragraph (c) (assault 
264.20 	in the fifth degree by a caregiver against a vulnerable adult); 609.2242 and 609.2243
264.21 	(domestic assault); 609.23 (mistreatment of persons confined); 609.231 (mistreatment of 
264.22 	residents or patients); 609.2325 (criminal abuse of a vulnerable adult); 609.233 (criminal 
264.23 	neglect of a vulnerable adult); 609.2335 (financial exploitation of a vulnerable adult); 
264.24 	609.234 (failure to report maltreatment of a vulnerable adult); 609.265 (abduction); 609.275
264.25 	(attempt to coerce); 609.324, subdivision 1a (other prohibited acts; minor engaged in 
264.26 	prostitution); 609.33 (disorderly house); 609.377 (malicious punishment of a child); 609.378
264.27 	(neglect or endangerment of a child); 609.466 (medical assistance fraud); 609.52 (theft); 
264.28 	609.522 (organized retail theft); 609.525 (bringing stolen goods into Minnesota); 609.527
264.29 	(identity theft); 609.53 (receiving stolen property); 609.535 (issuance of dishonored checks); 
264.30 	609.582 (burglary); 609.59 (possession of burglary tools); 609.611 (insurance fraud); 609.631
264.31 	(check forgery; offering a forged check); 609.66 (dangerous weapons); 609.71 (riot); 609.72, 
264.32 	subdivision 3 (disorderly conduct against a vulnerable adult); repeat offenses under 609.746
264.33 	(interference with privacy);609.749, subdivision 2 (harassment); 609.82 (fraud in obtaining 
264.34 	credit); 609.821 (financial transaction card fraud); 617.23 (indecent exposure), not involving 
264.35 	a minor; 617.241 (obscene materials and performances); 617.243 (indecent literature, 
265.1 	distribution); 617.293 (harmful materials; dissemination and display to minors prohibited); 
265.2 	or Minnesota Statutes 2012, section 609.21; or violation of an order for protection under 
265.3 	section 518B.01, subdivision 14.
265.4 	(b) An individual is disqualified under section 245C.14 if less than ten years has passed 
265.5 	since the individual's aiding and abetting, attempt, or conspiracy to commit any of the 
265.6 	offenses listed in paragraph (a), as each of these offenses is defined in Minnesota Statutes.
265.7 	(c) An individual is disqualified under section 245C.14 if less than ten years has passed 
265.8 	since the discharge of the sentence imposed for an offense in any other state or country, the 
265.9 	elements of which are substantially similar to the elements of any of the offenses listed in 
265.10 	paragraph (a).
265.11 	(d) If the individual studied commits one of the offenses listed in paragraph (a), but the 
265.12 	sentence or level of offense is a misdemeanor disposition, the individual is disqualified but 
265.13 	the disqualification lookback period for the offense is the period applicable to misdemeanors.
265.14 	(e) When a disqualification is based on a judicial determination other than a conviction, 
265.15 	the disqualification period begins from the date of the court order. When a disqualification 
265.16 	is based on an admission, the disqualification period begins from the date of an admission 
265.17 	in court. When a disqualification is based on an Alford Plea, the disqualification period 
265.18 	begins from the date the Alford Plea is entered in court. When a disqualification is based 
265.19 	on a preponderance of evidence of a disqualifying act, the disqualification date begins from 
265.20 	the date of the dismissal, the date of discharge of the sentence imposed for a conviction for 
265.21 	a disqualifying crime of similar elements, or the date of the incident, whichever occurs last.

265.22 	Sec. 22. Minnesota Statutes 2022, section 245C.15, subdivision 4, is amended to read:
265.23 		Subd. 4.Seven-year disqualification. (a) An individual is disqualified under section 
265.24 	245C.14 if: (1) less than seven years has passed since the discharge of the sentence imposed, 
265.25 	if any, for the offense; and (2) the individual has committed a misdemeanor-level violation 
265.26 	of any of the following offenses: sections 256.98 (wrongfully obtaining assistance); 260B.425 
265.27 	(criminal jurisdiction for contributing to status as a juvenile petty offender or delinquency); 
265.28 	260C.425 (criminal jurisdiction for contributing to need for protection or services); 268.182 
265.29 	(fraud); 393.07, subdivision 10, paragraph (c) (federal SNAP fraud); 609.2112, 609.2113, 
265.30 	or 609.2114 (criminal vehicular homicide or injury); 609.221 (assault in the first degree); 
265.31 	609.222 (assault in the second degree); 609.223 (assault in the third degree); 609.2231
265.32 	(assault in the fourth degree); 609.224 (assault in the fifth degree); 609.2242 (domestic 
265.33 	assault); 609.2335 (financial exploitation of a vulnerable adult); 609.234 (failure to report 
265.34 	maltreatment of a vulnerable adult); 609.2672 (assault of an unborn child in the third degree); 
266.1 	609.27 (coercion); violation of an order for protection under 609.3232 (protective order 
266.2 	authorized; procedures; penalties); 609.466 (medical assistance fraud); 609.52 (theft); 
266.3 	609.522 (organized retail theft); 609.525 (bringing stolen goods into Minnesota); 609.527
266.4 	(identity theft); 609.53 (receiving stolen property); 609.535 (issuance of dishonored checks); 
266.5 	609.611 (insurance fraud); 609.66 (dangerous weapons); 609.665 (spring guns); 609.746
266.6 	(interference with privacy); 609.79 (obscene or harassing telephone calls); 609.795 (letter, 
266.7 	telegram, or package; opening; harassment); 609.82 (fraud in obtaining credit); 609.821
266.8 	(financial transaction card fraud); 617.23 (indecent exposure), not involving a minor; 617.293
266.9 	(harmful materials; dissemination and display to minors prohibited); or Minnesota Statutes 
266.10 	2012, section 609.21; or violation of an order for protection under section 518B.01 (Domestic 
266.11 	Abuse Act).
266.12 	(b) An individual is disqualified under section 245C.14 if less than seven years has 
266.13 	passed since a determination or disposition of the individual's:
266.14 	(1) failure to make required reports under section 260E.06 or 626.557, subdivision 3, 
266.15 	for incidents in which: (i) the final disposition under section 626.557 or chapter 260E was 
266.16 	substantiated maltreatment, and (ii) the maltreatment was recurring or serious; or
266.17 	(2) substantiated serious or recurring maltreatment of a minor under chapter 260E, a 
266.18 	vulnerable adult under section 626.557, or serious or recurring maltreatment in any other 
266.19 	state, the elements of which are substantially similar to the elements of maltreatment under 
266.20 	section 626.557 or chapter 260E for which: (i) there is a preponderance of evidence that 
266.21 	the maltreatment occurred, and (ii) the subject was responsible for the maltreatment.
266.22 	(c) An individual is disqualified under section 245C.14 if less than seven years has 
266.23 	passed since the individual's aiding and abetting, attempt, or conspiracy to commit any of 
266.24 	the offenses listed in paragraphs (a) and (b), as each of these offenses is defined in Minnesota 
266.25 	Statutes.
266.26 	(d) An individual is disqualified under section 245C.14 if less than seven years has 
266.27 	passed since the discharge of the sentence imposed for an offense in any other state or 
266.28 	country, the elements of which are substantially similar to the elements of any of the offenses 
266.29 	listed in paragraphs (a) and (b).
266.30 	(e) When a disqualification is based on a judicial determination other than a conviction, 
266.31 	the disqualification period begins from the date of the court order. When a disqualification 
266.32 	is based on an admission, the disqualification period begins from the date of an admission 
266.33 	in court. When a disqualification is based on an Alford Plea, the disqualification period 
266.34 	begins from the date the Alford Plea is entered in court. When a disqualification is based 
267.1 	on a preponderance of evidence of a disqualifying act, the disqualification date begins from 
267.2 	the date of the dismissal, the date of discharge of the sentence imposed for a conviction for 
267.3 	a disqualifying crime of similar elements, or the date of the incident, whichever occurs last.
267.4 	(f) An individual is disqualified under section 245C.14 if less than seven years has passed 
267.5 	since the individual was disqualified under section 256.98, subdivision 8.

267.6 	Sec. 23. Minnesota Statutes 2023 Supplement, section 245C.15, subdivision 4a, is amended 
267.7 	to read:
267.8 		Subd. 4a.Licensed family foster setting disqualifications. (a) Notwithstanding 
267.9 	subdivisions 1 to 4, for a background study affiliated with a licensed family foster setting, 
267.10 	regardless of how much time has passed, an individual is disqualified under section 245C.14 
267.11 	if the individual committed an act that resulted in a felony-level conviction for sections: 
267.12 	609.185 (murder in the first degree); 609.19 (murder in the second degree); 609.195 (murder 
267.13 	in the third degree); 609.20 (manslaughter in the first degree); 609.205 (manslaughter in 
267.14 	the second degree); 609.2112 (criminal vehicular homicide); 609.221 (assault in the first 
267.15 	degree); 609.223, subdivision 2 (assault in the third degree, past pattern of child abuse); 
267.16 	609.223, subdivision 3 (assault in the third degree, victim under four); a felony offense 
267.17 	under sections 609.2242 and 609.2243 (domestic assault, spousal abuse, child abuse or 
267.18 	neglect, or a crime against children); 609.2247 (domestic assault by strangulation); 609.2325 
267.19 	(criminal abuse of a vulnerable adult resulting in the death of a vulnerable adult); 609.245 
267.20 	(aggravated robbery); 609.247, subdivision 2 or 3 (carjacking in the first or second degree); 
267.21 	609.25 (kidnapping); 609.255 (false imprisonment); 609.2661 (murder of an unborn child 
267.22 	in the first degree); 609.2662 (murder of an unborn child in the second degree); 609.2663 
267.23 	(murder of an unborn child in the third degree); 609.2664 (manslaughter of an unborn child 
267.24 	in the first degree); 609.2665 (manslaughter of an unborn child in the second degree); 
267.25 	609.267 (assault of an unborn child in the first degree); 609.2671 (assault of an unborn child 
267.26 	in the second degree); 609.268 (injury or death of an unborn child in the commission of a 
267.27 	crime); 609.322, subdivision 1 (solicitation, inducement, and promotion of prostitution; sex 
267.28 	trafficking in the first degree); 609.324, subdivision 1 (other prohibited acts; engaging in, 
267.29 	hiring, or agreeing to hire minor to engage in prostitution); 609.342 (criminal sexual conduct 
267.30 	in the first degree); 609.343 (criminal sexual conduct in the second degree); 609.344 (criminal 
267.31 	sexual conduct in the third degree); 609.345 (criminal sexual conduct in the fourth degree); 
267.32 	609.3451 (criminal sexual conduct in the fifth degree); 609.3453 (criminal sexual predatory 
267.33 	conduct); 609.3458 (sexual extortion); 609.352 (solicitation of children to engage in sexual 
267.34 	conduct); 609.377 (malicious punishment of a child); 609.378 (neglect or endangerment of 
267.35 	a child); 609.561 (arson in the first degree); 609.582, subdivision 1 (burglary in the first 
268.1 	degree); 609.746 (interference with privacy); 617.23 (indecent exposure); 617.246 (use of 
268.2 	minors in sexual performance prohibited); or 617.247 (possession of pictorial representations 
268.3 	of minors).
268.4 	(b) Notwithstanding subdivisions 1 to 4, for the purposes of a background study affiliated 
268.5 	with a licensed family foster setting, an individual is disqualified under section 245C.14, 
268.6 	regardless of how much time has passed, if the individual:
268.7 	(1) committed an action under paragraph (e) that resulted in death or involved sexual 
268.8 	abuse, as defined in section 260E.03, subdivision 20;
268.9 	(2) committed an act that resulted in a gross misdemeanor-level conviction for section 
268.10 	609.3451 (criminal sexual conduct in the fifth degree);
268.11 	(3) committed an act against or involving a minor that resulted in a felony-level conviction 
268.12 	for: section 609.222 (assault in the second degree); 609.223, subdivision 1 (assault in the 
268.13 	third degree); 609.2231 (assault in the fourth degree); or 609.224 (assault in the fifth degree); 
268.14 	or
268.15 	(4) committed an act that resulted in a misdemeanor or gross misdemeanor-level 
268.16 	conviction for section 617.293 (dissemination and display of harmful materials to minors).
268.17 	(c) Notwithstanding subdivisions 1 to 4, for a background study affiliated with a licensed 
268.18 	family foster setting, an individual is disqualified under section 245C.14 if fewer than 20 
268.19 	years have passed since the termination of the individual's parental rights under section 
268.20 	260C.301, subdivision 1, paragraph (b), or if the individual consented to a termination of 
268.21 	parental rights under section 260C.301, subdivision 1, paragraph (a), to settle a petition to 
268.22 	involuntarily terminate parental rights. An individual is disqualified under section 245C.14 
268.23 	if fewer than 20 years have passed since the termination of the individual's parental rights 
268.24 	in any other state or country, where the conditions for the individual's termination of parental 
268.25 	rights are substantially similar to the conditions in section 260C.301, subdivision 1, paragraph 
268.26 	(b).
268.27 	(d) Notwithstanding subdivisions 1 to 4, for a background study affiliated with a licensed 
268.28 	family foster setting, an individual is disqualified under section 245C.14 if fewer than five 
268.29 	years have passed since a felony-level violation for sections: 152.021 (controlled substance 
268.30 	crime in the first degree); 152.022 (controlled substance crime in the second degree); 152.023 
268.31 	(controlled substance crime in the third degree); 152.024 (controlled substance crime in the 
268.32 	fourth degree); 152.025 (controlled substance crime in the fifth degree); 152.0261 (importing 
268.33 	controlled substances across state borders); 152.0262, subdivision 1, paragraph (b) 
268.34 	(possession of substance with intent to manufacture methamphetamine); 152.027, subdivision 
269.1 	6, paragraph (c) (sale or possession of synthetic cannabinoids); 152.096 (conspiracies 
269.2 	prohibited); 152.097 (simulated controlled substances); 152.136 (anhydrous ammonia; 
269.3 	prohibited conduct; criminal penalties; civil liabilities); 152.137 (methamphetamine-related 
269.4 	crimes involving children or vulnerable adults); 169A.24 (felony first-degree driving while 
269.5 	impaired); 243.166 (violation of predatory offender registration requirements); 609.2113 
269.6 	(criminal vehicular operation; bodily harm); 609.2114 (criminal vehicular operation; unborn 
269.7 	child); 609.228 (great bodily harm caused by distribution of drugs); 609.2325 (criminal 
269.8 	abuse of a vulnerable adult not resulting in the death of a vulnerable adult); 609.233 (criminal 
269.9 	neglect); 609.235 (use of drugs to injure or facilitate a crime); 609.24 (simple robbery); 
269.10 	609.247, subdivision 4 (carjacking in the third degree); 609.322, subdivision 1a (solicitation, 
269.11 	inducement, and promotion of prostitution; sex trafficking in the second degree); 609.498, 
269.12 	subdivision 1 (tampering with a witness in the first degree); 609.498, subdivision 1b 
269.13 	(aggravated first-degree witness tampering); 609.562 (arson in the second degree); 609.563 
269.14 	(arson in the third degree); 609.582, subdivision 2 (burglary in the second degree); 609.66 
269.15 	(felony dangerous weapons); 609.687 (adulteration); 609.713 (terroristic threats); 609.749, 
269.16 	subdivision 3, 4, or 5 (felony-level harassment or stalking); 609.855, subdivision 5 (shooting 
269.17 	at or in a public transit vehicle or facility); or 624.713 (certain people not to possess firearms).
269.18 	(e) Notwithstanding subdivisions 1 to 4, except as provided in paragraph (a), for a 
269.19 	background study affiliated with a licensed family child foster care license, an individual 
269.20 	is disqualified under section 245C.14 if fewer than five years have passed since:
269.21 	(1) a felony-level violation for an act not against or involving a minor that constitutes: 
269.22 	section 609.222 (assault in the second degree); 609.223, subdivision 1 (assault in the third 
269.23 	degree); 609.2231 (assault in the fourth degree); or 609.224, subdivision 4 (assault in the 
269.24 	fifth degree);
269.25 	(2) a violation of an order for protection under section 518B.01, subdivision 14;
269.26 	(3) a determination or disposition of the individual's failure to make required reports 
269.27 	under section 260E.06 or 626.557, subdivision 3, for incidents in which the final disposition 
269.28 	under chapter 260E or section 626.557 was substantiated maltreatment and the maltreatment 
269.29 	was recurring or serious;
269.30 	(4) a determination or disposition of the individual's substantiated serious or recurring 
269.31 	maltreatment of a minor under chapter 260E, a vulnerable adult under section 626.557, or 
269.32 	serious or recurring maltreatment in any other state, the elements of which are substantially 
269.33 	similar to the elements of maltreatment under chapter 260E or section 626.557 and meet 
269.34 	the definition of serious maltreatment or recurring maltreatment;
270.1 	(5) a gross misdemeanor-level violation for sections: 609.224, subdivision 2 (assault in 
270.2 	the fifth degree); 609.2242 and 609.2243 (domestic assault); 609.233 (criminal neglect); 
270.3 	609.377 (malicious punishment of a child); 609.378 (neglect or endangerment of a child); 
270.4 	609.746 (interference with privacy); 609.749 (stalking); or 617.23 (indecent exposure); or
270.5 	(6) committing an act against or involving a minor that resulted in a misdemeanor-level 
270.6 	violation of section 609.224, subdivision 1 (assault in the fifth degree).
270.7 	(f) For purposes of this subdivision, the disqualification begins from:
270.8 	(1) the date of the alleged violation, if the individual was not convicted;
270.9 	(2) the date of conviction, if the individual was convicted of the violation but not 
270.10 	committed to the custody of the commissioner of corrections; or
270.11 	(3) the date of release from prison, if the individual was convicted of the violation and 
270.12 	committed to the custody of the commissioner of corrections.
270.13 	Notwithstanding clause (3), if the individual is subsequently reincarcerated for a violation 
270.14 	of the individual's supervised release, the disqualification begins from the date of release 
270.15 	from the subsequent incarceration.
270.16 	(g) An individual's aiding and abetting, attempt, or conspiracy to commit any of the 
270.17 	offenses listed in paragraphs (a) and (b), as each of these offenses is defined in Minnesota 
270.18 	Statutes, permanently disqualifies the individual under section 245C.14. An individual is 
270.19 	disqualified under section 245C.14 if fewer than five years have passed since the individual's 
270.20 	aiding and abetting, attempt, or conspiracy to commit any of the offenses listed in paragraphs 
270.21 	(d) and (e).
270.22 	(h) An individual's offense in any other state or country, where the elements of the 
270.23 	offense are substantially similar to any of the offenses listed in paragraphs (a) and (b), 
270.24 	permanently disqualifies the individual under section 245C.14. An individual is disqualified 
270.25 	under section 245C.14 if fewer than five years have passed since an offense in any other 
270.26 	state or country, the elements of which are substantially similar to the elements of any 
270.27 	offense listed in paragraphs (d) and (e).

270.28 	Sec. 24. Minnesota Statutes 2022, section 245C.22, subdivision 4, is amended to read:
270.29 		Subd. 4.Risk of harm; set aside. (a) The commissioner may set aside the disqualification 
270.30 	if the commissioner finds that the individual has submitted sufficient information to 
270.31 	demonstrate that the individual does not pose a risk of harm to any person served by the 
270.32 	applicant, license holder, or other entities as provided in this chapter.
271.1 	(b) In determining whether the individual has met the burden of proof by demonstrating 
271.2 	the individual does not pose a risk of harm, the commissioner shall consider:
271.3 	(1) the nature, severity, and consequences of the event or events that led to the 
271.4 	disqualification;
271.5 	(2) whether there is more than one disqualifying event;
271.6 	(3) the age and vulnerability of the victim at the time of the event;
271.7 	(4) the harm suffered by the victim;
271.8 	(5) vulnerability of persons served by the program;
271.9 	(6) the similarity between the victim and persons served by the program;
271.10 	(7) the time elapsed without a repeat of the same or similar event;
271.11 	(8) documentation of successful completion by the individual studied of training or 
271.12 	rehabilitation pertinent to the event; and
271.13 	(9) any other information relevant to reconsideration.
271.14 	(c) For an individual seeking a child foster care license who is a relative of the child, 
271.15 	the commissioner shall consider the importance of maintaining the child's relationship with 
271.16 	relatives as an additional significant factor in determining whether a background study 
271.17 	disqualification should be set aside.
271.18 	(c) (d) If the individual requested reconsideration on the basis that the information relied 
271.19 	upon to disqualify the individual was incorrect or inaccurate and the commissioner determines 
271.20 	that the information relied upon to disqualify the individual is correct, the commissioner 
271.21 	must also determine if the individual poses a risk of harm to persons receiving services in 
271.22 	accordance with paragraph (b).
271.23 	(d) (e) For an individual seeking employment in the substance use disorder treatment 
271.24 	field, the commissioner shall set aside the disqualification if the following criteria are met:
271.25 	(1) the individual is not disqualified for a crime of violence as listed under section 
271.26 	624.712, subdivision 5, except for the following crimes: crimes listed under section 152.021, 
271.27 	subdivision 2 or 2a; 152.022, subdivision 2; 152.023, subdivision 2; 152.024; or 152.025;
271.28 	(2) the individual is not disqualified under section 245C.15, subdivision 1;
271.29 	(3) the individual is not disqualified under section 245C.15, subdivision 4, paragraph 
271.30 	(b);
272.1 	(4) the individual provided documentation of successful completion of treatment, at least 
272.2 	one year prior to the date of the request for reconsideration, at a program licensed under 
272.3 	chapter 245G, and has had no disqualifying crimes or conduct under section 245C.15 after 
272.4 	the successful completion of treatment;
272.5 	(5) the individual provided documentation demonstrating abstinence from controlled 
272.6 	substances, as defined in section 152.01, subdivision 4, for the period of one year prior to 
272.7 	the date of the request for reconsideration; and
272.8 	(6) the individual is seeking employment in the substance use disorder treatment field.

272.9 	Sec. 25. Minnesota Statutes 2022, section 245C.24, subdivision 2, is amended to read:
272.10 		Subd. 2.Permanent bar to set aside a disqualification. (a) Except as provided in 
272.11 	paragraphs (b) to (f) (g), the commissioner may not set aside the disqualification of any 
272.12 	individual disqualified pursuant to this chapter, regardless of how much time has passed, 
272.13 	if the individual was disqualified for a crime or conduct listed in section 245C.15, subdivision 
272.14 	1.
272.15 	(b) For an individual in the substance use disorder or corrections field who was 
272.16 	disqualified for a crime or conduct listed under section 245C.15, subdivision 1, and whose 
272.17 	disqualification was set aside prior to July 1, 2005, the commissioner must consider granting 
272.18 	a variance pursuant to section 245C.30 for the license holder for a program dealing primarily 
272.19 	with adults. A request for reconsideration evaluated under this paragraph must include a 
272.20 	letter of recommendation from the license holder that was subject to the prior set-aside 
272.21 	decision addressing the individual's quality of care to children or vulnerable adults and the 
272.22 	circumstances of the individual's departure from that service.
272.23 	(c) If an individual who requires a background study for nonemergency medical 
272.24 	transportation services under section 245C.03, subdivision 12, was disqualified for a crime 
272.25 	or conduct listed under section 245C.15, subdivision 1, and if more than 40 years have 
272.26 	passed since the discharge of the sentence imposed, the commissioner may consider granting 
272.27 	a set-aside pursuant to section 245C.22. A request for reconsideration evaluated under this 
272.28 	paragraph must include a letter of recommendation from the employer. This paragraph does 
272.29 	not apply to a person disqualified based on a violation of sections 243.166; 609.185 to 
272.30 	609.205; 609.25; 609.342 to 609.3453; 609.352; 617.23, subdivision 2, clause (1), or 3, 
272.31 	clause (1); 617.246; or 617.247.
272.32 	(d) When a licensed foster care provider adopts an individual who had received foster 
272.33 	care services from the provider for over six months, and the adopted individual is required 
273.1 	to receive a background study under section 245C.03, subdivision 1, paragraph (a), clause 
273.2 	(2) or (6), the commissioner may grant a variance to the license holder under section 245C.30 
273.3 	to permit the adopted individual with a permanent disqualification to remain affiliated with 
273.4 	the license holder under the conditions of the variance when the variance is recommended 
273.5 	by the county of responsibility for each of the remaining individuals in placement in the 
273.6 	home and the licensing agency for the home.
273.7 	(e) For an individual 18 years of age or older affiliated with a licensed family foster 
273.8 	setting, the commissioner must not set aside or grant a variance for the disqualification of 
273.9 	any individual disqualified pursuant to this chapter, regardless of how much time has passed, 
273.10 	if the individual was disqualified for a crime or conduct listed in section 245C.15, subdivision 
273.11 	4a, paragraphs (a) and (b).
273.12 	(f) In connection with a family foster setting license, the commissioner may grant a 
273.13 	variance to the disqualification for an individual who is under 18 years of age at the time 
273.14 	the background study is submitted.
273.15 	(g) In connection with foster residence settings and children's residential facilities, the 
273.16 	commissioner must not set aside or grant a variance for the disqualification of any individual 
273.17 	disqualified pursuant to this chapter, regardless of how much time has passed, if the individual 
273.18 	was disqualified for a crime or conduct listed in section 245C.15, subdivision 4a, paragraph 
273.19 	(a) or (b).

273.20 	Sec. 26. Minnesota Statutes 2022, section 245C.24, subdivision 5, is amended to read:
273.21 		Subd. 5.Five-year bar to set aside or variance disqualification; children's residential 
273.22 	facilities, foster residence settings. The commissioner shall not set aside or grant a variance 
273.23 	for the disqualification of an individual in connection with a license for a children's residential 
273.24 	facility or foster residence setting who was convicted of a felony within the past five years 
273.25 	for: (1) physical assault or battery; or (2) a drug-related offense.

273.26 	Sec. 27. Minnesota Statutes 2022, section 245C.30, is amended by adding a subdivision 
273.27 	to read:
273.28 		Subd. 1b.Child foster care variances. For an individual seeking a child foster care 
273.29 	license who is a relative of the child, the commissioner shall consider the importance of 
273.30 	maintaining the child's relationship with relatives as an additional significant factor in 
273.31 	determining whether the individual should be granted a variance.

274.1 	Sec. 28. Minnesota Statutes 2022, section 245F.09, subdivision 2, is amended to read:
274.2 		Subd. 2.Protective procedures plan. A license holder must have a written policy and 
274.3 	procedure that establishes the protective procedures that program staff must follow when 
274.4 	a patient is in imminent danger of harming self or others. The policy must be appropriate 
274.5 	to the type of facility and the level of staff training. The protective procedures policy must 
274.6 	include:
274.7 	(1) an approval signed and dated by the program director and medical director prior to 
274.8 	implementation. Any changes to the policy must also be approved, signed, and dated by the 
274.9 	current program director and the medical director prior to implementation;
274.10 	(2) which protective procedures the license holder will use to prevent patients from 
274.11 	imminent danger of harming self or others;
274.12 	(3) the emergency conditions under which the protective procedures are permitted to be 
274.13 	used, if any;
274.14 	(4) the patient's health conditions that limit the specific procedures that may be used and 
274.15 	alternative means of ensuring safety;
274.16 	(5) emergency resources the program staff must contact when a patient's behavior cannot 
274.17 	be controlled by the procedures established in the policy;
274.18 	(6) the training that staff must have before using any protective procedure;
274.19 	(7) documentation of approved therapeutic holds;
274.20 	(8) the use of law enforcement personnel as described in subdivision 4;
274.21 	(9) standards governing emergency use of seclusion. Seclusion must be used only when 
274.22 	less restrictive measures are ineffective or not feasible. The standards in items (i) to (vii) 
274.23 	must be met when seclusion is used with a patient:
274.24 	(i) seclusion must be employed solely for the purpose of preventing a patient from 
274.25 	imminent danger of harming self or others;
274.26 	(ii) seclusion rooms must be equipped in a manner that prevents patients from self-harm 
274.27 	using projections, windows, electrical fixtures, or hard objects, and must allow the patient 
274.28 	to be readily observed without being interrupted;
274.29 	(iii) seclusion must be authorized by the program director, a licensed physician, a 
274.30 	registered nurse, or a licensed physician assistant. If one of these individuals is not present 
274.31 	in the facility, the program director or a licensed physician, registered nurse, or physician 
275.1 	assistant must be contacted and authorization must be obtained within 30 minutes of initiating 
275.2 	seclusion, according to written policies;
275.3 	(iv) patients must not be placed in seclusion for more than 12 hours at any one time;
275.4 	(v) once the condition of a patient in seclusion has been determined to be safe enough 
275.5 	to end continuous observation, a patient in seclusion must be observed at a minimum of 
275.6 	every 15 minutes for the duration of seclusion and must always be within hearing range of 
275.7 	program staff;
275.8 	(vi) a process for program staff to use to remove a patient to other resources available 
275.9 	to the facility if seclusion does not sufficiently assure patient safety; and
275.10 	(vii) a seclusion area may be used for other purposes, such as intensive observation, if 
275.11 	the room meets normal standards of care for the purpose and if the room is not locked; and
275.12 	(10) physical holds may only be used when less restrictive measures are not feasible. 
275.13 	The standards in items (i) to (iv) must be met when physical holds are used with a patient:
275.14 	(i) physical holds must be employed solely for preventing a patient from imminent 
275.15 	danger of harming self or others;
275.16 	(ii) physical holds must be authorized by the program director, a licensed physician, a 
275.17 	registered nurse, or a physician assistant. If one of these individuals is not present in the 
275.18 	facility, the program director or a licensed physician, registered nurse, or physician assistant 
275.19 	must be contacted and authorization must be obtained within 30 minutes of initiating a 
275.20 	physical hold, according to written policies;
275.21 	(iii) the patient's health concerns must be considered in deciding whether to use physical 
275.22 	holds and which holds are appropriate for the patient; and
275.23 	(iv) only approved holds may be utilized. Prone and contraindicated holds are not allowed 
275.24 	according to section 245A.211 and must not be authorized.

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

275.26 	Sec. 29. Minnesota Statutes 2022, section 245F.14, is amended by adding a subdivision 
275.27 	to read:
275.28 		Subd. 8.Notification to commissioner of changes in key staff positions. A license 
275.29 	holder must notify the commissioner within five business days of a change or vacancy in a 
275.30 	key staff position. The key positions are a program director as required by subdivision 1, a 
275.31 	registered nurse as required by subdivision 4, and a medical director as required by 
275.32 	subdivision 5. The license holder must notify the commissioner of the staffing change on 
276.1 	a form approved by the commissioner and include the name of the staff person now assigned 
276.2 	to the key staff position and the staff person's qualifications for the position. The license 
276.3 	holder must notify the program licensor of a vacancy to discuss how the duties of the key 
276.4 	staff position will be fulfilled during the vacancy.

276.5 	EFFECTIVE DATE. This section is effective January 1, 2025.

276.6 	Sec. 30. Minnesota Statutes 2022, section 245F.17, is amended to read:
276.7 	245F.17 PERSONNEL FILES.
276.8 	A license holder must maintain a separate personnel file for each staff member. At a 
276.9 	minimum, the file must contain:
276.10 	(1) a completed application for employment signed by the staff member that contains 
276.11 	the staff member's qualifications for employment and documentation related to the applicant's 
276.12 	background study data, as defined in chapter 245C;
276.13 	(2) documentation of the staff member's current professional license or registration, if 
276.14 	relevant;
276.15 	(3) documentation of orientation and subsequent training; and
276.16 	(4) documentation of a statement of freedom from substance use problems; and
276.17 	(5) an annual job performance evaluation.

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

276.19 	Sec. 31. Minnesota Statutes 2022, section 245G.07, subdivision 4, is amended to read:
276.20 		Subd. 4.Location of service provision. The license holder may provide services at any 
276.21 	of the license holder's licensed locations or at another suitable location including a school, 
276.22 	government building, medical or behavioral health facility, or social service organization, 
276.23 	upon notification and approval of the commissioner. If services are provided off site from 
276.24 	the licensed site, the reason for the provision of services remotely must be documented. 
276.25 	The license holder may provide additional services under subdivision 2, clauses (2) to (5), 
276.26 	off-site if the license holder includes a policy and procedure detailing the off-site location 
276.27 	as a part of the treatment service description and the program abuse prevention plan.
276.28 	(a) The license holder must provide all treatment services a client receives at one of the 
276.29 	license holder's substance use disorder treatment licensed locations or at a location allowed 
276.30 	under paragraphs (b) to (f). If the services are provided at the locations in paragraphs (b) to 
276.31 	(d), the license holder must document in the client record the location services were provided.
277.1 	(b) The license holder may provide nonresidential individual treatment services at a 
277.2 	client's home or place of residence.
277.3 	(c) If the license holder provides treatment services by telehealth, the services must be 
277.4 	provided according to this paragraph:
277.5 	(1) the license holder must maintain a licensed physical location in Minnesota where 
277.6 	the license holder must offer all treatment services in subdivision 1, paragraph (a), clauses 
277.7 	(1) to (4), physically in-person to each client;
277.8 	(2) the license holder must meet all requirements for the provision of telehealth in sections 
277.9 	254B.05, subdivision 5, paragraph (f), and 256B.0625, subdivision 3b. The license holder 
277.10 	must document all items in section 256B.0625, subdivision 3b, paragraph (c), for each client 
277.11 	receiving services by telehealth, regardless of payment type or whether the client is a medical 
277.12 	assistance enrollee;
277.13 	(3) the license holder may provide treatment services by telehealth to clients individually;
277.14 	(4) the license holder may provide treatment services by telehealth to a group of clients 
277.15 	that are each in a separate physical location;
277.16 	(5) the license holder must not provide treatment services remotely by telehealth to a 
277.17 	group of clients meeting together in person, unless permitted under clause (7);
277.18 	(6) clients and staff may join an in-person group by telehealth if a staff member qualified 
277.19 	to provide the treatment service is physically present with the group of clients meeting 
277.20 	together in person; and
277.21 	(7) the qualified professional providing a residential group treatment service by telehealth 
277.22 	must be physically present on-site at the licensed residential location while the service is 
277.23 	being provided. If weather conditions or short-term illness prohibit a qualified professional 
277.24 	from traveling to the residential program and another qualified professional is not available 
277.25 	to provide the service, a qualified professional may provide a residential group treatment 
277.26 	service by telehealth from a location away from the licensed residential location. In such 
277.27 	circumstances, the license holder must ensure that a qualified professional does not provide 
277.28 	a residential group treatment service by telehealth from a location away from the licensed 
277.29 	residential location for more than one day at a time, must ensure that a staff person who 
277.30 	qualifies as a paraprofessional is physically present with the group of clients, and must 
277.31 	document the reason for providing the remote telehealth service in the records of clients 
277.32 	receiving the service. The license holder must document the dates that residential group 
277.33 	treatment services were provided by telehealth from a location away from the licensed 
278.1 	residential location in a central log and must provide the log to the commissioner upon 
278.2 	request.
278.3 	(d) The license holder may provide the additional treatment services under subdivision 
278.4 	2, clauses (2) to (6) and (8), away from the licensed location at a suitable location appropriate 
278.5 	to the treatment service.
278.6 	(e) Upon written approval from the commissioner for each satellite location, the license 
278.7 	holder may provide nonresidential treatment services at satellite locations that are in a 
278.8 	school, jail, or nursing home. A satellite location may only provide services to students of 
278.9 	the school, inmates of the jail, or residents of the nursing home. Schools, jails, and nursing 
278.10 	homes are exempt from the licensing requirements in section 245A.04, subdivision 2a, to 
278.11 	document compliance with building codes, fire and safety codes, health rules, and zoning 
278.12 	ordinances.
278.13 	(f) The commissioner may approve other suitable locations as satellite locations for 
278.14 	nonresidential treatment services. The commissioner may require satellite locations under 
278.15 	this paragraph to meet all applicable licensing requirements. The license holder may not 
278.16 	have more than two satellite locations per license under this paragraph.
278.17 	(g) The license holder must provide the commissioner access to all files, documentation, 
278.18 	staff persons, and any other information the commissioner requires at the main licensed 
278.19 	location for all clients served at any location under paragraphs (b) to (f).
278.20 	(h) Notwithstanding sections 245A.65, subdivision 2, and 626.557, subdivision 14, a 
278.21 	program abuse prevention plan is not required for satellite or other locations under paragraphs 
278.22 	(b) to (e). An individual abuse prevention plan is still required for any client that is a 
278.23 	vulnerable adult as defined in section 626.5572, subdivision 21.

278.24 	EFFECTIVE DATE. This section is effective January 1, 2025.

278.25 	Sec. 32. Minnesota Statutes 2022, section 245G.08, subdivision 5, is amended to read:
278.26 		Subd. 5.Administration of medication and assistance with self-medication. (a) A 
278.27 	license holder must meet the requirements in this subdivision if a service provided includes 
278.28 	the administration of medication.
278.29 	(b) A staff member, other than a licensed practitioner or nurse, who is delegated by a 
278.30 	licensed practitioner or a registered nurse the task of administration of medication or assisting 
278.31 	with self-medication, must:
279.1 	(1) successfully complete a medication administration training program for unlicensed 
279.2 	personnel through an accredited Minnesota postsecondary educational institution. A staff 
279.3 	member's completion of the course must be documented in writing and placed in the staff 
279.4 	member's personnel file;
279.5 	(2) be trained according to a formalized training program that is taught by a registered 
279.6 	nurse and offered by the license holder. The training must include the process for 
279.7 	administration of naloxone, if naloxone is kept on site. A staff member's completion of the 
279.8 	training must be documented in writing and placed in the staff member's personnel records; 
279.9 	or
279.10 	(3) demonstrate to a registered nurse competency to perform the delegated activity. A 
279.11 	registered nurse must be employed or contracted to develop the policies and procedures for 
279.12 	administration of medication or assisting with self-administration of medication, or both.
279.13 	(c) A registered nurse must provide supervision as defined in section 148.171, subdivision 
279.14 	23. The registered nurse's supervision must include, at a minimum, monthly on-site 
279.15 	supervision or more often if warranted by a client's health needs. The policies and procedures 
279.16 	must include:
279.17 	(1) a provision that a delegation of administration of medication is limited to a method 
279.18 	a staff member has been trained to administer and limited to:
279.19 	(i) a medication that is administered orally, topically, or as a suppository, an eye drop, 
279.20 	an ear drop, an inhalant, or an intranasal; and
279.21 	(ii) an intramuscular injection of naloxone an opiate antagonist as defined in section 
279.22 	604A.04, subdivision 1, or epinephrine;
279.23 	(2) a provision that each client's file must include documentation indicating whether 
279.24 	staff must conduct the administration of medication or the client must self-administer 
279.25 	medication, or both;
279.26 	(3) a provision that a client may carry emergency medication such as nitroglycerin as 
279.27 	instructed by the client's physician, advanced practice registered nurse, or physician assistant;
279.28 	(4) a provision for the client to self-administer medication when a client is scheduled to 
279.29 	be away from the facility;
279.30 	(5) a provision that if a client self-administers medication when the client is present in 
279.31 	the facility, the client must self-administer medication under the observation of a trained 
279.32 	staff member;
280.1 	(6) a provision that when a license holder serves a client who is a parent with a child, 
280.2 	the parent may only administer medication to the child under a staff member's supervision;
280.3 	(7) requirements for recording the client's use of medication, including staff signatures 
280.4 	with date and time;
280.5 	(8) guidelines for when to inform a nurse of problems with self-administration of 
280.6 	medication, including a client's failure to administer, refusal of a medication, adverse 
280.7 	reaction, or error; and
280.8 	(9) procedures for acceptance, documentation, and implementation of a prescription, 
280.9 	whether written, verbal, telephonic, or electronic.

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

280.11 	Sec. 33. Minnesota Statutes 2022, section 245G.08, subdivision 6, is amended to read:
280.12 		Subd. 6.Control of drugs. A license holder must have and implement written policies 
280.13 	and procedures developed by a registered nurse that contain:
280.14 	(1) a requirement that each drug must be stored in a locked compartment. A Schedule 
280.15 	II drug, as defined by section 152.02, subdivision 3, must be stored in a separately locked 
280.16 	compartment, permanently affixed to the physical plant or medication cart;
280.17 	(2) a system which accounts for all scheduled drugs each shift;
280.18 	(3) a procedure for recording the client's use of medication, including the signature of 
280.19 	the staff member who completed the administration of the medication with the time and 
280.20 	date;
280.21 	(4) a procedure to destroy a discontinued, outdated, or deteriorated medication;
280.22 	(5) a statement that only authorized personnel are permitted access to the keys to a locked 
280.23 	compartment;
280.24 	(6) a statement that no legend drug supply for one client shall be given to another client; 
280.25 	and
280.26 	(7) a procedure for monitoring the available supply of naloxone an opiate antagonist as 
280.27 	defined in section 604A.04, subdivision 1, on site, and replenishing the naloxone supply 
280.28 	when needed, and destroying naloxone according to clause (4).

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

281.1 	Sec. 34. Minnesota Statutes 2022, section 245G.10, is amended by adding a subdivision 
281.2 	to read:
281.3 		Subd. 6.Notification to commissioner of changes in key staff positions. A license 
281.4 	holder must notify the commissioner within five business days of a change or vacancy in a 
281.5 	key staff position. The key positions are a treatment director as required by subdivision 1, 
281.6 	an alcohol and drug counselor supervisor as required by subdivision 2, and a registered 
281.7 	nurse as required by section 245G.08, subdivision 5, paragraph (c). The license holder must 
281.8 	notify the commissioner of the staffing change on a form approved by the commissioner 
281.9 	and include the name of the staff person now assigned to the key staff position and the staff 
281.10 	person's qualifications for the position. The license holder must notify the program licensor 
281.11 	of a vacancy to discuss how the duties of the key staff position will be fulfilled during the 
281.12 	vacancy.

281.13 	EFFECTIVE DATE. This section is effective January 1, 2025.

281.14 	Sec. 35. Minnesota Statutes 2023 Supplement, section 245G.22, subdivision 2, is amended 
281.15 	to read:
281.16 		Subd. 2.Definitions. (a) For purposes of this section, the terms defined in this subdivision 
281.17 	have the meanings given them.
281.18 	(b) "Diversion" means the use of a medication for the treatment of opioid addiction being 
281.19 	diverted from intended use of the medication.
281.20 	(c) "Guest dose" means administration of a medication used for the treatment of opioid 
281.21 	addiction to a person who is not a client of the program that is administering or dispensing 
281.22 	the medication.
281.23 	(d) "Medical director" means a practitioner licensed to practice medicine in the 
281.24 	jurisdiction that the opioid treatment program is located who assumes responsibility for 
281.25 	administering all medical services performed by the program, either by performing the 
281.26 	services directly or by delegating specific responsibility to a practitioner of the opioid 
281.27 	treatment program.
281.28 	(e) "Medication used for the treatment of opioid use disorder" means a medication 
281.29 	approved by the Food and Drug Administration for the treatment of opioid use disorder.
281.30 	(f) "Minnesota health care programs" has the meaning given in section 256B.0636.
281.31 	(g) "Opioid treatment program" has the meaning given in Code of Federal Regulations, 
281.32 	title 42, section 8.12, and includes programs licensed under this chapter.
282.1 	(h) "Practitioner" means a staff member holding a current, unrestricted license to practice 
282.2 	medicine issued by the Board of Medical Practice or nursing issued by the Board of Nursing 
282.3 	and is currently registered with the Drug Enforcement Administration to order or dispense 
282.4 	controlled substances in Schedules II to V under the Controlled Substances Act, United 
282.5 	States Code, title 21, part B, section 821. Practitioner includes an advanced practice registered 
282.6 	nurse and physician assistant if the staff member receives a variance by the state opioid 
282.7 	treatment authority under section 254A.03 and the federal Substance Abuse and Mental 
282.8 	Health Services Administration.
282.9 	(i) "Unsupervised use" or "take-home" means the use of a medication for the treatment 
282.10 	of opioid use disorder dispensed for use by a client outside of the program setting.

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

282.12 	Sec. 36. Minnesota Statutes 2022, section 245G.22, subdivision 6, is amended to read:
282.13 		Subd. 6.Criteria for unsupervised use. (a) To limit the potential for diversion of 
282.14 	medication used for the treatment of opioid use disorder to the illicit market, medication 
282.15 	dispensed to a client for unsupervised use shall be subject to the requirements of this 
282.16 	subdivision. Any client in an opioid treatment program may receive a single unsupervised 
282.17 	use dose for a day that the clinic is closed for business, including Sundays and state and 
282.18 	federal holidays their individualized take-home doses as ordered for days that the clinic is 
282.19 	closed for business, on one weekend day (e.g., Sunday) and state and federal holidays, no 
282.20 	matter their length of time in treatment, as allowed under Code of Federal Regulations, title 
282.21 	42, part 8.12 (i)(1).
282.22 	(b) For take-home doses beyond those allowed by paragraph (a), a practitioner with
282.23 	authority to prescribe must review and document the criteria in this paragraph and paragraph 
282.24 	(c) the Code of Federal Regulations, title 42, part 8.12 (i)(2), when determining whether 
282.25 	dispensing medication for a client's unsupervised use is safe and it is appropriate to 
282.26 	implement, increase, or extend the amount of time between visits to the program. The criteria 
282.27 	are:
282.28 	(1) absence of recent abuse of drugs including but not limited to opioids, non-narcotics, 
282.29 	and alcohol;
282.30 	(2) regularity of program attendance;
282.31 	(3) absence of serious behavioral problems at the program;
282.32 	(4) absence of known recent criminal activity such as drug dealing;
283.1 	(5) stability of the client's home environment and social relationships;
283.2 	(6) length of time in comprehensive maintenance treatment;
283.3 	(7) reasonable assurance that unsupervised use medication will be safely stored within 
283.4 	the client's home; and
283.5 	(8) whether the rehabilitative benefit the client derived from decreasing the frequency 
283.6 	of program attendance outweighs the potential risks of diversion or unsupervised use.
283.7 	(c) The determination, including the basis of the determination must be documented by 
283.8 	a practitioner in the client's medical record.

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

283.10 	Sec. 37. Minnesota Statutes 2022, section 245G.22, subdivision 7, is amended to read:
283.11 		Subd. 7.Restrictions for unsupervised use of methadone hydrochloride. (a) If a 
283.12 	medical director or prescribing practitioner assesses and, determines, and documents that 
283.13 	a client meets the criteria in subdivision 6 and may be dispensed a medication used for the 
283.14 	treatment of opioid addiction, the restrictions in this subdivision must be followed when 
283.15 	the medication to be dispensed is methadone hydrochloride. The results of the assessment 
283.16 	must be contained in the client file. The number of unsupervised use medication doses per 
283.17 	week in paragraphs (b) to (d) is in addition to the number of unsupervised use medication 
283.18 	doses a client may receive for days the clinic is closed for business as allowed by subdivision 
283.19 	6, paragraph (a) and that a patient is safely able to manage unsupervised doses of methadone, 
283.20 	the number of take-home doses the client receives must be limited by the number allowed 
283.21 	by the Code of Federal Regulations, title 42, part 8.12 (i)(3).
283.22 	(b) During the first 90 days of treatment, the unsupervised use medication supply must 
283.23 	be limited to a maximum of a single dose each week and the client shall ingest all other 
283.24 	doses under direct supervision.
283.25 	(c) In the second 90 days of treatment, the unsupervised use medication supply must be 
283.26 	limited to two doses per week.
283.27 	(d) In the third 90 days of treatment, the unsupervised use medication supply must not 
283.28 	exceed three doses per week.
283.29 	(e) In the remaining months of the first year, a client may be given a maximum six-day 
283.30 	unsupervised use medication supply.
283.31 	(f) After one year of continuous treatment, a client may be given a maximum two-week 
283.32 	unsupervised use medication supply.
284.1 	(g) After two years of continuous treatment, a client may be given a maximum one-month 
284.2 	unsupervised use medication supply, but must make monthly visits to the program.

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

284.4 	Sec. 38. Minnesota Statutes 2023 Supplement, section 245G.22, subdivision 17, is amended 
284.5 	to read:
284.6 		Subd. 17.Policies and procedures. (a) A license holder must develop and maintain the 
284.7 	policies and procedures required in this subdivision.
284.8 	(b) For a program that is not open every day of the year, the license holder must maintain 
284.9 	a policy and procedure that covers requirements under section 245G.22, subdivisions 6 and 
284.10 	7. Unsupervised use of medication used for the treatment of opioid use disorder for days 
284.11 	that the program is closed for business, including but not limited to Sundays on one weekend 
284.12 	day and state and federal holidays, must meet the requirements under section 245G.22, 
284.13 	subdivisions 6 and 7.
284.14 	(c) The license holder must maintain a policy and procedure that includes specific 
284.15 	measures to reduce the possibility of diversion. The policy and procedure must:
284.16 	(1) specifically identify and define the responsibilities of the medical and administrative 
284.17 	staff for performing diversion control measures; and
284.18 	(2) include a process for contacting no less than five percent of clients who have 
284.19 	unsupervised use of medication, excluding clients approved solely under subdivision 6, 
284.20 	paragraph (a), to require clients to physically return to the program each month. The system 
284.21 	must require clients to return to the program within a stipulated time frame and turn in all 
284.22 	unused medication containers related to opioid use disorder treatment. The license holder 
284.23 	must document all related contacts on a central log and the outcome of the contact for each 
284.24 	client in the client's record. The medical director must be informed of each outcome that 
284.25 	results in a situation in which a possible diversion issue was identified.
284.26 	(d) Medication used for the treatment of opioid use disorder must be ordered, 
284.27 	administered, and dispensed according to applicable state and federal regulations and the 
284.28 	standards set by applicable accreditation entities. If a medication order requires assessment 
284.29 	by the person administering or dispensing the medication to determine the amount to be 
284.30 	administered or dispensed, the assessment must be completed by an individual whose 
284.31 	professional scope of practice permits an assessment. For the purposes of enforcement of 
284.32 	this paragraph, the commissioner has the authority to monitor the person administering or 
284.33 	dispensing the medication for compliance with state and federal regulations and the relevant 
285.1 	standards of the license holder's accreditation agency and may issue licensing actions 
285.2 	according to sections 245A.05, 245A.06, and 245A.07, based on the commissioner's 
285.3 	determination of noncompliance.
285.4 	(e) A counselor in an opioid treatment program must not supervise more than 50 clients.
285.5 	(f) Notwithstanding paragraph (e), from July 1, 2023, to June 30, 2024, a counselor in 
285.6 	an opioid treatment program may supervise up to 60 clients. The license holder may continue 
285.7 	to serve a client who was receiving services at the program on June 30, 2024, at a counselor 
285.8 	to client ratio of up to one to 60 and is not required to discharge any clients in order to return 
285.9 	to the counselor to client ratio of one to 50. The license holder may not, however, serve a 
285.10 	new client after June 30, 2024, unless the counselor who would supervise the new client is 
285.11 	supervising fewer than 50 existing clients.

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

285.13 	Sec. 39. Minnesota Statutes 2023 Supplement, section 256B.064, subdivision 4, is amended 
285.14 	to read:
285.15 		Subd. 4.Notice. (a) The department shall serve the notice required under subdivision 2 
285.16 	by certified mail at using a signature-verified confirmed delivery method to the address 
285.17 	submitted to the department by the individual or entity. Service is complete upon mailing.
285.18 	(b) The department shall give notice in writing to a recipient placed in the Minnesota 
285.19 	restricted recipient program under section 256B.0646 and Minnesota Rules, part 9505.2200. 
285.20 	The department shall send the notice by first class mail to the recipient's current address on 
285.21 	file with the department. A recipient placed in the Minnesota restricted recipient program 
285.22 	may contest the placement by submitting a written request for a hearing to the department 
285.23 	within 90 days of the notice being mailed.

285.24 	Sec. 40. Minnesota Statutes 2022, section 256B.0757, subdivision 4a, is amended to read:
285.25 		Subd. 4a.Behavioral health home services provider requirements. A behavioral 
285.26 	health home services provider must:
285.27 	(1) be an enrolled Minnesota Health Care Programs provider;
285.28 	(2) provide a medical assistance covered primary care or behavioral health service;
285.29 	(3) utilize an electronic health record;
285.30 	(4) utilize an electronic patient registry that contains data elements required by the 
285.31 	commissioner;
286.1 	(5) demonstrate the organization's capacity to administer screenings approved by the 
286.2 	commissioner for substance use disorder or alcohol and tobacco use;
286.3 	(6) demonstrate the organization's capacity to refer an individual to resources appropriate 
286.4 	to the individual's screening results;
286.5 	(7) have policies and procedures to track referrals to ensure that the referral met the 
286.6 	individual's needs;
286.7 	(8) conduct a brief needs assessment when an individual begins receiving behavioral 
286.8 	health home services. The brief needs assessment must be completed with input from the 
286.9 	individual and the individual's identified supports. The brief needs assessment must address 
286.10 	the individual's immediate safety and transportation needs and potential barriers to 
286.11 	participating in behavioral health home services;
286.12 	(9) conduct a health wellness assessment within 60 days after intake that contains all 
286.13 	required elements identified by the commissioner;
286.14 	(10) conduct a health action plan that contains all required elements identified by the 
286.15 	commissioner. The plan must be completed within 90 days after intake and must be updated 
286.16 	at least once every six months, or more frequently if significant changes to an individual's 
286.17 	needs or goals occur;
286.18 	(11) agree to cooperate with and participate in the state's monitoring and evaluation of 
286.19 	behavioral health home services; and
286.20 	(12) obtain the individual's written consent to begin receiving behavioral health home 
286.21 	services using a form approved by the commissioner.

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

286.23 	Sec. 41. Minnesota Statutes 2022, section 256B.0757, subdivision 4d, is amended to read:
286.24 		Subd. 4d.Behavioral health home services delivery standards. (a) A behavioral health 
286.25 	home services provider must meet the following service delivery standards:
286.26 	(1) establish and maintain processes to support the coordination of an individual's primary 
286.27 	care, behavioral health, and dental care;
286.28 	(2) maintain a team-based model of care, including regular coordination and 
286.29 	communication between behavioral health home services team members;
287.1 	(3) use evidence-based practices that recognize and are tailored to the medical, social, 
287.2 	economic, behavioral health, functional impairment, cultural, and environmental factors 
287.3 	affecting the individual's health and health care choices;
287.4 	(4) use person-centered planning practices to ensure the individual's health action plan 
287.5 	accurately reflects the individual's preferences, goals, resources, and optimal outcomes for 
287.6 	the individual and the individual's identified supports;
287.7 	(5) use the patient registry to identify individuals and population subgroups requiring 
287.8 	specific levels or types of care and provide or refer the individual to needed treatment, 
287.9 	intervention, or services;
287.10 	(6) utilize the Department of Human Services Partner Portal to identify past and current 
287.11 	treatment or services and identify potential gaps in care using a tool approved by the 
287.12 	commissioner;
287.13 	(7) deliver services consistent with the standards for frequency and face-to-face contact 
287.14 	required by the commissioner;
287.15 	(8) ensure that a diagnostic assessment is completed for each individual receiving 
287.16 	behavioral health home services within six months of the start of behavioral health home 
287.17 	services;
287.18 	(9) deliver services in locations and settings that meet the needs of the individual;
287.19 	(10) provide a central point of contact to ensure that individuals and the individual's 
287.20 	identified supports can successfully navigate the array of services that impact the individual's 
287.21 	health and well-being;
287.22 	(11) have capacity to assess an individual's readiness for change and the individual's 
287.23 	capacity to integrate new health care or community supports into the individual's life;
287.24 	(12) offer or facilitate the provision of wellness and prevention education on 
287.25 	evidenced-based curriculums specific to the prevention and management of common chronic 
287.26 	conditions;
287.27 	(13) help an individual set up and prepare for medical, behavioral health, social service, 
287.28 	or community support appointments, including accompanying the individual to appointments 
287.29 	as appropriate, and providing follow-up with the individual after these appointments;
287.30 	(14) offer or facilitate the provision of health coaching related to chronic disease 
287.31 	management and how to navigate complex systems of care to the individual, the individual's 
287.32 	family, and identified supports;
288.1 	(15) connect an individual, the individual's family, and identified supports to appropriate 
288.2 	support services that help the individual overcome access or service barriers, increase 
288.3 	self-sufficiency skills, and improve overall health;
288.4 	(16) provide effective referrals and timely access to services; and
288.5 	(17) establish a continuous quality improvement process for providing behavioral health 
288.6 	home services.
288.7 	(b) The behavioral health home services provider must also create a plan, in partnership 
288.8 	with the individual and the individual's identified supports, to support the individual after 
288.9 	discharge from a hospital, residential treatment program, or other setting. The plan must 
288.10 	include protocols for:
288.11 	(1) maintaining contact between the behavioral health home services team member, the 
288.12 	individual, and the individual's identified supports during and after discharge;
288.13 	(2) linking the individual to new resources as needed;
288.14 	(3) reestablishing the individual's existing services and community and social supports; 
288.15 	and
288.16 	(4) following up with appropriate entities to transfer or obtain the individual's service 
288.17 	records as necessary for continued care.
288.18 	(c) If the individual is enrolled in a managed care plan, a behavioral health home services 
288.19 	provider must:
288.20 	(1) notify the behavioral health home services contact designated by the managed care 
288.21 	plan within 30 days of when the individual begins behavioral health home services; and
288.22 	(2) adhere to the managed care plan communication and coordination requirements 
288.23 	described in the behavioral health home services manual.
288.24 	(d) Before terminating behavioral health home services, the behavioral health home 
288.25 	services provider must:
288.26 	(1) provide a 60-day notice of termination of behavioral health home services to all 
288.27 	individuals receiving behavioral health home services, the commissioner, and managed care 
288.28 	plans, if applicable; and
288.29 	(2) refer individuals receiving behavioral health home services to a new behavioral 
288.30 	health home services provider.

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

289.1 	Sec. 42. Minnesota Statutes 2023 Supplement, section 256D.01, subdivision 1a, is amended 
289.2 	to read:
289.3 		Subd. 1a.Standards. (a) A principal objective in providing general assistance is to 
289.4 	provide for single adults, childless couples, or children as defined in section 256D.02, 
289.5 	subdivision 2b, ineligible for federal programs who are unable to provide for themselves. 
289.6 	The minimum standard of assistance determines the total amount of the general assistance 
289.7 	grant without separate standards for shelter, utilities, or other needs.
289.8 	(b) The standard of assistance for an assistance unit consisting of a recipient who is 
289.9 	childless and unmarried or living apart from children and spouse and who does not live with 
289.10 	a parent or parents or a legal custodian, or consisting of a childless couple, is $350 per month 
289.11 	effective October 1, 2024, and must be adjusted by a percentage equal to the change in the 
289.12 	consumer price index as of January 1 every year, beginning October 1, 2025.
289.13 	(c) For an assistance unit consisting of a single adult who lives with a parent or parents, 
289.14 	the general assistance standard of assistance is $350 per month effective October 1, 2023
289.15 	2024, and must be adjusted by a percentage equal to the change in the consumer price index 
289.16 	as of January 1 every year, beginning October 1, 2025. Benefits received by a responsible 
289.17 	relative of the assistance unit under the Supplemental Security Income program, a workers' 
289.18 	compensation program, the Minnesota supplemental aid program, or any other program 
289.19 	based on the responsible relative's disability, and any benefits received by a responsible 
289.20 	relative of the assistance unit under the Social Security retirement program, may not be 
289.21 	counted in the determination of eligibility or benefit level for the assistance unit. Except as 
289.22 	provided below, the assistance unit is ineligible for general assistance if the available 
289.23 	resources or the countable income of the assistance unit and the parent or parents with whom 
289.24 	the assistance unit lives are such that a family consisting of the assistance unit's parent or 
289.25 	parents, the parent or parents' other family members and the assistance unit as the only or 
289.26 	additional minor child would be financially ineligible for general assistance. For the purposes 
289.27 	of calculating the countable income of the assistance unit's parent or parents, the calculation 
289.28 	methods must follow the provisions under section 256P.06.

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

289.30 	Sec. 43. Minnesota Statutes 2022, section 256I.04, subdivision 2f, is amended to read:
289.31 		Subd. 2f.Required services. (a) In licensed and registered authorized settings under 
289.32 	subdivision 2a, providers shall ensure that participants have at a minimum:
289.33 	(1) food preparation and service for three nutritional meals a day on site;
290.1 	(2) a bed, clothing storage, linen, bedding, laundering, and laundry supplies or service;
290.2 	(3) housekeeping, including cleaning and lavatory supplies or service; and
290.3 	(4) maintenance and operation of the building and grounds, including heat, water, garbage 
290.4 	removal, electricity, telephone for the site, cooling, supplies, and parts and tools to repair 
290.5 	and maintain equipment and facilities.
290.6 	(b) In addition, when providers serve participants described in subdivision 1, paragraph 
290.7 	(c), the providers are required to assist the participants in applying for continuing housing 
290.8 	support payments before the end of the eligibility period.

290.9 	Sec. 44. Minnesota Statutes 2023 Supplement, section 256I.05, subdivision 1a, is amended 
290.10 	to read:
290.11 		Subd. 1a.Supplementary service rates. (a) Subject to the provisions of section 256I.04, 
290.12 	subdivision 3, the agency may negotiate a payment not to exceed $494.91 for other services 
290.13 	necessary to provide room and board if the residence is licensed by or registered by the 
290.14 	Department of Health, or licensed by the Department of Human Services to provide services 
290.15 	in addition to room and board, and if the provider of services is not also concurrently 
290.16 	receiving funding for services for a recipient in the residence under the following programs 
290.17 	or funding sources: (1) home and community-based waiver services under chapter 256S or 
290.18 	section 256B.0913, 256B.092, or 256B.49; (2) personal care assistance under section 
290.19 	256B.0659; (3) community first services and supports under section 256B.85; or (4) services 
290.20 	for adults with mental illness grants under section 245.73. If funding is available for other 
290.21 	necessary services through a home and community-based waiver under chapter 256S, or 
290.22 	section 256B.0913, 256B.092, or 256B.49; personal care assistance services under section 
290.23 	256B.0659; community first services and supports under section 256B.85; or services for 
290.24 	adults with mental illness grants under section 245.73, then the housing support rate is 
290.25 	limited to the rate set in subdivision 1. Unless otherwise provided in law, in no case may 
290.26 	the supplementary service rate exceed $494.91. The registration and licensure requirement 
290.27 	does not apply to establishments which are exempt from state licensure because they are 
290.28 	located on Indian reservations and for which the tribe has prescribed health and safety 
290.29 	requirements. Service payments under this section may be prohibited under rules to prevent 
290.30 	the supplanting of federal funds with state funds.
290.31 	(b) The commissioner is authorized to make cost-neutral transfers from the housing 
290.32 	support fund for beds under this section to other funding programs administered by the 
290.33 	department after consultation with the agency in which the affected beds are located. The 
290.34 	commissioner may also make cost-neutral transfers from the housing support fund to agencies 
291.1 	for beds permanently removed from the housing support census under a plan submitted by 
291.2 	the agency and approved by the commissioner. The commissioner shall report the amount 
291.3 	of any transfers under this provision annually to the legislature.
291.4 	(c) (b) Agencies must not negotiate supplementary service rates with providers of housing 
291.5 	support that are licensed as board and lodging with special services and that do not encourage 
291.6 	a policy of sobriety on their premises and make referrals to available community services 
291.7 	for volunteer and employment opportunities for residents.

291.8 	Sec. 45. Minnesota Statutes 2023 Supplement, section 256I.05, subdivision 11, is amended 
291.9 	to read:
291.10 		Subd. 11.Transfer of emergency shelter funds Cost-neutral transfers from the 
291.11 	housing support fund. (a) The commissioner is authorized to make cost-neutral transfers 
291.12 	from the housing support fund for beds under this section to other funding programs 
291.13 	administered by the department after consultation with the agency in which the affected 
291.14 	beds are located.
291.15 	(b) The commissioner may also make cost-neutral transfers from the housing support 
291.16 	fund to agencies for beds removed from the housing support census under a plan submitted 
291.17 	by the agency and approved by the commissioner.
291.18 	(a) (c) The commissioner shall make a cost-neutral transfer of funding from the housing 
291.19 	support fund to the agency for emergency shelter beds removed from the housing support 
291.20 	census under a biennial plan submitted by the agency and approved by the commissioner.
291.21 	Plans submitted under this paragraph must include anticipated and actual outcomes for 
291.22 	persons experiencing homelessness in emergency shelters.
291.23 	The plan (d) Plans submitted under paragraph (b) or (c) must describe: (1) anticipated 
291.24 	and actual outcomes for persons experiencing homelessness in emergency shelters; (2)
291.25 	improved efficiencies in administration; (3) (2) requirements for individual eligibility; and 
291.26 	(4) (3) plans for quality assurance monitoring and quality assurance outcomes. The 
291.27 	commissioner shall review the agency plan plans to monitor implementation and outcomes 
291.28 	at least biennially, and more frequently if the commissioner deems necessary.
291.29 	(b) The (e) Funding under paragraph (a) (b), (c), or (d) may be used for the provision 
291.30 	of room and board or supplemental services according to section 256I.03, subdivisions 14a 
291.31 	and 14b. Providers must meet the requirements of section 256I.04, subdivisions 2a to 2f. 
291.32 	Funding must be allocated annually, and the room and board portion of the allocation shall 
291.33 	be adjusted according to the percentage change in the housing support room and board rate. 
292.1 	The room and board portion of the allocation shall be determined at the time of transfer.
292.2 	The commissioner or agency may return beds to the housing support fund with 180 days' 
292.3 	notice, including financial reconciliation.

292.4 	Sec. 46. Minnesota Statutes 2022, section 260E.33, subdivision 2, as amended by Laws 
292.5 	2024, chapter 80, article 8, section 44, is amended to read:
292.6 		Subd. 2.Request for reconsideration. (a) Except as provided under subdivision 5, an 
292.7 	individual or facility that the commissioner of human services; commissioner of children, 
292.8 	youth, and families; a local welfare agency; or the commissioner of education determines 
292.9 	has maltreated a child, an interested person acting on behalf of the child, regardless of the 
292.10 	determination, who contests the investigating agency's final determination regarding 
292.11 	maltreatment may request the investigating agency to reconsider its final determination 
292.12 	regarding maltreatment. The request for reconsideration must be submitted in writing or 
292.13 	submitted in the provider licensing and reporting hub to the investigating agency within 15 
292.14 	calendar days after receipt of notice of the final determination regarding maltreatment or, 
292.15 	if the request is made by an interested person who is not entitled to notice, within 15 days 
292.16 	after receipt of the notice by the parent or guardian of the child. If mailed, the request for 
292.17 	reconsideration must be postmarked and sent to the investigating agency within 15 calendar 
292.18 	days of the individual's or facility's receipt of the final determination. If the request for 
292.19 	reconsideration is made by personal service, it must be received by the investigating agency 
292.20 	within 15 calendar days after the individual's or facility's receipt of the final determination.
292.21 	Upon implementation of the provider licensing and reporting hub, the individual or facility 
292.22 	must use the hub to request reconsideration. The reconsideration must be received by the 
292.23 	commissioner within 15 calendar days of the individual's receipt of the notice of 
292.24 	disqualification.
292.25 	(b) An individual who was determined to have maltreated a child under this chapter and 
292.26 	who was disqualified on the basis of serious or recurring maltreatment under sections 
292.27 	245C.14 and 245C.15 may request reconsideration of the maltreatment determination and 
292.28 	the disqualification. The request for reconsideration of the maltreatment determination and 
292.29 	the disqualification must be submitted within 30 calendar days of the individual's receipt 
292.30 	of the notice of disqualification under sections 245C.16 and 245C.17. If mailed, the request 
292.31 	for reconsideration of the maltreatment determination and the disqualification must be 
292.32 	postmarked and sent to the investigating agency within 30 calendar days of the individual's 
292.33 	receipt of the maltreatment determination and notice of disqualification. If the request for 
292.34 	reconsideration is made by personal service, it must be received by the investigating agency 
292.35 	within 30 calendar days after the individual's receipt of the notice of disqualification.

293.1 	Sec. 47. Laws 2024, chapter 80, article 2, section 6, subdivision 2, is amended to read:
293.2 		Subd. 2.Change in ownership. (a) If the commissioner determines that there is a change 
293.3 	in ownership, the commissioner shall require submission of a new license application. This 
293.4 	subdivision does not apply to a licensed program or service located in a home where the 
293.5 	license holder resides. A change in ownership occurs when:
293.6 	(1) except as provided in paragraph (b), the license holder sells or transfers 100 percent 
293.7 	of the property, stock, or assets;
293.8 	(2) the license holder merges with another organization;
293.9 	(3) the license holder consolidates with two or more organizations, resulting in the 
293.10 	creation of a new organization;
293.11 	(4) there is a change to the federal tax identification number associated with the license 
293.12 	holder; or
293.13 	(5) except as provided in paragraph (b),all controlling individuals associated with for
293.14 	the original application license have changed.
293.15 	(b) Notwithstanding For changes under paragraph (a), clauses (1) and (5) clause (1) or 
293.16 	(5), no change in ownership has occurred and a new license application is not required if 
293.17 	at least one controlling individual has been listed affiliated as a controlling individual for 
293.18 	the license for at least the previous 12 months immediately preceding the change.

293.19 	EFFECTIVE DATE. This section is effective January 1, 2025.

293.20 	Sec. 48. Laws 2024, chapter 80, article 2, section 6, subdivision 3, is amended to read:
293.21 		Subd. 3.Standard change of ownership process. (a) When a change in ownership is 
293.22 	proposed and the party intends to assume operation without an interruption in service longer 
293.23 	than 60 days after acquiring the program or service, the license holder must provide the 
293.24 	commissioner with written notice of the proposed change on a form provided by the 
293.25 	commissioner at least 60 90 days before the anticipated date of the change in ownership. 
293.26 	For purposes of this subdivision and subdivision 4 section, "party" means the party that 
293.27 	intends to operate the service or program.
293.28 	(b) The party must submit a license application under this chapter on the form and in 
293.29 	the manner prescribed by the commissioner at least 30 90 days before the change in 
293.30 	ownership is anticipated to be complete and must include documentation to support the 
293.31 	upcoming change. The party must comply with background study requirements under chapter 
293.32 	245C and shall pay the application fee required under section 245A.10.
294.1 	(c) The commissioner may streamline application procedures when the party is an existing 
294.2 	license holder under this chapter and is acquiring a program licensed under this chapter or 
294.3 	service in the same service class as one or more licensed programs or services the party 
294.4 	operates and those licenses are in substantial compliance. For purposes of this subdivision, 
294.5 	"substantial compliance" means within the previous 12 months the commissioner did not 
294.6 	(1) issue a sanction under section 245A.07 against a license held by the party, or (2) make 
294.7 	a license held by the party conditional according to section 245A.06.
294.8 	(d) Except when a temporary change in ownership license is issued pursuant to 
294.9 	subdivision 4 While the standard change of ownership process is pending, the existing 
294.10 	license holder is solely remains responsible for operating the program according to applicable 
294.11 	laws and rules until a license under this chapter is issued to the party.
294.12 	(e) If a licensing inspection of the program or service was conducted within the previous 
294.13 	12 months and the existing license holder's license record demonstrates substantial 
294.14 	compliance with the applicable licensing requirements, the commissioner may waive the 
294.15 	party's inspection required by section 245A.04, subdivision 4. The party must submit to the 
294.16 	commissioner (1) proof that the premises was inspected by a fire marshal or that the fire 
294.17 	marshal deemed that an inspection was not warranted, and (2) proof that the premises was 
294.18 	inspected for compliance with the building code or that no inspection was deemed warranted.
294.19 	(f) If the party is seeking a license for a program or service that has an outstanding action 
294.20 	under section 245A.06 or 245A.07, the party must submit a letter as part of the application 
294.21 	process identifying how the party has or will come into full compliance with the licensing 
294.22 	requirements.
294.23 	(g) The commissioner shall evaluate the party's application according to section 245A.04, 
294.24 	subdivision 6. If the commissioner determines that the party has remedied or demonstrates 
294.25 	the ability to remedy the outstanding actions under section 245A.06 or 245A.07 and has 
294.26 	determined that the program otherwise complies with all applicable laws and rules, the 
294.27 	commissioner shall issue a license or conditional license under this chapter. A conditional 
294.28 	license issued under this section is final and not subject to reconsideration under section 
294.29 	142B.16, subdivision 4. The conditional license remains in effect until the commissioner 
294.30 	determines that the grounds for the action are corrected or no longer exist.
294.31 	(h) The commissioner may deny an application as provided in section 245A.05. An 
294.32 	applicant whose application was denied by the commissioner may appeal the denial according 
294.33 	to section 245A.05.
295.1 	(i) This subdivision does not apply to a licensed program or service located in a home 
295.2 	where the license holder resides.

295.3 	EFFECTIVE DATE. This section is effective January 1, 2025.

295.4 	Sec. 49. Laws 2024, chapter 80, article 2, section 6, is amended by adding a subdivision 
295.5 	to read:
295.6 		Subd. 3a.Emergency change in ownership process.  (a) In the event of a death of a 
295.7 	license holder or sole controlling individual or a court order or other event that results in 
295.8 	the license holder being inaccessible or unable to operate the program or service, a party 
295.9 	may submit a request to the commissioner to allow the party to assume operation of the 
295.10 	program or service under an emergency change in ownership process to ensure persons 
295.11 	continue to receive services while the commissioner evaluates the party's license application.
295.12 	(b) To request the emergency change of ownership process, the party must immediately:
295.13 	(1) notify the commissioner of the event resulting in the inability of the license holder 
295.14 	to operate the program and of the party's intent to assume operations; and
295.15 	(2) provide the commissioner with documentation that demonstrates the party has a legal 
295.16 	or legitimate ownership interest in the program or service if applicable and is able to operate 
295.17 	the program or service.
295.18 	(c) If the commissioner approves the party to continue operating the program or service 
295.19 	under an emergency change in ownership process, the party must:
295.20 	(1) request to be added as a controlling individual or license holder to the existing license;
295.21 	(2) notify persons receiving services of the emergency change in ownership in a manner 
295.22 	approved by the commissioner;
295.23 	(3) submit an application for a new license within 30 days of approval;
295.24 	(4) comply with the background study requirements under chapter 245C; and
295.25 	(5) pay the application fee required under section 142B.12.
295.26 	(d) While the emergency change of ownership process is pending, a party approved 
295.27 	under this subdivision is responsible for operating the program under the existing license 
295.28 	according to applicable laws and rules until a new license under this chapter is issued.
295.29 	(e) The provisions in subdivision 3, paragraphs (c), (g), and (h), apply to this subdivision.
295.30 	(f) Once a party is issued a new license or has decided not to seek a new license, the 
295.31 	commissioner must close the existing license.
296.1 	(g) This subdivision applies to any program or service licensed under this chapter.

296.2 	EFFECTIVE DATE. This section is effective January 1, 2025.

296.3 	Sec. 50. Laws 2024, chapter 80, article 2, section 6, is amended by adding a subdivision 
296.4 	to read:
296.5 		Subd. 5.Failure to comply. If the commissioner finds that the applicant or license holder 
296.6 	has not fully complied with this section, the commissioner may impose a licensing sanction 
296.7 	under section 142B.15, 142B.16, or 142B.18.

296.8 	EFFECTIVE DATE. This section is effective January 1, 2025.

296.9 	Sec. 51. Laws 2024, chapter 80, article 2, section 10, subdivision 1, is amended to read:
296.10 		Subdivision 1.Sanctions; appeals; license. (a) In addition to making a license conditional 
296.11 	under section 142B.16, the commissioner may suspend or revoke the license, impose a fine, 
296.12 	or secure an injunction against the continuing operation of the program of a license holder 
296.13 	who:
296.14 	(1) does not comply with applicable law or rule;
296.15 	(2) has nondisqualifying background study information, as described in section 245C.05, 
296.16 	subdivision 4, that reflects on the license holder's ability to safely provide care to foster 
296.17 	children; or
296.18 	(3) has an individual living in the household where the licensed services are provided 
296.19 	or is otherwise subject to a background study, and the individual has nondisqualifying 
296.20 	background study information, as described in section 245C.05, subdivision 4, that reflects 
296.21 	on the license holder's ability to safely provide care to foster children.
296.22 	When applying sanctions authorized under this section, the commissioner shall consider 
296.23 	the nature, chronicity, or severity of the violation of law or rule and the effect of the violation 
296.24 	on the health, safety, or rights of persons served by the program.
296.25 	(b) If a license holder appeals the suspension or revocation of a license and the license 
296.26 	holder continues to operate the program pending a final order on the appeal, the commissioner 
296.27 	shall issue the license holder a temporary provisional license. Unless otherwise specified 
296.28 	by the commissioner, variances in effect on the date of the license sanction under appeal 
296.29 	continue under the temporary provisional license. The commissioner may include terms the 
296.30 	license holder must follow pending a final order on the appeal.If a license holder fails to 
296.31 	comply with applicable law or rule while operating under a temporary provisional license, 
297.1 	the commissioner may impose additional sanctions under this section and section 142B.16
297.2 	and may terminate any prior variance. If a temporary provisional license is set to expire, a 
297.3 	new temporary provisional license shall be issued to the license holder upon payment of 
297.4 	any fee required under section 142B.12. The temporary provisional license shall expire on 
297.5 	the date the final order is issued. If the license holder prevails on the appeal, a new 
297.6 	nonprovisional license shall be issued for the remainder of the current license period.
297.7 	(c) If a license holder is under investigation and the license issued under this chapter is 
297.8 	due to expire before completion of the investigation, the program shall be issued a new 
297.9 	license upon completion of the reapplication requirements and payment of any applicable 
297.10 	license fee. Upon completion of the investigation, a licensing sanction may be imposed 
297.11 	against the new license under this section or section 142B.16 or 142B.20.
297.12 	(d) Failure to reapply or closure of a license issued under this chapter by the license 
297.13 	holder prior to the completion of any investigation shall not preclude the commissioner 
297.14 	from issuing a licensing sanction under this section or section 142B.16 at the conclusion of 
297.15 	the investigation.

297.16 	EFFECTIVE DATE. This section is effective January 1, 2025.

297.17 	Sec. 52. REVISOR INSTRUCTION.
 297.18 	The revisor of statutes shall renumber Minnesota Statutes, section 256D.21, as Minnesota 
297.19 	Statutes, section 261.004.

297.20 	Sec. 53. REPEALER.
 297.21 	(a) Minnesota Statutes 2022, sections 256D.19, subdivisions 1 and 2; 256D.20, 
297.22 	subdivisions 1, 2, 3, and 4; and 256D.23, subdivisions 1, 2, and 3, are repealed.
297.23 	(b) Minnesota Statutes 2022, section 245C.125, is repealed.
297.24 	(c) Minnesota Statutes 2023 Supplement, section 245C.08, subdivision 2, is repealed.
297.25 	(d) Laws 2024, chapter 80, article 2, section 6, subdivision 4, is repealed.

297.26 	EFFECTIVE DATE. Paragraph (a) is effective the day following final enactment.

298.1 	ARTICLE 10
298.2 	OFFICE OF EMERGENCY MEDICAL SERVICES

298.3 	Section 1. Minnesota Statutes 2022, section 144E.001, is amended by adding a subdivision 
298.4 	to read:
298.5 		Subd. 16.Director. "Director" means the director of the Office of Emergency Medical 
298.6 	Services.

298.7 	EFFECTIVE DATE. This section is effective January 1, 2025.

298.8 	Sec. 2. Minnesota Statutes 2022, section 144E.001, is amended by adding a subdivision 
298.9 	to read:
298.10 		Subd. 17.Office. "Office" means the Office of Emergency Medical Services.

298.11 	EFFECTIVE DATE. This section is effective January 1, 2025.

298.12 	Sec. 3. [144E.011] OFFICE OF EMERGENCY MEDICAL SERVICES.
298.13 		Subdivision 1.Establishment. The Office of Emergency Medical Services is established 
298.14 	with the powers and duties established in law. In administering this chapter, the office must 
298.15 	promote the public health and welfare, protect the safety of the public, and effectively 
298.16 	regulate and support the operation of the emergency medical services system in this state.
298.17 		Subd. 2.Director. The governor must appoint a director for the office with the advice 
298.18 	and consent of the senate. The director must be in the unclassified service and must serve 
298.19 	at the pleasure of the governor. The salary of the director shall be determined according to 
298.20 	section 15A.0815. The director shall direct the activities of the office.
298.21 		Subd. 3.Powers and duties. The director has the following powers and duties:
298.22 	(1) to administer and enforce this chapter and adopt rules as needed to implement this 
298.23 	chapter. Rules for which notice is published in the State Register before July 1, 2026, may 
298.24 	be adopted using the expedited rulemaking process in section 14.389;
298.25 	(2) to license ambulance services in the state and regulate their operation;
298.26 	(3) to establish and modify primary service areas;
298.27 	(4) to designate an ambulance service as authorized to provide service in a primary 
298.28 	service area and to remove an ambulance service's authorization to provide service in a 
298.29 	primary service area;
298.30 	(5) to register medical response units in the state and regulate their operation;
299.1 	(6) to certify emergency medical technicians, advanced emergency medical technicians, 
299.2 	community emergency medical technicians, paramedics, and community paramedics and 
299.3 	to register emergency medical responders;
299.4 	(7) to approve education programs for ambulance service personnel and emergency 
299.5 	medical responders and to administer qualifications for instructors of education programs;
299.6 	(8) to administer grant programs related to emergency medical services;
299.7 	(9) to report to the legislature, by February 15 each year, on the work of the office and 
299.8 	the advisory councils in the previous calendar year and with recommendations for any 
299.9 	needed policy changes related to emergency medical services, including but not limited to 
299.10 	improving access to emergency medical services, improving service delivery by ambulance 
299.11 	services and medical response units, and improving the effectiveness of the state's emergency 
299.12 	medical services system. The director must develop the reports and recommendations in 
299.13 	consultation with the office's deputy directors and advisory councils;
299.14 	(10) to investigate complaints against and hold hearings regarding ambulance services, 
299.15 	ambulance service personnel, and emergency medical responders and to impose disciplinary 
299.16 	action or otherwise resolve complaints; and
299.17 	(11) to perform other duties related to the provision of emergency medical services in 
299.18 	the state.
299.19 		Subd. 4.Employees. The director may employ personnel in the classified service and 
299.20 	unclassified personnel as necessary to carry out the duties of this chapter.
299.21 		Subd. 5.Work plan. The director must prepare a work plan to guide the work of the 
299.22 	office. The work plan must be updated biennially.

299.23 	EFFECTIVE DATE. This section is effective January 1, 2025.

299.24 	Sec. 4. [144E.015] MEDICAL SERVICES DIVISION.
299.25 	A Medical Services Division is created in the Office of Emergency Medical Services. 
299.26 	The Medical Services Division shall be under the supervision of a deputy director of medical 
299.27 	services appointed by the director. The deputy director of medical services must be a 
299.28 	physician licensed under chapter 147. The deputy director, under the direction of the director, 
299.29 	shall enforce and coordinate the laws, rules, and policies assigned by the director, which 
299.30 	may include overseeing the clinical aspects of prehospital medical care and education 
299.31 	programs for emergency medical service personnel.

299.32 	EFFECTIVE DATE. This section is effective January 1, 2025.

300.1 	Sec. 5. [144E.016] AMBULANCE SERVICES DIVISION.
300.2 	An Ambulance Services Division is created in the Office of Emergency Medical Services. 
300.3 	The Ambulance Services Division shall be under the supervision of a deputy director of 
300.4 	ambulance services appointed by the director. The deputy director, under the direction of 
300.5 	the director, shall enforce and coordinate the laws, rules, and policies assigned by the director, 
300.6 	which may include operating standards and licensing of ambulance services; registration 
300.7 	and operation of medical response units; establishment and modification of primary service 
300.8 	areas; authorization of ambulance services to provide service in a primary service area and 
300.9 	revocation of such authorization; coordination of ambulance services within regions and 
300.10 	across the state; and administration of grants.

300.11 	EFFECTIVE DATE. This section is effective January 1, 2025.

300.12 	Sec. 6. [144E.017] EMERGENCY MEDICAL SERVICE PROVIDERS DIVISION.
300.13 	An Emergency Medical Service Providers Division is created in the Office of Emergency 
300.14 	Medical Services. The Emergency Medical Service Providers Division shall be under the 
300.15 	supervision of a deputy director of emergency medical service providers appointed by the 
300.16 	director. The deputy director, under the direction of the director, shall enforce and coordinate 
300.17 	the laws, rules, and policies assigned by the director, which may include certification and 
300.18 	registration of individual emergency medical service providers; overseeing worker safety, 
300.19 	worker well-being, and working conditions; implementation of education programs; and 
300.20 	administration of grants.

300.21 	EFFECTIVE DATE. This section is effective January 1, 2025.

300.22 	Sec. 7. [144E.03] EMERGENCY MEDICAL SERVICES ADVISORY COUNCIL.
300.23 		Subdivision 1.Establishment; membership. The Emergency Medical Services Advisory 
300.24 	Council is established and consists of the following members:
300.25 	(1) one emergency medical technician currently practicing with a licensed ambulance 
300.26 	service, appointed by the Minnesota Ambulance Association;
300.27 	(2) one paramedic currently practicing with a licensed ambulance service or a medical 
300.28 	response unit, appointed jointly by the Minnesota Professional Fire Fighters Association 
300.29 	and the Minnesota Ambulance Association;
300.30 	(3) one medical director of a licensed ambulance service, appointed by the National 
300.31 	Association of EMS Physicians, Minnesota Chapter;
301.1 	(4) one firefighter currently serving as an emergency medical responder, appointed by 
301.2 	the Minnesota State Fire Chiefs Association;
301.3 	(5) one registered nurse who is certified or currently practicing as a flight nurse, appointed 
301.4 	jointly by the regional emergency services boards of the designated regional emergency 
301.5 	medical services systems;
301.6 	(6) one hospital administrator, appointed by the Minnesota Hospital Association;
301.7 	(7) one social worker, appointed by the Board of Social Work;
301.8 	(8) one member of a federally recognized Tribal Nation in Minnesota, appointed by the 
301.9 	Minnesota Indian Affairs Council;
301.10 	(9) three public members, appointed by the governor. At least one of the public members 
301.11 	must reside outside the metropolitan counties listed in section 473.121, subdivision 4;
301.12 	(10) one member with experience working as an employee organization representative 
301.13 	representing emergency medical service providers, appointed by an employee organization 
301.14 	representing emergency medical service providers;
301.15 	(11) one member representing a local government, appointed by the Coalition of Greater 
301.16 	Minnesota Cities;
301.17 	(12) one member representing a local government in the seven-county metropolitan area, 
301.18 	appointed by the League of Minnesota Cities;
301.19 	(13) two members of the house of representatives and two members of the senate, 
301.20 	appointed according to subdivision 2; and
301.21 	(14) the commissioner of health and commissioner of public safety or their designees 
301.22 	as ex officio members.
301.23 		Subd. 2.Legislative members. The speaker of the house and the house minority leader 
301.24 	must each appoint one member of the house of representatives to serve on the advisory 
301.25 	council. The senate majority leader and the senate minority leader must each appoint one 
301.26 	member of the senate to serve on the advisory council. Legislative members appointed under 
301.27 	this subdivision serve until successors are appointed. Legislative members may receive per 
301.28 	diem compensation and reimbursement for expenses according to the rules of their respective 
301.29 	bodies.
301.30 		Subd. 3.Terms, compensation, removal, vacancies, and expiration. Compensation 
301.31 	and reimbursement for expenses for members appointed under subdivision 1, clauses (1) 
301.32 	to (12); removal of members; filling of vacancies of members; and, except for initial 
302.1 	appointments, membership terms are governed by section 15.059. Notwithstanding section 
302.2 	15.059, subdivision 6, the advisory council does not expire.
302.3 		Subd. 4.Officers; meetings. (a) The advisory council must elect a chair and vice-chair 
302.4 	from among its membership and may elect other officers as the advisory council deems 
302.5 	necessary.
302.6 	(b) The advisory council must meet quarterly or at the call of the chair.
302.7 	(c) Meetings of the advisory council are subject to chapter 13D.
302.8 		Subd. 5.Duties. The advisory council must review and make recommendations to the 
302.9 	director and the deputy director of ambulance services on the administration of this chapter; 
302.10 	the regulation of ambulance services and medical response units; the operation of the 
302.11 	emergency medical services system in the state; and other topics as directed by the director.

302.12 	EFFECTIVE DATE. This section is effective January 1, 2025.

302.13 	Sec. 8. [144E.035] EMERGENCY MEDICAL SERVICES PHYSICIAN ADVISORY 
302.14 	COUNCIL.
302.15 		Subdivision 1.Establishment; membership. The Emergency Medical Services Physician 
302.16 	Advisory Council is established and consists of the following members:
302.17 	(1) eight physicians who meet the qualifications for medical directors in section 144E.265, 
302.18 	subdivision 1, with one physician appointed by each of the regional emergency services 
302.19 	boards of the designated regional emergency medical services systems;
302.20 	(2) one physician who meets the qualifications for medical directors in section 144E.265, 
302.21 	subdivision 1, appointed by the Minnesota State Fire Chiefs Association;
302.22 	(3) one physician who is board-certified in pediatrics, appointed by the Minnesota 
302.23 	Emergency Medical Services for Children program; and
302.24 	(4) the medical director member of the Emergency Medical Services Advisory Council 
302.25 	appointed under section 144E.03, subdivision 1, clause (3).
302.26 		Subd. 2.Terms, compensation, removal, vacancies, and expiration. Compensation 
302.27 	and reimbursement for expenses, removal of members, filling of vacancies of members, 
302.28 	and, except for initial appointments, membership terms are governed by section 15.059. 
302.29 	Notwithstanding section 15.059, subdivision 6, the advisory council shall not expire.
302.30 		Subd. 3.Officers; meetings. (a) The advisory council must elect a chair and vice-chair 
302.31 	from among its membership and may elect other officers as it deems necessary.
303.1 	(b) The advisory council must meet twice per year or upon the call of the chair.
303.2 	(c) Meetings of the advisory council are subject to chapter 13D.
303.3 		Subd. 4.Duties. The advisory council must:
303.4 	(1) review and make recommendations to the director and deputy director of medical 
303.5 	services on clinical aspects of prehospital medical care. In doing so, the advisory council 
303.6 	must incorporate information from medical literature, advances in bedside clinical practice, 
303.7 	and advisory council member experience; and
303.8 	(2) serve as subject matter experts for the director and deputy director of medical services 
303.9 	on evolving topics in clinical medicine, including but not limited to infectious disease, 
303.10 	pharmaceutical and equipment shortages, and implementation of new therapeutics.

303.11 	EFFECTIVE DATE. This section is effective January 1, 2025.

303.12 	Sec. 9. [144E.04] LABOR AND EMERGENCY MEDICAL SERVICE PROVIDERS 
303.13 	ADVISORY COUNCIL.
303.14 		Subdivision 1.Establishment; membership. The Labor and Emergency Medical Service 
303.15 	Providers Advisory Council is established and consists of the following members:
303.16 	(1) one emergency medical service provider of any type from each of the designated 
303.17 	regional emergency medical services systems, appointed by their respective regional 
303.18 	emergency services boards;
303.19 	(2) one emergency medical technician instructor, appointed by an employee organization 
303.20 	representing emergency medical service providers;
303.21 	(3) two members with experience working as an employee organization representative 
303.22 	representing emergency medical service providers, appointed by an employee organization 
303.23 	representing emergency medical service providers;
303.24 	(4) one emergency medical service provider based in a fire department, appointed jointly 
303.25 	by the Minnesota State Fire Chiefs Association and the Minnesota Professional Fire Fighters 
303.26 	Association; and
303.27 	(5) one emergency medical service provider not based in a fire department, appointed 
303.28 	by the League of Minnesota Cities.
303.29 		Subd. 2.Terms, compensation, removal, vacancies, and expiration. Compensation 
303.30 	and reimbursement for expenses for members appointed under subdivision 1; removal of 
303.31 	members; filling of vacancies of members; and, except for initial appointments, membership 
304.1 	terms are governed by section 15.059. Notwithstanding section 15.059, subdivision 6, the 
304.2 	Labor and Emergency Medical Service Providers Advisory Council does not expire.
304.3 		Subd. 3.Officers; meetings. (a) The Labor and Emergency Medical Service Providers 
304.4 	Advisory Council must elect a chair and vice-chair from among its membership and may 
304.5 	elect other officers as the advisory council deems necessary.
304.6 	(b) The Labor and Emergency Medical Service Providers Advisory Council must meet 
304.7 	quarterly or at the call of the chair.
304.8 	(c) Meetings of the Labor and Emergency Medical Service Providers Advisory Council 
304.9 	are subject to chapter 13D.
304.10 		Subd. 4.Duties. The Labor and Emergency Medical Service Providers Advisory Council 
304.11 	must review and make recommendations to the director and deputy director of emergency 
304.12 	medical service providers on the laws, rules, and policies assigned to the Emergency Medical 
304.13 	Service Providers Division and other topics as directed by the director.

304.14 	EFFECTIVE DATE. This section is effective January 1, 2025.

304.15 	Sec. 10. Minnesota Statutes 2022, section 144E.16, subdivision 5, is amended to read:
304.16 		Subd. 5.Local government's powers. (a) Local units of government may, with the 
304.17 	approval of the board director, establish standards for ambulance services which impose 
304.18 	additional requirements upon such services. Local units of government intending to impose 
304.19 	additional requirements shall consider whether any benefit accruing to the public health 
304.20 	would outweigh the costs associated with the additional requirements.
304.21 	(b) Local units of government that desire to impose additional requirements shall, prior 
304.22 	to adoption of relevant ordinances, rules, or regulations, furnish the board director with a 
304.23 	copy of the proposed ordinances, rules, or regulations, along with information that 
304.24 	affirmatively substantiates that the proposed ordinances, rules, or regulations:
304.25 	(1) will in no way conflict with the relevant rules of the board office;
304.26 	(2) will establish additional requirements tending to protect the public health;
304.27 	(3) will not diminish public access to ambulance services of acceptable quality; and
304.28 	(4) will not interfere with the orderly development of regional systems of emergency 
304.29 	medical care.
304.30 	(c) The board director shall base any decision to approve or disapprove local standards 
304.31 	upon whether or not the local unit of government in question has affirmatively substantiated 
305.1 	that the proposed ordinances, rules, or regulations meet the criteria specified in paragraph 
305.2 	(b).

305.3 	EFFECTIVE DATE. This section is effective January 1, 2025.

305.4 	Sec. 11. Minnesota Statutes 2022, section 144E.19, subdivision 3, is amended to read:
305.5 		Subd. 3.Temporary suspension. (a) In addition to any other remedy provided by law, 
305.6 	the board director may temporarily suspend the license of a licensee after conducting a 
305.7 	preliminary inquiry to determine whether the boarddirector believes that the licensee has 
305.8 	violated a statute or rule that the board director is empowered to enforce and determining 
305.9 	that the continued provision of service by the licensee would create an imminent risk to 
305.10 	public health or harm to others.
305.11 	(b) A temporary suspension order prohibiting a licensee from providing ambulance 
305.12 	service shall give notice of the right to a preliminary hearing according to paragraph (d) 
305.13 	and shall state the reasons for the entry of the temporary suspension order.
305.14 	(c) Service of a temporary suspension order is effective when the order is served on the 
305.15 	licensee personally or by certified mail, which is complete upon receipt, refusal, or return 
305.16 	for nondelivery to the most recent address provided to the board director for the licensee.
305.17 	(d) At the time the board director issues a temporary suspension order, the board director
305.18 	shall schedule a hearing, to be held before a group of its members designated by the board,
305.19 	that shall begin within 60 days after issuance of the temporary suspension order or within 
305.20 	15 working days of the date of the board's director's receipt of a request for a hearing from 
305.21 	a licensee, whichever is sooner. The hearing shall be on the sole issue of whether there is 
305.22 	a reasonable basis to continue, modify, or lift the temporary suspension. A hearing under 
305.23 	this paragraph is not subject to chapter 14.
305.24 	(e) Evidence presented by the board director or licensee may be in the form of an affidavit. 
305.25 	The licensee or the licensee's designee may appear for oral argument.
305.26 	(f) Within five working days of the hearing, the board director shall issue its order and, 
305.27 	if the suspension is continued, notify the licensee of the right to a contested case hearing 
305.28 	under chapter 14.
305.29 	(g) If a licensee requests a contested case hearing within 30 days after receiving notice 
305.30 	under paragraph (f), the boarddirector shall initiate a contested case hearing according to 
305.31 	chapter 14. The administrative law judge shall issue a report and recommendation within 
305.32 	30 days after the closing of the contested case hearing record. The board director shall issue 
305.33 	a final order within 30 days after receipt of the administrative law judge's report.

306.1 	EFFECTIVE DATE. This section is effective January 1, 2025.

306.2 	Sec. 12. Minnesota Statutes 2022, section 144E.27, subdivision 5, is amended to read:
306.3 		Subd. 5.Denial, suspension, revocation. (a) The boarddirector may deny, suspend, 
306.4 	revoke, place conditions on, or refuse to renew the registration of an individual who the 
306.5 	boarddirector determines:
306.6 	(1) violates sections 144E.001 to 144E.33 or the rules adopted under those sections, an 
306.7 	agreement for corrective action, or an order that the boarddirector issued or is otherwise 
306.8 	empowered to enforce;
306.9 	(2) misrepresents or falsifies information on an application form for registration;
306.10 	(3) is convicted or pleads guilty or nolo contendere to any felony; any gross misdemeanor 
306.11 	relating to assault, sexual misconduct, theft, or the illegal use of drugs or alcohol; or any 
306.12 	misdemeanor relating to assault, sexual misconduct, theft, or the illegal use of drugs or 
306.13 	alcohol;
306.14 	(4) is actually or potentially unable to provide emergency medical services with 
306.15 	reasonable skill and safety to patients by reason of illness, use of alcohol, drugs, chemicals, 
306.16 	or any other material, or as a result of any mental or physical condition;
306.17 	(5) engages in unethical conduct, including, but not limited to, conduct likely to deceive, 
306.18 	defraud, or harm the public, or demonstrating a willful or careless disregard for the health, 
306.19 	welfare, or safety of the public;
306.20 	(6) maltreats or abandons a patient;
306.21 	(7) violates any state or federal controlled substance law;
306.22 	(8) engages in unprofessional conduct or any other conduct which has the potential for 
306.23 	causing harm to the public, including any departure from or failure to conform to the 
306.24 	minimum standards of acceptable and prevailing practice without actual injury having to 
306.25 	be established;
306.26 	(9) provides emergency medical services under lapsed or nonrenewed credentials;
306.27 	(10) is subject to a denial, corrective, disciplinary, or other similar action in another 
306.28 	jurisdiction or by another regulatory authority;
306.29 	(11) engages in conduct with a patient that is sexual or may reasonably be interpreted 
306.30 	by the patient as sexual, or in any verbal behavior that is seductive or sexually demeaning 
306.31 	to a patient; or
307.1 	(12) makes a false statement or knowingly provides false information to the board
307.2 	director, or fails to cooperate with an investigation of the boarddirector as required by 
307.3 	section 144E.30.; or
307.4 	(13) fails to engage with the health professionals services program or diversion program 
307.5 	required under section 144E.287 after being referred to the program, violates the terms of 
307.6 	the program participation agreement, or leaves the program except upon fulfilling the terms 
307.7 	for successful completion of the program as set forth in the participation agreement.
307.8 	(b) Before taking action under paragraph (a), the boarddirector shall give notice to an 
307.9 	individual of the right to a contested case hearing under chapter 14. If an individual requests 
307.10 	a contested case hearing within 30 days after receiving notice, the boarddirector shall initiate 
307.11 	a contested case hearing according to chapter 14.
307.12 	(c) The administrative law judge shall issue a report and recommendation within 30 
307.13 	days after closing the contested case hearing record. The boarddirector shall issue a final 
307.14 	order within 30 days after receipt of the administrative law judge's report.
307.15 	(d) After six months from the board'sdirector's decision to deny, revoke, place conditions 
307.16 	on, or refuse renewal of an individual's registration for disciplinary action, the individual 
307.17 	shall have the opportunity to apply to the boarddirector for reinstatement.

307.18 	EFFECTIVE DATE. This section is effective January 1, 2025.

307.19 	Sec. 13. Minnesota Statutes 2022, section 144E.28, subdivision 5, is amended to read:
307.20 		Subd. 5.Denial, suspension, revocation. (a) The boarddirector may deny certification 
307.21 	or take any action authorized in subdivision 4 against an individual who the boarddirector 
307.22 	determines:
307.23 	(1) violates sections 144E.001 to 144E.33 or the rules adopted under those sections, or 
307.24 	an order that the boarddirector issued or is otherwise authorized or empowered to enforce, 
307.25 	or agreement for corrective action;
307.26 	(2) misrepresents or falsifies information on an application form for certification;
307.27 	(3) is convicted or pleads guilty or nolo contendere to any felony; any gross misdemeanor 
307.28 	relating to assault, sexual misconduct, theft, or the illegal use of drugs or alcohol; or any 
307.29 	misdemeanor relating to assault, sexual misconduct, theft, or the illegal use of drugs or 
307.30 	alcohol;
308.1 	(4) is actually or potentially unable to provide emergency medical services with 
308.2 	reasonable skill and safety to patients by reason of illness, use of alcohol, drugs, chemicals, 
308.3 	or any other material, or as a result of any mental or physical condition;
308.4 	(5) engages in unethical conduct, including, but not limited to, conduct likely to deceive, 
308.5 	defraud, or harm the public or demonstrating a willful or careless disregard for the health, 
308.6 	welfare, or safety of the public;
308.7 	(6) maltreats or abandons a patient;
308.8 	(7) violates any state or federal controlled substance law;
308.9 	(8) engages in unprofessional conduct or any other conduct which has the potential for 
308.10 	causing harm to the public, including any departure from or failure to conform to the 
308.11 	minimum standards of acceptable and prevailing practice without actual injury having to 
308.12 	be established;
308.13 	(9) provides emergency medical services under lapsed or nonrenewed credentials;
308.14 	(10) is subject to a denial, corrective, disciplinary, or other similar action in another 
308.15 	jurisdiction or by another regulatory authority;
308.16 	(11) engages in conduct with a patient that is sexual or may reasonably be interpreted 
308.17 	by the patient as sexual, or in any verbal behavior that is seductive or sexually demeaning 
308.18 	to a patient; or
308.19 	(12) makes a false statement or knowingly provides false information to the boarddirector 
308.20 	or fails to cooperate with an investigation of the boarddirector as required by section 
308.21 	144E.30.; or
308.22 	(13) fails to engage with the health professionals services program or diversion program 
308.23 	required under section 144E.287 after being referred to the program, violates the terms of 
308.24 	the program participation agreement, or leaves the program except upon fulfilling the terms 
308.25 	for successful completion of the program as set forth in the participation agreement.
308.26 	(b) Before taking action under paragraph (a), the boarddirector shall give notice to an 
308.27 	individual of the right to a contested case hearing under chapter 14. If an individual requests 
308.28 	a contested case hearing within 30 days after receiving notice, the boarddirector shall initiate 
308.29 	a contested case hearing according to chapter 14 and no disciplinary action shall be taken 
308.30 	at that time.
309.1 	(c) The administrative law judge shall issue a report and recommendation within 30 
309.2 	days after closing the contested case hearing record. The boarddirector shall issue a final 
309.3 	order within 30 days after receipt of the administrative law judge's report.
309.4 	(d) After six months from the board'sdirector's decision to deny, revoke, place conditions 
309.5 	on, or refuse renewal of an individual's certification for disciplinary action, the individual 
309.6 	shall have the opportunity to apply to the boarddirector for reinstatement.

309.7 	EFFECTIVE DATE. This section is effective January 1, 2025.

309.8 	Sec. 14. Minnesota Statutes 2022, section 144E.28, subdivision 6, is amended to read:
309.9 		Subd. 6.Temporary suspension. (a) In addition to any other remedy provided by law, 
309.10 	the board director may temporarily suspend the certification of an individual after conducting 
309.11 	a preliminary inquiry to determine whether the board director believes that the individual 
309.12 	has violated a statute or rule that the board director is empowered to enforce and determining 
309.13 	that the continued provision of service by the individual would create an imminent risk to 
309.14 	public health or harm to others.
309.15 	(b) A temporary suspension order prohibiting an individual from providing emergency 
309.16 	medical care shall give notice of the right to a preliminary hearing according to paragraph 
309.17 	(d) and shall state the reasons for the entry of the temporary suspension order.
309.18 	(c) Service of a temporary suspension order is effective when the order is served on the 
309.19 	individual personally or by certified mail, which is complete upon receipt, refusal, or return 
309.20 	for nondelivery to the most recent address provided to the board director for the individual.
309.21 	(d) At the time the board director issues a temporary suspension order, the board director
309.22 	shall schedule a hearing, to be held before a group of its members designated by the board,
309.23 	that shall begin within 60 days after issuance of the temporary suspension order or within 
309.24 	15 working days of the date of the board's director's receipt of a request for a hearing from 
309.25 	the individual, whichever is sooner. The hearing shall be on the sole issue of whether there 
309.26 	is a reasonable basis to continue, modify, or lift the temporary suspension. A hearing under 
309.27 	this paragraph is not subject to chapter 14.
309.28 	(e) Evidence presented by the board director or the individual may be in the form of an 
309.29 	affidavit. The individual or individual's designee may appear for oral argument.
309.30 	(f) Within five working days of the hearing, the board director shall issue its order and, 
309.31 	if the suspension is continued, notify the individual of the right to a contested case hearing 
309.32 	under chapter 14.
310.1 	(g) If an individual requests a contested case hearing within 30 days of receiving notice 
310.2 	under paragraph (f), the board director shall initiate a contested case hearing according to 
310.3 	chapter 14. The administrative law judge shall issue a report and recommendation within 
310.4 	30 days after the closing of the contested case hearing record. The board director shall issue 
310.5 	a final order within 30 days after receipt of the administrative law judge's report.

310.6 	EFFECTIVE DATE. This section is effective January 1, 2025.

310.7 	Sec. 15. Minnesota Statutes 2022, section 144E.285, subdivision 6, is amended to read:
310.8 		Subd. 6.Temporary suspension. (a) In addition to any other remedy provided by law, 
310.9 	the board director may temporarily suspend approval of the education program after 
310.10 	conducting a preliminary inquiry to determine whether the board director believes that the 
310.11 	education program has violated a statute or rule that the board director is empowered to 
310.12 	enforce and determining that the continued provision of service by the education program 
310.13 	would create an imminent risk to public health or harm to others.
310.14 	(b) A temporary suspension order prohibiting the education program from providing 
310.15 	emergency medical care training shall give notice of the right to a preliminary hearing 
310.16 	according to paragraph (d) and shall state the reasons for the entry of the temporary 
310.17 	suspension order.
310.18 	(c) Service of a temporary suspension order is effective when the order is served on the 
310.19 	education program personally or by certified mail, which is complete upon receipt, refusal, 
310.20 	or return for nondelivery to the most recent address provided to the board director for the 
310.21 	education program.
310.22 	(d) At the time the board director issues a temporary suspension order, the board director
310.23 	shall schedule a hearing, to be held before a group of its members designated by the board,
310.24 	that shall begin within 60 days after issuance of the temporary suspension order or within 
310.25 	15 working days of the date of the board's director's receipt of a request for a hearing from 
310.26 	the education program, whichever is sooner. The hearing shall be on the sole issue of whether 
310.27 	there is a reasonable basis to continue, modify, or lift the temporary suspension. A hearing 
310.28 	under this paragraph is not subject to chapter 14.
310.29 	(e) Evidence presented by the board director or the individual may be in the form of an 
310.30 	affidavit. The education program or counsel of record may appear for oral argument.
310.31 	(f) Within five working days of the hearing, the board director shall issue its order and, 
310.32 	if the suspension is continued, notify the education program of the right to a contested case 
310.33 	hearing under chapter 14.
311.1 	(g) If an education program requests a contested case hearing within 30 days of receiving 
311.2 	notice under paragraph (f), the board director shall initiate a contested case hearing according 
311.3 	to chapter 14. The administrative law judge shall issue a report and recommendation within 
311.4 	30 days after the closing of the contested case hearing record. The board director shall issue 
311.5 	a final order within 30 days after receipt of the administrative law judge's report.

311.6 	EFFECTIVE DATE. This section is effective January 1, 2025.

311.7 	Sec. 16. Minnesota Statutes 2022, section 144E.287, is amended to read:
311.8 	144E.287 DIVERSION PROGRAM.
311.9 	The board director shall either conduct a health professionals service services program 
311.10 	under sections 214.31 to 214.37 or contract for a diversion program under section 214.28
311.11 	for professionals regulated by the board under this chapter who are unable to perform their 
311.12 	duties with reasonable skill and safety by reason of illness, use of alcohol, drugs, chemicals, 
311.13 	or any other materials, or as a result of any mental, physical, or psychological condition.

311.14 	EFFECTIVE DATE. This section is effective January 1, 2025.

311.15 	Sec. 17. Minnesota Statutes 2022, section 144E.305, subdivision 3, is amended to read:
311.16 		Subd. 3.Immunity. (a) An individual, licensee, health care facility, business, or 
311.17 	organization is immune from civil liability or criminal prosecution for submitting in good 
311.18 	faith a report to the boarddirector under subdivision 1 or 2 or for otherwise reporting in 
311.19 	good faith to the boarddirector violations or alleged violations of sections 144E.001 to 
311.20 	144E.33. Reports are classified as confidential data on individuals or protected nonpublic 
311.21 	data under section 13.02 while an investigation is active. Except for the board'sdirector's 
311.22 	final determination, all communications or information received by or disclosed to the board
311.23 	director relating to disciplinary matters of any person or entity subject to the board'sdirector's 
311.24 	regulatory jurisdiction are confidential and privileged and any disciplinary hearing shall be 
311.25 	closed to the public.
311.26 	(b) Members of the board The director, persons employed by the board director, persons 
311.27 	engaged in the investigation of violations and in the preparation and management of charges 
311.28 	of violations of sections 144E.001 to 144E.33 on behalf of the board director, and persons 
311.29 	participating in the investigation regarding charges of violations are immune from civil 
311.30 	liability and criminal prosecution for any actions, transactions, or publications, made in 
311.31 	good faith, in the execution of, or relating to, their duties under sections 144E.001 to 144E.33.
312.1 	(c) For purposes of this section, a member of the board is considered a state employee 
312.2 	under section 3.736, subdivision 9.

312.3 	EFFECTIVE DATE. This section is effective January 1, 2025.

312.4 	Sec. 18. INITIAL MEMBERS AND FIRST MEETING; EMERGENCY MEDICAL 
312.5 	SERVICES ADVISORY COUNCIL.
 312.6 	(a) Initial appointments of members to the Emergency Medical Services Advisory 
312.7 	Council must be made by January 1, 2025. The terms of initial appointees shall be determined 
312.8 	by lot by the secretary of state and shall be as follows:
312.9 	(1) eight members shall serve two-year terms; and
312.10 	(2) eight members shall serve three-year terms.
312.11 	(b) The medical director appointee must convene the first meeting of the Emergency 
312.12 	Medical Services Advisory Council by February 1, 2025.

312.13 	Sec. 19. INITIAL MEMBERS AND FIRST MEETING; EMERGENCY MEDICAL 
312.14 	SERVICES PHYSICIAN ADVISORY COUNCIL.
 312.15 	(a) Initial appointments of members to the Emergency Medical Services Physician 
312.16 	Advisory Council must be made by January 1, 2025. The terms of initial appointees shall 
312.17 	be determined by lot by the secretary of state and shall be as follows:
312.18 	(1) five members shall serve two-year terms;
312.19 	(2) five members shall serve three-year terms; and
312.20 	(3) the term for the medical director appointee to the Emergency Medical Services 
312.21 	Physician Advisory Council shall coincide with that member's term on the Emergency 
312.22 	Medical Services Advisory Council.
312.23 	(b) The medical director appointee must convene the first meeting of the Emergency 
312.24 	Medical Services Physician Advisory Council by February 1, 2025.

312.25 	Sec. 20. INITIAL MEMBERS AND FIRST MEETING; LABOR AND EMERGENCY 
312.26 	MEDICAL SERVICE PROVIDERS ADVISORY COUNCIL.
 312.27 	(a) Initial appointments of members to the Labor and Emergency Medical Service 
312.28 	Providers Advisory Council must be made by January 1, 2025. The terms of initial appointees 
312.29 	shall be determined by lot by the secretary of state and shall be as follows:
312.30 	(1) six members shall serve two-year terms; and
313.1 	(2) seven members shall serve three-year terms.
313.2 	(b) The emergency medical technician instructor appointee must convene the first meeting 
313.3 	of the Labor and Emergency Medical Service Providers Advisory Council by February 1, 
313.4 	2025.

313.5 	Sec. 21. TRANSITION.
 313.6 		Subdivision 1.Appointment of director; operation of office. No later than October 
313.7 	1, 2024, the governor shall appoint a director-designee of the Office of Emergency Medical 
313.8 	Services. The individual appointed as the director-designee of the Office of Emergency 
313.9 	Medical Services shall become the governor's appointee as director of the Office of 
313.10 	Emergency Medical Services on January 1, 2025. Effective January 1, 2025, the 
313.11 	responsibilities to regulate emergency medical services in the state under Minnesota Statutes, 
313.12 	chapter 144E, and Minnesota Rules, chapter 4690, are transferred from the Emergency 
313.13 	Medical Services Regulatory Board to the Office of Emergency Medical Services and the 
313.14 	director of the Office of Emergency Medical Services.
313.15 		Subd. 2.Transfer of responsibilities. Minnesota Statutes, section 15.039, applies to 
313.16 	the transfer of responsibilities from the Emergency Medical Services Regulatory Board to 
313.17 	the Office of Emergency Medical Services required by this act. The commissioner of 
313.18 	administration, with the approval of the governor, may issue reorganization orders under 
313.19 	Minnesota Statutes, section 16B.37, as necessary to carry out the transfer of responsibilities 
313.20 	required by this act. The provision of Minnesota Statutes, section 16B.37, subdivision 1, 
313.21 	which states that transfers under that section may be made only to an agency that has been 
313.22 	in existence for at least one year, does not apply to transfers in this act to the Office of 
313.23 	Emergency Medical Services.

313.24 	Sec. 22. REVISOR INSTRUCTION.
 313.25 	(a) In Minnesota Statutes, chapter 144E, the revisor of statutes shall replace "board" 
313.26 	with "director"; "board's" with "director's"; "Emergency Medical Services Regulatory Board" 
313.27 	or "Minnesota Emergency Medical Services Regulatory Board" with "director"; and 
313.28 	"board-approved" with "director-approved," except that:
313.29 	(1) in Minnesota Statutes, section 144E.11, the revisor of statutes shall not modify the 
313.30 	term "county board," "community health board," or "community health boards";
314.1 	(2) in Minnesota Statutes, sections 144E.40, subdivision 2; 144E.42, subdivision 2; 
314.2 	144E.44; and 144E.45, subdivision 2, the revisor of statutes shall not modify the term "State 
314.3 	Board of Investment"; and
314.4 	(3) in Minnesota Statutes, sections 144E.50 and 144E.52, the revisor of statutes shall 
314.5 	not modify the term "regional emergency medical services board," "regional board," "regional 
314.6 	emergency medical services board's," or "regional boards."
314.7 	(b) In the following sections of Minnesota Statutes, the revisor of statutes shall replace 
314.8 	"Emergency Medical Services Regulatory Board" with "director of the Office of Emergency 
314.9 	Medical Services": sections 13.717, subdivision 10; 62J.49, subdivision 2; 144.604; 144.608; 
314.10 	147.09; 156.12, subdivision 2; 169.686, subdivision 3; and 299A.41, subdivision 4.
314.11 	(c) In the following sections of Minnesota Statutes, the revisor of statutes shall replace 
314.12 	"Emergency Medical Services Regulatory Board" with "Office of Emergency Medical 
314.13 	Services": sections 144.603 and 161.045, subdivision 3.
314.14 	(d) In making the changes specified in this section, the revisor of statutes may make 
314.15 	technical and other necessary changes to sentence structure to preserve the meaning of the 
314.16 	text.

314.17 	Sec. 23. REPEALER.
 314.18 	Minnesota Statutes 2022, sections 144E.001, subdivision 5; 144E.01; 144E.123, 
314.19 	subdivision 5; and 144E.50, subdivision 3, are repealed.

314.20 	EFFECTIVE DATE. This section is effective January 1, 2025.

314.21 	ARTICLE 11
314.22 	EMERGENCY MEDICAL SERVICES CONFORMING CHANGES

314.23 	Section 1. Minnesota Statutes 2023 Supplement, section 15A.0815, subdivision 2, is 
314.24 	amended to read:
314.25 		Subd. 2.Agency head salaries. The salary for a position listed in this subdivision shall 
314.26 	be determined by the Compensation Council under section 15A.082. The commissioner of 
314.27 	management and budget must publish the salaries on the department's website. This 
314.28 	subdivision applies to the following positions:
314.29 	Commissioner of administration;
314.30 	Commissioner of agriculture;
314.31 	Commissioner of education;
315.1 	Commissioner of children, youth, and families;
315.2 	Commissioner of commerce;
315.3 	Commissioner of corrections;
315.4 	Commissioner of health;
315.5 	Commissioner, Minnesota Office of Higher Education;
315.6 	Commissioner, Minnesota IT Services;
315.7 	Commissioner, Housing Finance Agency;
315.8 	Commissioner of human rights;
315.9 	Commissioner of human services;
315.10 	Commissioner of labor and industry;
315.11 	Commissioner of management and budget;
315.12 	Commissioner of natural resources;
315.13 	Commissioner, Pollution Control Agency;
315.14 	Commissioner of public safety;
315.15 	Commissioner of revenue;
315.16 	Commissioner of employment and economic development;
315.17 	Commissioner of transportation;
315.18 	Commissioner of veterans affairs;
315.19 	Executive director of the Gambling Control Board;
315.20 	Executive director of the Minnesota State Lottery;
315.21 	Commissioner of Iron Range resources and rehabilitation;
315.22 	Commissioner, Bureau of Mediation Services;
315.23 	Ombudsman for mental health and developmental disabilities;
315.24 	Ombudsperson for corrections;
315.25 	Chair, Metropolitan Council;
315.26 	Chair, Metropolitan Airports Commission;
315.27 	School trust lands director;
316.1 	Executive director of pari-mutuel racing; and
316.2 	Commissioner, Public Utilities Commission.; and
316.3 	Director of the Office of Emergency Medical Services.

316.4 	EFFECTIVE DATE. This section is effective January 1, 2025.

316.5 	Sec. 2. Minnesota Statutes 2023 Supplement, section 43A.08, subdivision 1a, is amended 
316.6 	to read:
316.7 		Subd. 1a.Additional unclassified positions. Appointing authorities for the following 
316.8 	agencies may designate additional unclassified positions according to this subdivision: the 
316.9 	Departments of Administration; Agriculture; Children, Youth, and Families; Commerce; 
316.10 	Corrections; Direct Care and Treatment; Education; Employment and Economic 
316.11 	Development; Explore Minnesota Tourism; Management and Budget; Health; Human 
316.12 	Rights; Human Services; Labor and Industry; Natural Resources; Public Safety; Revenue; 
316.13 	Transportation; and Veterans Affairs; the Housing Finance and Pollution Control Agencies; 
316.14 	the State Lottery; the State Board of Investment; the Office of Administrative Hearings; the 
316.15 	Department of Information Technology Services; the Offices of the Attorney General, 
316.16 	Secretary of State, and State Auditor; the Minnesota State Colleges and Universities; the 
316.17 	Minnesota Office of Higher Education; the Perpich Center for Arts Education; and the 
316.18 	Minnesota Zoological Board; and the Office of Emergency Medical Services.
316.19 	A position designated by an appointing authority according to this subdivision must 
316.20 	meet the following standards and criteria:
316.21 	(1) the designation of the position would not be contrary to other law relating specifically 
316.22 	to that agency;
316.23 	(2) the person occupying the position would report directly to the agency head or deputy 
316.24 	agency head and would be designated as part of the agency head's management team;
316.25 	(3) the duties of the position would involve significant discretion and substantial 
316.26 	involvement in the development, interpretation, and implementation of agency policy;
316.27 	(4) the duties of the position would not require primarily personnel, accounting, or other 
316.28 	technical expertise where continuity in the position would be important;
316.29 	(5) there would be a need for the person occupying the position to be accountable to, 
316.30 	loyal to, and compatible with, the governor and the agency head, the employing statutory 
316.31 	board or commission, or the employing constitutional officer;
317.1 	(6) the position would be at the level of division or bureau director or assistant to the 
317.2 	agency head; and
317.3 	(7) the commissioner has approved the designation as being consistent with the standards 
317.4 	and criteria in this subdivision.

317.5 	EFFECTIVE DATE. This section is effective January 1, 2025.

317.6 	Sec. 3. Minnesota Statutes 2022, section 62J.49, subdivision 1, is amended to read:
317.7 		Subdivision 1.Establishment. The director of the Office of Emergency Medical Services 
317.8 	Regulatory Board established under chapter 144 144E shall establish a financial data 
317.9 	collection system for all ambulance services licensed in this state. To establish the financial 
317.10 	database, the Emergency Medical Services Regulatory Board director may contract with 
317.11 	an entity that has experience in ambulance service financial data collection.

317.12 	EFFECTIVE DATE. This section is effective January 1, 2025.

317.13 	Sec. 4. Minnesota Statutes 2023 Supplement, section 152.126, subdivision 6, is amended 
317.14 	to read:
317.15 		Subd. 6.Access to reporting system data. (a) Except as indicated in this subdivision, 
317.16 	the data submitted to the board under subdivision 4 is private data on individuals as defined 
317.17 	in section 13.02, subdivision 12, and not subject to public disclosure.
317.18 	(b) Except as specified in subdivision 5, the following persons shall be considered 
317.19 	permissible users and may access the data submitted under subdivision 4 in the same or 
317.20 	similar manner, and for the same or similar purposes, as those persons who are authorized 
317.21 	to access similar private data on individuals under federal and state law:
317.22 	(1) a prescriber or an agent or employee of the prescriber to whom the prescriber has 
317.23 	delegated the task of accessing the data, to the extent the information relates specifically to 
317.24 	a current patient, to whom the prescriber is:
317.25 	(i) prescribing or considering prescribing any controlled substance;
317.26 	(ii) providing emergency medical treatment for which access to the data may be necessary;
317.27 	(iii) providing care, and the prescriber has reason to believe, based on clinically valid 
317.28 	indications, that the patient is potentially abusing a controlled substance; or
317.29 	(iv) providing other medical treatment for which access to the data may be necessary 
317.30 	for a clinically valid purpose and the patient has consented to access to the submitted data, 
318.1 	and with the provision that the prescriber remains responsible for the use or misuse of data 
318.2 	accessed by a delegated agent or employee;
318.3 	(2) a dispenser or an agent or employee of the dispenser to whom the dispenser has 
318.4 	delegated the task of accessing the data, to the extent the information relates specifically to 
318.5 	a current patient to whom that dispenser is dispensing or considering dispensing any 
318.6 	controlled substance and with the provision that the dispenser remains responsible for the 
318.7 	use or misuse of data accessed by a delegated agent or employee;
318.8 	(3) a licensed dispensing practitioner or licensed pharmacist to the extent necessary to 
318.9 	determine whether corrections made to the data reported under subdivision 4 are accurate;
318.10 	(4) a licensed pharmacist who is providing pharmaceutical care for which access to the 
318.11 	data may be necessary to the extent that the information relates specifically to a current 
318.12 	patient for whom the pharmacist is providing pharmaceutical care: (i) if the patient has 
318.13 	consented to access to the submitted data; or (ii) if the pharmacist is consulted by a prescriber 
318.14 	who is requesting data in accordance with clause (1);
318.15 	(5) an individual who is the recipient of a controlled substance prescription for which 
318.16 	data was submitted under subdivision 4, or a guardian of the individual, parent or guardian 
318.17 	of a minor, or health care agent of the individual acting under a health care directive under 
318.18 	chapter 145C. For purposes of this clause, access by individuals includes persons in the 
318.19 	definition of an individual under section 13.02;
318.20 	(6) personnel or designees of a health-related licensing board listed in section 214.01, 
318.21 	subdivision 2, or of the Office of Emergency Medical Services Regulatory Board, assigned 
318.22 	to conduct a bona fide investigation of a complaint received by that board or office that 
318.23 	alleges that a specific licensee is impaired by use of a drug for which data is collected under 
318.24 	subdivision 4, has engaged in activity that would constitute a crime as defined in section 
318.25 	152.025, or has engaged in the behavior specified in subdivision 5, paragraph (a);
318.26 	(7) personnel of the board engaged in the collection, review, and analysis of controlled 
318.27 	substance prescription information as part of the assigned duties and responsibilities under 
318.28 	this section;
318.29 	(8) authorized personnel under contract with the board, or under contract with the state 
318.30 	of Minnesota and approved by the board, who are engaged in the design, evaluation, 
318.31 	implementation, operation, or maintenance of the prescription monitoring program as part 
318.32 	of the assigned duties and responsibilities of their employment, provided that access to data 
318.33 	is limited to the minimum amount necessary to carry out such duties and responsibilities, 
319.1 	and subject to the requirement of de-identification and time limit on retention of data specified 
319.2 	in subdivision 5, paragraphs (d) and (e);
319.3 	(9) federal, state, and local law enforcement authorities acting pursuant to a valid search 
319.4 	warrant;
319.5 	(10) personnel of the Minnesota health care programs assigned to use the data collected 
319.6 	under this section to identify and manage recipients whose usage of controlled substances 
319.7 	may warrant restriction to a single primary care provider, a single outpatient pharmacy, and 
319.8 	a single hospital;
319.9 	(11) personnel of the Department of Human Services assigned to access the data pursuant 
319.10 	to paragraph (k);
319.11 	(12) personnel of the health professionals services program established under section 
319.12 	214.31, to the extent that the information relates specifically to an individual who is currently 
319.13 	enrolled in and being monitored by the program, and the individual consents to access to 
319.14 	that information. The health professionals services program personnel shall not provide this 
319.15 	data to a health-related licensing board or the Emergency Medical Services Regulatory 
319.16 	Board, except as permitted under section 214.33, subdivision 3;
319.17 	(13) personnel or designees of a health-related licensing board other than the Board of 
319.18 	Pharmacy listed in section 214.01, subdivision 2, assigned to conduct a bona fide 
319.19 	investigation of a complaint received by that board that alleges that a specific licensee is 
319.20 	inappropriately prescribing controlled substances as defined in this section. For the purposes 
319.21 	of this clause, the health-related licensing board may also obtain utilization data; and
319.22 	(14) personnel of the board specifically assigned to conduct a bona fide investigation 
319.23 	of a specific licensee or registrant. For the purposes of this clause, the board may also obtain 
319.24 	utilization data.
319.25 	(c) By July 1, 2017, every prescriber licensed by a health-related licensing board listed 
319.26 	in section 214.01, subdivision 2, practicing within this state who is authorized to prescribe 
319.27 	controlled substances for humans and who holds a current registration issued by the federal 
319.28 	Drug Enforcement Administration, and every pharmacist licensed by the board and practicing 
319.29 	within the state, shall register and maintain a user account with the prescription monitoring 
319.30 	program. Data submitted by a prescriber, pharmacist, or their delegate during the registration 
319.31 	application process, other than their name, license number, and license type, is classified 
319.32 	as private pursuant to section 13.02, subdivision 12.
320.1 	(d) Notwithstanding paragraph (b), beginning January 1, 2021, a prescriber or an agent 
320.2 	or employee of the prescriber to whom the prescriber has delegated the task of accessing 
320.3 	the data, must access the data submitted under subdivision 4 to the extent the information 
320.4 	relates specifically to the patient:
320.5 	(1) before the prescriber issues an initial prescription order for a Schedules II through 
320.6 	IV opiate controlled substance to the patient; and
320.7 	(2) at least once every three months for patients receiving an opiate for treatment of 
320.8 	chronic pain or participating in medically assisted treatment for an opioid addiction.
320.9 	(e) Paragraph (d) does not apply if:
320.10 	(1) the patient is receiving palliative care, or hospice or other end-of-life care;
320.11 	(2) the patient is being treated for pain due to cancer or the treatment of cancer;
320.12 	(3) the prescription order is for a number of doses that is intended to last the patient five 
320.13 	days or less and is not subject to a refill;
320.14 	(4) the prescriber and patient have a current or ongoing provider/patient relationship of 
320.15 	a duration longer than one year;
320.16 	(5) the prescription order is issued within 14 days following surgery or three days 
320.17 	following oral surgery or follows the prescribing protocols established under the opioid 
320.18 	prescribing improvement program under section 256B.0638;
320.19 	(6) the controlled substance is prescribed or administered to a patient who is admitted 
320.20 	to an inpatient hospital;
320.21 	(7) the controlled substance is lawfully administered by injection, ingestion, or any other 
320.22 	means to the patient by the prescriber, a pharmacist, or by the patient at the direction of a 
320.23 	prescriber and in the presence of the prescriber or pharmacist;
320.24 	(8) due to a medical emergency, it is not possible for the prescriber to review the data 
320.25 	before the prescriber issues the prescription order for the patient; or
320.26 	(9) the prescriber is unable to access the data due to operational or other technological 
320.27 	failure of the program so long as the prescriber reports the failure to the board.
320.28 	(f) Only permissible users identified in paragraph (b), clauses (1), (2), (3), (4), (7), (8), 
320.29 	(10), and (11), may directly access the data electronically. No other permissible users may 
320.30 	directly access the data electronically. If the data is directly accessed electronically, the 
320.31 	permissible user shall implement and maintain a comprehensive information security program 
320.32 	that contains administrative, technical, and physical safeguards that are appropriate to the 
321.1 	user's size and complexity, and the sensitivity of the personal information obtained. The 
321.2 	permissible user shall identify reasonably foreseeable internal and external risks to the 
321.3 	security, confidentiality, and integrity of personal information that could result in the 
321.4 	unauthorized disclosure, misuse, or other compromise of the information and assess the 
321.5 	sufficiency of any safeguards in place to control the risks.
321.6 	(g) The board shall not release data submitted under subdivision 4 unless it is provided 
321.7 	with evidence, satisfactory to the board, that the person requesting the information is entitled 
321.8 	to receive the data.
321.9 	(h) The board shall maintain a log of all persons who access the data for a period of at 
321.10 	least three years and shall ensure that any permissible user complies with paragraph (c) 
321.11 	prior to attaining direct access to the data.
321.12 	(i) Section 13.05, subdivision 6, shall apply to any contract the board enters into pursuant 
321.13 	to subdivision 2. A vendor shall not use data collected under this section for any purpose 
321.14 	not specified in this section.
321.15 	(j) The board may participate in an interstate prescription monitoring program data 
321.16 	exchange system provided that permissible users in other states have access to the data only 
321.17 	as allowed under this section, and that section 13.05, subdivision 6, applies to any contract 
321.18 	or memorandum of understanding that the board enters into under this paragraph.
321.19 	(k) With available appropriations, the commissioner of human services shall establish 
321.20 	and implement a system through which the Department of Human Services shall routinely 
321.21 	access the data for the purpose of determining whether any client enrolled in an opioid 
321.22 	treatment program licensed according to chapter 245A has been prescribed or dispensed a 
321.23 	controlled substance in addition to that administered or dispensed by the opioid treatment 
321.24 	program. When the commissioner determines there have been multiple prescribers or multiple 
321.25 	prescriptions of controlled substances, the commissioner shall:
321.26 	(1) inform the medical director of the opioid treatment program only that the 
321.27 	commissioner determined the existence of multiple prescribers or multiple prescriptions of 
321.28 	controlled substances; and
321.29 	(2) direct the medical director of the opioid treatment program to access the data directly, 
321.30 	review the effect of the multiple prescribers or multiple prescriptions, and document the 
321.31 	review.
322.1 	If determined necessary, the commissioner of human services shall seek a federal waiver 
322.2 	of, or exception to, any applicable provision of Code of Federal Regulations, title 42, section 
322.3 	2.34, paragraph (c), prior to implementing this paragraph.
322.4 	(l) The board shall review the data submitted under subdivision 4 on at least a quarterly 
322.5 	basis and shall establish criteria, in consultation with the advisory task force, for referring 
322.6 	information about a patient to prescribers and dispensers who prescribed or dispensed the 
322.7 	prescriptions in question if the criteria are met.
322.8 	(m) The board shall conduct random audits, on at least a quarterly basis, of electronic 
322.9 	access by permissible users, as identified in paragraph (b), clauses (1), (2), (3), (4), (7), (8), 
322.10 	(10), and (11), to the data in subdivision 4, to ensure compliance with permissible use as 
322.11 	defined in this section. A permissible user whose account has been selected for a random 
322.12 	audit shall respond to an inquiry by the board, no later than 30 days after receipt of notice 
322.13 	that an audit is being conducted. Failure to respond may result in deactivation of access to 
322.14 	the electronic system and referral to the appropriate health licensing board, or the 
322.15 	commissioner of human services, for further action. The board shall report the results of 
322.16 	random audits to the chairs and ranking minority members of the legislative committees 
322.17 	with jurisdiction over health and human services policy and finance and government data 
322.18 	practices.
322.19 	(n) A permissible user who has delegated the task of accessing the data in subdivision 
322.20 	4 to an agent or employee shall audit the use of the electronic system by delegated agents 
322.21 	or employees on at least a quarterly basis to ensure compliance with permissible use as 
322.22 	defined in this section. When a delegated agent or employee has been identified as 
322.23 	inappropriately accessing data, the permissible user must immediately remove access for 
322.24 	that individual and notify the board within seven days. The board shall notify all permissible 
322.25 	users associated with the delegated agent or employee of the alleged violation.
322.26 	(o) A permissible user who delegates access to the data submitted under subdivision 4 
322.27 	to an agent or employee shall terminate that individual's access to the data within three 
322.28 	business days of the agent or employee leaving employment with the permissible user. The 
322.29 	board may conduct random audits to determine compliance with this requirement.

322.30 	EFFECTIVE DATE. This section is effective January 1, 2025.

323.1 	Sec. 5. Minnesota Statutes 2022, section 214.025, is amended to read:
323.2 	214.025 COUNCIL OF HEALTH BOARDS.
323.3 	The health-related licensing boards may establish a Council of Health Boards consisting 
323.4 	of representatives of the health-related licensing boards and the Emergency Medical Services 
323.5 	Regulatory Board. When reviewing legislation or legislative proposals relating to the 
323.6 	regulation of health occupations, the council shall include the commissioner of health or a 
323.7 	designee and the director of the Office of Emergency Medical Services or a designee.

323.8 	EFFECTIVE DATE. This section is effective January 1, 2025.

323.9 	Sec. 6. Minnesota Statutes 2022, section 214.04, subdivision 2a, is amended to read:
323.10 		Subd. 2a.Performance of executive directors. The governor may request that a 
323.11 	health-related licensing board or the Emergency Medical Services Regulatory Board review 
323.12 	the performance of the board's executive director. Upon receipt of the request, the board 
323.13 	must respond by establishing a performance improvement plan or taking disciplinary or 
323.14 	other corrective action, including dismissal. The board shall include the governor's 
323.15 	representative as a voting member of the board in the board's discussions and decisions 
323.16 	regarding the governor's request. The board shall report to the governor on action taken by 
323.17 	the board, including an explanation if no action is deemed necessary.

323.18 	EFFECTIVE DATE. This section is effective January 1, 2025.

323.19 	Sec. 7. Minnesota Statutes 2022, section 214.29, is amended to read:
323.20 	214.29 PROGRAM REQUIRED.
323.21 	Each health-related licensing board, including the Emergency Medical Services 
323.22 	Regulatory Board under chapter 144E, shall either conduct a health professionals service 
323.23 	program under sections 214.31 to 214.37 or contract for a diversion program under section 
323.24 	214.28.

323.25 	EFFECTIVE DATE. This section is effective January 1, 2025.

323.26 	Sec. 8. Minnesota Statutes 2022, section 214.31, is amended to read:
323.27 	214.31 AUTHORITY.
323.28 	Two or more of the health-related licensing boards listed in section 214.01, subdivision 
323.29 	2, may jointly conduct a health professionals services program to protect the public from 
323.30 	persons regulated by the boards who are unable to practice with reasonable skill and safety 
324.1 	by reason of illness, use of alcohol, drugs, chemicals, or any other materials, or as a result 
324.2 	of any mental, physical, or psychological condition. The program does not affect a board's 
324.3 	authority to discipline violations of a board's practice act. For purposes of sections 214.31
324.4 	to 214.37, the emergency medical services regulatory board shall be included in the definition 
324.5 	of a health-related licensing board under chapter 144E.

324.6 	EFFECTIVE DATE. This section is effective January 1, 2025.

324.7 	Sec. 9. Minnesota Statutes 2022, section 214.355, is amended to read:
324.8 	214.355 GROUNDS FOR DISCIPLINARY ACTION.
324.9 	Each health-related licensing board, including the Emergency Medical Services 
324.10 	Regulatory Board under chapter 144E, shall consider it grounds for disciplinary action if a 
324.11 	regulated person violates the terms of the health professionals services program participation 
324.12 	agreement or leaves the program except upon fulfilling the terms for successful completion 
324.13 	of the program as set forth in the participation agreement.

324.14 	EFFECTIVE DATE. This section is effective January 1, 2025.

324.15 	ARTICLE 12
324.16 	AMBULANCE SERVICE PERSONNEL AND EMERGENCY MEDICAL 
324.17 	RESPONDERS

324.18 	Section 1. Minnesota Statutes 2022, section 144E.001, subdivision 3a, is amended to read:
324.19 		Subd. 3a.Ambulance service personnel. "Ambulance service personnel" means 
324.20 	individuals who are authorized by a licensed ambulance service to provide emergency care 
324.21 	for the ambulance service and are:
324.22 	(1) EMTs, AEMTs, or paramedics;
324.23 	(2) Minnesota registered nurses who are: (i) EMTs, are currently practicing nursing, and 
324.24 	have passed a paramedic practical skills test, as approved by the board and administered by 
324.25 	an educational program approved by the board been approved by the ambulance service 
324.26 	medical director; (ii) on the roster of an ambulance service on or before January 1, 2000; 
324.27 	or (iii) after petitioning the board, deemed by the board to have training and skills equivalent 
324.28 	to an EMT, as determined on a case-by-case basis; or (iv) certified as a certified flight 
324.29 	registered nurse or certified emergency nurse; or
324.30 	(3) Minnesota licensed physician assistants who are: (i) EMTs, are currently practicing 
324.31 	as physician assistants, and have passed a paramedic practical skills test, as approved by 
324.32 	the board and administered by an educational program approved by the board been approved 
325.1 	by the ambulance service medical director; (ii) on the roster of an ambulance service on or 
325.2 	before January 1, 2000; or (iii) after petitioning the board, deemed by the board to have 
325.3 	training and skills equivalent to an EMT, as determined on a case-by-case basis.

325.4 	Sec. 2. Minnesota Statutes 2023 Supplement, section 144E.101, subdivision 6, is amended 
325.5 	to read:
325.6 		Subd. 6.Basic life support. (a) Except as provided in paragraph (f) subdivision 6a, a 
325.7 	basic life-support ambulance shall be staffed by at least two EMTs, one of whom must 
325.8 	accompany the patient and provide a level of care so as to ensure that:
325.9 	(1) one individual who is:
325.10 	(i) certified as an EMT;
325.11 	(ii) a Minnesota registered nurse who meets the qualification requirements in section 
325.12 	144E.001, subdivision 3a, clause (2); or
325.13 	(iii) a Minnesota licensed physician assistant who meets the qualification requirements 
325.14 	in section 144E.001, subdivision 3a, clause (3); and
325.15 	(2) one individual to drive the ambulance who:
325.16 	(i) either meets one of the qualification requirements in clause (1) or is a registered 
325.17 	emergency medical responder driver; and
325.18 	(ii) satisfies the requirements in subdivision 10.
325.19 	(b) An individual who meets one of the qualification requirements in paragraph (a), 
325.20 	clause (1), must accompany the patient and provide a level of care so as to ensure that:
325.21 	(1) life-threatening situations and potentially serious injuries are recognized;
325.22 	(2) patients are protected from additional hazards;
325.23 	(3) basic treatment to reduce the seriousness of emergency situations is administered; 
325.24 	and
325.25 	(4) patients are transported to an appropriate medical facility for treatment.
325.26 	(b) (c) A basic life-support service shall provide basic airway management.
325.27 	(c) (d) A basic life-support service shall provide automatic defibrillation.
325.28 	(d) (e) A basic life-support service shall administer opiate antagonists consistent with 
325.29 	protocols established by the service's medical director.
326.1 	(e) (f) A basic life-support service licensee's medical director may authorize ambulance 
326.2 	service personnel to perform intravenous infusion and use equipment that is within the 
326.3 	licensure level of the ambulance service. Ambulance service personnel must be properly 
326.4 	trained. Documentation of authorization for use, guidelines for use, continuing education, 
326.5 	and skill verification must be maintained in the licensee's files.
326.6 	(f) For emergency ambulance calls and interfacility transfers, an ambulance service may 
326.7 	staff its basic life-support ambulances with one EMT, who must accompany the patient, 
326.8 	and one registered emergency medical responder driver. For purposes of this paragraph, 
326.9 	"ambulance service" means either an ambulance service whose primary service area is 
326.10 	mainly located outside the metropolitan counties listed in section 473.121, subdivision 4, 
326.11 	and outside the cities of Duluth, Mankato, Moorhead, Rochester, and St. Cloud; or an 
326.12 	ambulance service based in a community with a population of less than 2,500.

326.13 	Sec. 3. Minnesota Statutes 2022, section 144E.101, is amended by adding a subdivision 
326.14 	to read:
326.15 		Subd. 6a.Variance; staffing of basic life-support ambulance. (a) Upon application 
326.16 	from an ambulance service that includes evidence demonstrating hardship, the board may 
326.17 	grant a variance from the staff requirements in subdivision 6, paragraph (a), and may 
326.18 	authorize a basic life-support ambulance to be staffed, for all emergency calls and interfacility 
326.19 	transfers, with one individual who meets the qualification requirements in paragraph (b) to 
326.20 	drive the ambulance and one individual who meets one of the qualification requirements in 
326.21 	subdivision 6, paragraph (a), clause (1), and who must accompany the patient. The variance 
326.22 	applies to basic life-support ambulances until the ambulance service renews its license. 
326.23 	When the variance expires, the ambulance service may apply for a new variance under this 
326.24 	subdivision.
326.25 	(b) In order to drive an ambulance under a variance granted under this subdivision, an 
326.26 	individual must:
326.27 	(1) hold a valid driver's license from any state;
326.28 	(2) have attended an emergency vehicle driving course approved by the ambulance 
326.29 	service;
326.30 	(3) have completed a course on cardiopulmonary resuscitation approved by the ambulance 
326.31 	service; and
326.32 	(4) register with the board according to a process established by the board.
327.1 	(c) If an individual serving as a driver under this subdivision commits or has a record 
327.2 	of committing an act listed in section 144E.27, subdivision 5, paragraph (a), the board may 
327.3 	temporarily suspend or prohibit the individual from driving an ambulance or place conditions 
327.4 	on the individual's ability to drive an ambulance using the procedures and authority in 
327.5 	section 144E.27, subdivisions 5 and 6.

327.6 	Sec. 4. Minnesota Statutes 2023 Supplement, section 144E.101, subdivision 7, as amended 
327.7 	by Laws 2024, chapter 85, section 32, is amended to read:
327.8 		Subd. 7.Advanced life support. (a) Except as provided in paragraphs (f) and (g), an 
327.9 	advanced life-support ambulance shall be staffed by at least:
327.10 	(1) one EMT or one AEMT and one paramedic;
327.11 	(2) one EMT or one AEMT and one registered nurse who: (i) is an EMT or an AEMT, 
327.12 	is currently practicing nursing, and has passed a paramedic practical skills test approved by 
327.13 	the board and administered by an education program has been approved by the ambulance 
327.14 	service medical director; or (ii) is certified as a certified flight registered nurse or certified 
327.15 	emergency nurse; or
327.16 	(3) one EMT or one AEMT and one physician assistant who is an EMT or an AEMT, 
327.17 	is currently practicing as a physician assistant, and has passed a paramedic practical skills 
327.18 	test approved by the board and administered by an education program has been approved 
327.19 	by the ambulance service medical director.
327.20 	(b) An advanced life-support service shall provide basic life support, as specified under 
327.21 	subdivision 6, paragraph (a) (b), advanced airway management, manual defibrillation, 
327.22 	administration of intravenous fluids and pharmaceuticals, and administration of opiate 
327.23 	antagonists.
327.24 	(c) In addition to providing advanced life support, an advanced life-support service may 
327.25 	staff additional ambulances to provide basic life support according to subdivision 6 and 
327.26 	section 144E.103, subdivision 1.
327.27 	(d) An ambulance service providing advanced life support shall have a written agreement 
327.28 	with its medical director to ensure medical control for patient care 24 hours a day, seven 
327.29 	days a week. The terms of the agreement shall include a written policy on the administration 
327.30 	of medical control for the service. The policy shall address the following issues:
327.31 	(1) two-way communication for physician direction of ambulance service personnel;
327.32 	(2) patient triage, treatment, and transport;
328.1 	(3) use of standing orders; and
328.2 	(4) the means by which medical control will be provided 24 hours a day.
328.3 	The agreement shall be signed by the licensee's medical director and the licensee or the 
328.4 	licensee's designee and maintained in the files of the licensee.
328.5 	(e) When an ambulance service provides advanced life support, the authority of a 
328.6 	paramedic, Minnesota registered nurse-EMT, or Minnesota registered physician 
328.7 	assistant-EMT to determine the delivery of patient care prevails over the authority of an 
328.8 	EMT.
328.9 	(f) Upon application from an ambulance service that includes evidence demonstrating 
328.10 	hardship, the board may grant a variance from the staff requirements in paragraph (a), clause 
328.11 	(1), and may authorize an advanced life-support ambulance to be staffed by a registered 
328.12 	emergency medical responder driver with a paramedic for all emergency calls and interfacility 
328.13 	transfers. The variance shall apply to advanced life-support ambulance services until the 
328.14 	ambulance service renews its license. When the variance expires, an ambulance service 
328.15 	may apply for a new variance under this paragraph. This paragraph applies only to an 
328.16 	ambulance service whose primary service area is mainly located outside the metropolitan 
328.17 	counties listed in section 473.121, subdivision 4, and outside the cities of Duluth, Mankato, 
328.18 	Moorhead, Rochester, and St. Cloud, or an ambulance service based in a community with 
328.19 	a population of less than 1,000 persons.
328.20 	(g) After an initial emergency ambulance call, each subsequent emergency ambulance 
328.21 	response, until the initial ambulance is again available, and interfacility transfers, may be 
328.22 	staffed by one registered emergency medical responder driver and an EMT or paramedic. 
328.23 	This paragraph applies only to an ambulance service whose primary service area is mainly 
328.24 	located outside the metropolitan counties listed in section 473.121, subdivision 4, and outside 
328.25 	the cities of Duluth, Mankato, Moorhead, Rochester, and St. Cloud, or an ambulance service 
328.26 	based in a community with a population of less than 1,000 persons.
328.27 	(h) An individual who staffs an advanced life-support ambulance as a driver must also 
328.28 	meet the requirements in subdivision 10.

328.29 	Sec. 5. Minnesota Statutes 2022, section 144E.27, subdivision 3, is amended to read:
328.30 		Subd. 3.Renewal. (a) The board may renew the registration of an emergency medical 
328.31 	responder who:
328.32 	(1) successfully completes a board-approved refresher course; and
329.1 	(2) successfully completes a course in cardiopulmonary resuscitation approved by the 
329.2 	board or by the licensee's medical director. This course may be a component of a 
329.3 	board-approved refresher course; and
329.4 	(2) (3) submits a completed renewal application to the board before the registration 
329.5 	expiration date.
329.6 	(b) The board may renew the lapsed registration of an emergency medical responder 
329.7 	who:
329.8 	(1) successfully completes a board-approved refresher course; and
329.9 	(2) successfully completes a course in cardiopulmonary resuscitation approved by the 
329.10 	board or by the licensee's medical director. This course may be a component of a 
329.11 	board-approved refresher course; and
329.12 	(2) (3) submits a completed renewal application to the board within 12 48 months after 
329.13 	the registration expiration date.

329.14 	Sec. 6. Minnesota Statutes 2022, section 144E.27, subdivision 5, is amended to read:
329.15 		Subd. 5.Denial, suspension, revocation; emergency medical responders and 
329.16 	drivers. (a) This subdivision applies to individuals seeking registration or registered as an 
329.17 	emergency medical responder and to individuals seeking registration or registered as a driver 
329.18 	of a basic life-support ambulance under section 144E.101, subdivision 6a. The board may 
329.19 	deny, suspend, revoke, place conditions on, or refuse to renew the registration of an individual 
329.20 	who the board determines:
329.21 	(1) violates sections 144E.001 to 144E.33 or the rules adopted under those sections, an 
329.22 	agreement for corrective action, or an order that the board issued or is otherwise empowered 
329.23 	to enforce;
329.24 	(2) misrepresents or falsifies information on an application form for registration;
329.25 	(3) is convicted or pleads guilty or nolo contendere to any felony; any gross misdemeanor 
329.26 	relating to assault, sexual misconduct, theft, or the illegal use of drugs or alcohol; or any 
329.27 	misdemeanor relating to assault, sexual misconduct, theft, or the illegal use of drugs or 
329.28 	alcohol;
329.29 	(4) is actually or potentially unable to provide emergency medical services or drive an 
329.30 	ambulance with reasonable skill and safety to patients by reason of illness, use of alcohol, 
329.31 	drugs, chemicals, or any other material, or as a result of any mental or physical condition;
330.1 	(5) engages in unethical conduct, including, but not limited to, conduct likely to deceive, 
330.2 	defraud, or harm the public, or demonstrating a willful or careless disregard for the health, 
330.3 	welfare, or safety of the public;
330.4 	(6) maltreats or abandons a patient;
330.5 	(7) violates any state or federal controlled substance law;
330.6 	(8) engages in unprofessional conduct or any other conduct which has the potential for 
330.7 	causing harm to the public, including any departure from or failure to conform to the 
330.8 	minimum standards of acceptable and prevailing practice without actual injury having to 
330.9 	be established;
330.10 	(9) for emergency medical responders, provides emergency medical services under 
330.11 	lapsed or nonrenewed credentials;
330.12 	(10) is subject to a denial, corrective, disciplinary, or other similar action in another 
330.13 	jurisdiction or by another regulatory authority;
330.14 	(11) engages in conduct with a patient that is sexual or may reasonably be interpreted 
330.15 	by the patient as sexual, or in any verbal behavior that is seductive or sexually demeaning 
330.16 	to a patient; or
330.17 	(12) makes a false statement or knowingly provides false information to the board, or 
330.18 	fails to cooperate with an investigation of the board as required by section 144E.30.
330.19 	(b) Before taking action under paragraph (a), the board shall give notice to an individual 
330.20 	of the right to a contested case hearing under chapter 14. If an individual requests a contested 
330.21 	case hearing within 30 days after receiving notice, the board shall initiate a contested case 
330.22 	hearing according to chapter 14.
330.23 	(c) The administrative law judge shall issue a report and recommendation within 30 
330.24 	days after closing the contested case hearing record. The board shall issue a final order 
330.25 	within 30 days after receipt of the administrative law judge's report.
330.26 	(d) After six months from the board's decision to deny, revoke, place conditions on, or 
330.27 	refuse renewal of an individual's registration for disciplinary action, the individual shall 
330.28 	have the opportunity to apply to the board for reinstatement.

330.29 	Sec. 7. Minnesota Statutes 2022, section 144E.27, subdivision 6, is amended to read:
330.30 		Subd. 6.Temporary suspension; emergency medical responders and drivers. (a) 
330.31 	This subdivision applies to emergency medical responders registered under this section and 
330.32 	to individuals registered as drivers of basic life-support ambulances under section 144E.101, 
331.1 	subdivision 6a. In addition to any other remedy provided by law, the board may temporarily 
331.2 	suspend the registration of an individual after conducting a preliminary inquiry to determine 
331.3 	whether the board believes that the individual has violated a statute or rule that the board 
331.4 	is empowered to enforce and determining that the continued provision of service by the 
331.5 	individual would create an imminent risk to public health or harm to others.
331.6 	(b) A temporary suspension order prohibiting an individual from providing emergency 
331.7 	medical care or from driving a basic life-support ambulance shall give notice of the right 
331.8 	to a preliminary hearing according to paragraph (d) and shall state the reasons for the entry 
331.9 	of the temporary suspension order.
331.10 	(c) Service of a temporary suspension order is effective when the order is served on the 
331.11 	individual personally or by certified mail, which is complete upon receipt, refusal, or return 
331.12 	for nondelivery to the most recent address provided to the board for the individual.
331.13 	(d) At the time the board issues a temporary suspension order, the board shall schedule 
331.14 	a hearing, to be held before a group of its members designated by the board, that shall begin 
331.15 	within 60 days after issuance of the temporary suspension order or within 15 working days 
331.16 	of the date of the board's receipt of a request for a hearing from the individual, whichever 
331.17 	is sooner. The hearing shall be on the sole issue of whether there is a reasonable basis to 
331.18 	continue, modify, or lift the temporary suspension. A hearing under this paragraph is not 
331.19 	subject to chapter 14.
331.20 	(e) Evidence presented by the board or the individual may be in the form of an affidavit. 
331.21 	The individual or the individual's designee may appear for oral argument.
331.22 	(f) Within five working days of the hearing, the board shall issue its order and, if the 
331.23 	suspension is continued, notify the individual of the right to a contested case hearing under 
331.24 	chapter 14.
331.25 	(g) If an individual requests a contested case hearing within 30 days after receiving 
331.26 	notice under paragraph (f), the board shall initiate a contested case hearing according to 
331.27 	chapter 14. The administrative law judge shall issue a report and recommendation within 
331.28 	30 days after the closing of the contested case hearing record. The board shall issue a final 
331.29 	order within 30 days after receipt of the administrative law judge's report.

331.30 	Sec. 8. Minnesota Statutes 2022, section 144E.28, subdivision 3, is amended to read:
331.31 		Subd. 3.Reciprocity. The board may certify an individual who possesses a current 
331.32 	National Registry of Emergency Medical Technicians registration certification from another 
331.33 	jurisdiction if the individual submits a board-approved application form. The board 
332.1 	certification classification shall be the same as the National Registry's classification. 
332.2 	Certification shall be for the duration of the applicant's registration certification period in 
332.3 	another jurisdiction, not to exceed two years.

332.4 	Sec. 9. Minnesota Statutes 2022, section 144E.28, subdivision 8, is amended to read:
332.5 		Subd. 8.Reinstatement. (a) Within four years of a certification expiration date, a person 
332.6 	whose certification has expired under subdivision 7, paragraph (d), may have the certification 
332.7 	reinstated upon submission of:
332.8 	(1) evidence to the board of training equivalent to the continuing education requirements 
332.9 	of subdivision 7 or, for community paramedics, evidence to the board of training equivalent 
332.10 	to the continuing education requirements of subdivision 9, paragraph (c); and
332.11 	(2) a board-approved application form.
332.12 	(b) If more than four years have passed since a certificate expiration date, an applicant 
332.13 	must complete the initial certification process required under subdivision 1.
332.14 	(c) Beginning July 1, 2024, through December 31, 2025, and notwithstanding paragraph 
332.15 	(b), a person whose certification as an EMT, AEMT, paramedic, or community paramedic 
332.16 	expired more than four years ago but less than ten years ago may have the certification 
332.17 	reinstated upon submission of:
332.18 	(1) evidence to the board of the training required under paragraph (a), clause (1). This 
332.19 	training must have been completed within the 24 months prior to the date of the application 
332.20 	for reinstatement;
332.21 	(2) a board-approved application form; and
332.22 	(3) a recommendation from an ambulance service medical director.
332.23 	This paragraph expires December 31, 2025.

332.24 	Sec. 10. Minnesota Statutes 2022, section 144E.285, subdivision 1, is amended to read:
332.25 		Subdivision 1.Approval required. (a) All education programs for an EMR, EMT, 
332.26 	AEMT, or paramedic must be approved by the board.
332.27 	(b) To be approved by the board, an education program must:
332.28 	(1) submit an application prescribed by the board that includes:
332.29 	(i) type and length of course to be offered;
333.1 	(ii) names, addresses, and qualifications of the program medical director, program 
333.2 	education coordinator, and instructors;
333.3 	(iii) names and addresses of clinical sites, including a contact person and telephone 
333.4 	number;
333.5 	(iv) (iii) admission criteria for students; and
333.6 	(v) (iv) materials and equipment to be used;
333.7 	(2) for each course, implement the most current version of the United States Department 
333.8 	of Transportation EMS Education Standards, or its equivalent as determined by the board 
333.9 	applicable to EMR, EMT, AEMT, or paramedic education;
333.10 	(3) have a program medical director and a program coordinator;
333.11 	(4) utilize instructors who meet the requirements of section 144E.283 for teaching at 
333.12 	least 50 percent of the course content. The remaining 50 percent of the course may be taught 
333.13 	by guest lecturers approved by the education program coordinator or medical director;
333.14 	(5) have at least one instructor for every ten students at the practical skill stations;
333.15 	(6) maintain a written agreement with a licensed hospital or licensed ambulance service 
333.16 	designating a clinical training site;
333.17 	(7) (5) retain documentation of program approval by the board, course outline, and 
333.18 	student information;
333.19 	(8) (6) notify the board of the starting date of a course prior to the beginning of a course;
333.20 	and
333.21 	(9) (7) submit the appropriate fee as required under section 144E.29; and.
333.22 	(10) maintain a minimum average yearly pass rate as set by the board on an annual basis. 
333.23 	The pass rate will be determined by the percent of candidates who pass the exam on the 
333.24 	first attempt. An education program not meeting this yearly standard shall be placed on 
333.25 	probation and shall be on a performance improvement plan approved by the board until 
333.26 	meeting the pass rate standard. While on probation, the education program may continue 
333.27 	providing classes if meeting the terms of the performance improvement plan as determined 
333.28 	by the board. If an education program having probation status fails to meet the pass rate 
333.29 	standard after two years in which an EMT initial course has been taught, the board may 
333.30 	take disciplinary action under subdivision 5.

334.1 	Sec. 11. Minnesota Statutes 2022, section 144E.285, is amended by adding a subdivision 
334.2 	to read:
334.3 		Subd. 1a.EMR education program requirements. The National EMS Education 
334.4 	Standards established by the National Highway Traffic Safety Administration of the United 
334.5 	States Department of Transportation specify the minimum requirements for knowledge and 
334.6 	skills for emergency medical responders. An education program applying for approval to 
334.7 	teach EMRs must comply with the requirements under subdivision 1, paragraph (b). A 
334.8 	medical director of an emergency medical responder group may establish additional 
334.9 	knowledge and skill requirements for EMRs.

334.10 	Sec. 12. Minnesota Statutes 2022, section 144E.285, is amended by adding a subdivision 
334.11 	to read:
334.12 		Subd. 1b.EMT education program requirements. In addition to the requirements 
334.13 	under subdivision 1, paragraph (b), an education program applying for approval to teach 
334.14 	EMTs must:
334.15 	(1) include in the application prescribed by the board the names and addresses of clinical 
334.16 	sites, including a contact person and telephone number;
334.17 	(2) maintain a written agreement with at least one clinical training site that is of a type 
334.18 	recognized by the National EMS Education Standards established by the National Highway 
334.19 	Traffic Safety Administration; and
334.20 	(3) maintain a minimum average yearly pass rate as set by the board. An education 
334.21 	program not meeting this standard must be placed on probation and must comply with a 
334.22 	performance improvement plan approved by the board until the program meets the pass-rate 
334.23 	standard. While on probation, the education program may continue to provide classes if the 
334.24 	program meets the terms of the performance improvement plan, as determined by the board. 
334.25 	If an education program that is on probation status fails to meet the pass-rate standard after 
334.26 	two years in which an EMT initial course has been taught, the board may take disciplinary 
334.27 	action under subdivision 5.

334.28 	Sec. 13. Minnesota Statutes 2022, section 144E.285, subdivision 2, is amended to read:
334.29 		Subd. 2.AEMT and paramedic education program requirements. (a) In addition to 
334.30 	the requirements under subdivision 1, paragraph (b), an education program applying for 
334.31 	approval to teach AEMTs and paramedics must:
335.1 	(1) be administered by an educational institution accredited by the Commission of 
335.2 	Accreditation of Allied Health Education Programs (CAAHEP).;
335.3 	(2) include in the application prescribed by the board the names and addresses of clinical 
335.4 	sites, including a contact person and telephone number; and
335.5 	(3) maintain a written agreement with a licensed hospital or licensed ambulance service 
335.6 	designating a clinical training site.
335.7 	(b) An AEMT and paramedic education program that is administered by an educational 
335.8 	institution not accredited by CAAHEP, but that is in the process of completing the 
335.9 	accreditation process, may be granted provisional approval by the board upon verification 
335.10 	of submission of its self-study report and the appropriate review fee to CAAHEP.
335.11 	(c) An educational institution that discontinues its participation in the accreditation 
335.12 	process must notify the board immediately and provisional approval shall be withdrawn.
335.13 	(d) This subdivision does not apply to a paramedic education program when the program 
335.14 	is operated by an advanced life-support ambulance service licensed by the Emergency 
335.15 	Medical Services Regulatory Board under this chapter, and the ambulance service meets 
335.16 	the following criteria:
335.17 	(1) covers a rural primary service area that does not contain a hospital within the primary 
335.18 	service area or contains a hospital within the primary service area that has been designated 
335.19 	as a critical access hospital under section 144.1483, clause (9);
335.20 	(2) has tax-exempt status in accordance with the Internal Revenue Code, section 
335.21 	501(c)(3);
335.22 	(3) received approval before 1991 from the commissioner of health to operate a paramedic 
335.23 	education program;
335.24 	(4) operates an AEMT and paramedic education program exclusively to train paramedics 
335.25 	for the local ambulance service; and
335.26 	(5) limits enrollment in the AEMT and paramedic program to five candidates per 
335.27 	biennium.

335.28 	Sec. 14. Minnesota Statutes 2022, section 144E.285, subdivision 4, is amended to read:
335.29 		Subd. 4.Reapproval. An education program shall apply to the board for reapproval at 
335.30 	least three months 30 days prior to the expiration date of its approval and must:
336.1 	(1) submit an application prescribed by the board specifying any changes from the 
336.2 	information provided for prior approval and any other information requested by the board 
336.3 	to clarify incomplete or ambiguous information presented in the application; and
336.4 	(2) comply with the requirements under subdivision 1, paragraph (b), clauses (2) to (10).
336.5 	(7);
336.6 	(3) be subject to a site visit by the board;
336.7 	(4) for education programs that teach EMRs, comply with the requirements in subdivision 
336.8 	1a;
336.9 	(5) for education programs that teach EMTs, comply with the requirements in subdivision 
336.10 	1b; and
336.11 	(6) for education programs that teach AEMTs and paramedics, comply with the 
336.12 	requirements in subdivision 2 and maintain accreditation with CAAHEP.

336.13 	Sec. 15. REPEALER.
 336.14 	Minnesota Statutes 2022, section 144E.27, subdivisions 1 and 1a, are repealed.

336.15 	ARTICLE 13
336.16 	MISCELLANEOUS

336.17 	Section 1. Minnesota Statutes 2022, section 16A.055, subdivision 1a, is amended to read:
336.18 		Subd. 1a.Additional duties Program evaluation and organizational development 
336.19 	services. The commissioner may assist state agencies by providing analytical, statistical, 
336.20 	program evaluation using experimental or quasi-experimental design, and organizational 
336.21 	development services to state agencies in order to assist the agency to achieve the agency's 
336.22 	mission and to operate efficiently and effectively. For purposes of this section, "experimental 
336.23 	design" means a method of evaluating the impact of a service that uses random assignment 
336.24 	to assign participants into groups that respectively receive the studied service and those that 
336.25 	receive service as usual, so that any difference in outcomes found at the end of the evaluation 
336.26 	can be attributed to the studied service; and "quasi-experimental design" means a method 
336.27 	of evaluating the impact of a service that uses strategies other than random assignment to 
336.28 	establish statistically similar groups that respectively receive the service and those that 
336.29 	receive service as usual, so that any difference in outcomes found at the end of the evaluation 
336.30 	can be attributed to the studied service.

337.1 	Sec. 2. Minnesota Statutes 2022, section 16A.055, is amended by adding a subdivision to 
337.2 	read:
337.3 		Subd. 1b.Consultation to develop performance measures for grants. (a) The 
337.4 	commissioner must, in consultation with the commissioners of health, human services, and 
337.5 	children, youth, and families, develop an ongoing consultation schedule to create, review, 
337.6 	and revise, as necessary, performance measures, data collection, and program evaluation 
337.7 	plans for all state-funded grants administered by the commissioners of health, human 
337.8 	services, and children, youth, and families that distribute at least $1,000,000 annually.
337.9 	(b) Following the development of the ongoing consultation schedule under paragraph 
337.10 	(a), the commissioner and the commissioner of the administering agency must conduct a 
337.11 	grant program consultation in accordance with the ongoing consultation schedule. Each 
337.12 	grant program consultation must include a review of performance measures, data collection, 
337.13 	program evaluation plans, and reporting for each grant program. Following each consultation, 
337.14 	the commissioner and the commissioner of the administering agency may revise evaluation 
337.15 	metrics of a grant program. The commissioner may provide continuing support to the grant 
337.16 	program in accordance with subdivision 1a.

337.17 	Sec. 3. [137.095] EVIDENCE IN SUPPORT OF APPROPRIATION.
337.18 		Subdivision 1.Written report. Prior to the introduction of a bill proposing to appropriate 
337.19 	money to the Board of Regents of the University of Minnesota to benefit the University of 
337.20 	Minnesota's health sciences schools and colleges, the proponents of the bill are requested 
337.21 	to submit a written report to the chairs and ranking minority members of the legislative 
337.22 	committees with jurisdiction over higher education and health and human services policy 
337.23 	and finance setting out the information described in subdivision 2. The University of 
337.24 	Minnesota's health sciences schools and colleges are medicine, nursing, public health, 
337.25 	pharmacy, dentistry, and veterinary medicine.
337.26 		Subd. 2.Contents of report. (a) The report requested under this section must include 
337.27 	the following information as specifically as possible:
337.28 	(1) the dollar amount requested;
337.29 	(2) how the requested dollar amount was calculated;
337.30 	(3) the necessity for the appropriation's purpose to be funded by public funds;
337.31 	(4) University of Minnesota budgeting considerations and decisions impacting the 
337.32 	necessity analysis required by clause (3);
338.1 	(5) all goals, outcomes, and purposes of the appropriation;
338.2 	(6) performance measures as defined by the University of Minnesota that the University 
338.3 	of Minnesota will utilize to ensure the funds are dedicated to the successful achievement 
338.4 	of the identified goals, outcomes, and purposes; and
338.5 	(7) the extent to which the appropriation advances recruitment from, and training for 
338.6 	and retention of, health professionals from and in greater Minnesota and from underserved 
338.7 	communities in metropolitan areas.
338.8 	(b) This subdivision only applies when the Board of Regents of the University of 
338.9 	Minnesota approves a legislative funding request for the University of Minnesota's health 
338.10 	sciences schools and colleges.
338.11 		Subd. 3.Certifications for academic health. A report submitted under this section 
338.12 	must include, in addition to the information listed in subdivision 2, a certification, by the 
338.13 	University of Minnesota Vice President and Budget Director, that:
338.14 	(1) the appropriation will not be used to cover academic health clinical revenue deficits;
338.15 	(2) the goals, outcomes, and purposes of the appropriation are aligned with state goals 
338.16 	for population health improvement; and
338.17 	(3) the appropriation is aligned with the University of Minnesota's strategic plan for its 
338.18 	health sciences schools and colleges, including but not limited to shared goals and strategies 
338.19 	for the health professional schools.
338.20 		Subd. 4.Right to request. The chair of a standing committee in either house of the 
338.21 	legislature may request and obtain the reports submitted pursuant to this section from the 
338.22 	chair of a legislative committee with jurisdiction over higher education or health and human 
338.23 	services policy and finance.

338.24 	Sec. 4. Minnesota Statutes 2023 Supplement, section 142A.03, is amended by adding a 
338.25 	subdivision to read:
338.26 		Subd. 2a.Grant consultation. The commissioner must consult with the commissioner 
338.27 	of management and budget to create, review, and revise grant program performance measures 
338.28 	and to evaluate grant programs administered by the commissioner in accordance with section 
338.29 	16A.055, subdivisions 1a and 1b.

339.1 	Sec. 5. Minnesota Statutes 2022, section 144.05, is amended by adding a subdivision to 
339.2 	read:
339.3 		Subd. 8.Grant consultation. The commissioner must consult with the commissioner 
339.4 	of management and budget to create, review, and revise grant program performance measures 
339.5 	and to evaluate grant programs administered by the commissioner in accordance with section 
339.6 	16A.055, subdivisions 1a and 1b.

339.7 	Sec. 6. Minnesota Statutes 2022, section 144.292, subdivision 6, is amended to read:
339.8 		Subd. 6.Cost. (a) When a patient requests a copy of the patient's record for purposes of 
339.9 	reviewing current medical care, the provider must not charge a fee.
339.10 	(b) When a provider or its representative makes copies of patient records upon a patient's 
339.11 	request under this section, the provider or its representative may charge the patient or the 
339.12 	patient's representative no more than 75 cents per page, plus $10 for time spent retrieving 
339.13 	and copying the records, unless other law or a rule or contract provide for a lower maximum 
339.14 	charge. This limitation does not apply to x-rays. The provider may charge a patient no more 
339.15 	than the actual cost of reproducing x-rays, plus no more than $10 for the time spent retrieving 
339.16 	and copying the x-rays the following amount, unless other law or a rule or contract provide 
339.17 	for a lower maximum charge:
339.18 	(1) for paper copies, $1 per page, plus $10 for time spent retrieving and copying the 
339.19 	records;
339.20 	(2) for x-rays, a total of $30 for retrieving and reproducing x-rays; and
339.21 	(3) for electronic copies, a total of $20 for retrieving the records.
339.22 	(c) The respective maximum charges of 75 cents per page and $10 for time provided in 
339.23 	this subdivision are in effect for calendar year 1992 and may be adjusted annually each 
339.24 	calendar year as provided in this subdivision. The permissible maximum charges shall 
339.25 	change each year by an amount that reflects the change, as compared to the previous year, 
339.26 	in the Consumer Price Index for all Urban Consumers, Minneapolis-St. Paul (CPI-U), 
339.27 	published by the Department of Labor. For any copies of paper records provided under 
339.28 	paragraph (b), clause (1), a provider or the provider's representative may not charge more 
339.29 	than a total of:
339.30 	(1) $10 if there are no records available;
339.31 	(2) $30 for copies of records of up to 25 pages;
339.32 	(3) $50 for copies of records of up to 100 pages;
340.1 	(4) $50, plus an additional 20 cents per page for pages 101 and above; or
340.2 	(5) $500 for any request.
340.3 	(d) A provider or its representative may charge the a $10 retrieval fee, but must not 
340.4 	charge a per page fee or x-ray fee to provide copies of records requested by a patient or the 
340.5 	patient's authorized representative if the request for copies of records is for purposes of 
340.6 	appealing a denial of Social Security disability income or Social Security disability benefits 
340.7 	under title II or title XVI of the Social Security Act; except that no fee shall be charged to 
340.8 	a patient who is receiving public assistance, or to a patient who is represented by an attorney 
340.9 	on behalf of a civil legal services program or a volunteer attorney program based on 
340.10 	indigency. Notwithstanding the foregoing, a provider or its representative must not charge 
340.11 	a fee, including a retrieval fee, to provide copies of records requested by a patient or the 
340.12 	patient's authorized representative if the request for copies of records is for purposes of 
340.13 	appealing a denial of Social Security disability income or Social Security disability benefits 
340.14 	under title II or title XVI of the Social Security Act when the patient is receiving public 
340.15 	assistance, represented by an attorney on behalf of a civil legal services program, or 
340.16 	represented by a volunteer attorney program based on indigency. The patient or the patient's 
340.17 	representative must submit one of the following to show that they are entitled to receive 
340.18 	records without charge under this paragraph:
340.19 	(1) a public assistance statement from the county or state administering assistance;
340.20 	(2) a request for records on the letterhead of the civil legal services program or volunteer 
340.21 	attorney program based on indigency; or
340.22 	(3) a benefits statement from the Social Security Administration.
340.23 	For the purpose of further appeals, a patient may receive no more than two medical record 
340.24 	updates without charge, but only for medical record information previously not provided.
340.25 	For purposes of this paragraph, a patient's authorized representative does not include units 
340.26 	of state government engaged in the adjudication of Social Security disability claims.

340.27 	EFFECTIVE DATE. This section is effective January 1, 2025.

340.28 	Sec. 7. [144.2925] CONSTRUCTION.
340.29 	Sections 144.291 to 144.298 must be construed to protect the privacy of a patient's health 
340.30 	records in a more stringent manner than provided in Code of Federal Regulations, title 45, 
340.31 	part 164. For purposes of this section, "more stringent" has the meaning given to that term 
340.32 	in Code of Federal Regulations, title 45, section 160.202, with respect to a use or disclosure 
341.1 	or the need for express legal permission from an individual to disclose individually 
341.2 	identifiable health information.

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

341.4 	Sec. 8. Minnesota Statutes 2022, section 144.293, subdivision 2, is amended to read:
341.5 		Subd. 2.Patient consent to release of records. A provider, or a person who receives 
341.6 	health records from a provider, may not release a patient's health records to a person without:
341.7 	(1) a signed and dated consent from the patient or the patient's legally authorized 
341.8 	representative authorizing the release;
341.9 	(2) specific authorization in Minnesota law; or
341.10 	(3) a representation from a provider that holds a signed and dated consent from the 
341.11 	patient authorizing the release.

341.12 	EFFECTIVE DATE. This section is effective the day following final enactment and 
341.13 	applies to health records released on or after that date.

341.14 	Sec. 9. Minnesota Statutes 2022, section 144.293, subdivision 4, is amended to read:
341.15 		Subd. 4.Duration of consent. Except as provided in this section, a consent is valid for 
341.16 	one year or for a period specified in the consent or for a different period provided by 
341.17 	Minnesota law.

341.18 	EFFECTIVE DATE. This section is effective the day following final enactment and 
341.19 	applies to health records released on or after that date.

341.20 	Sec. 10. Minnesota Statutes 2022, section 144.293, subdivision 9, is amended to read:
341.21 		Subd. 9.Documentation of release. (a) In cases where a provider releases health records 
341.22 	without patient consent as authorized by Minnesota law, the release must be documented 
341.23 	in the patient's health record. In the case of a release under section 144.294, subdivision 2, 
341.24 	the documentation must include the date and circumstances under which the release was 
341.25 	made, the person or agency to whom the release was made, and the records that were released.
341.26 	(b) When a health record is released using a representation from a provider that holds a 
341.27 	consent from the patient, the releasing provider shall document:
341.28 	(1) the provider requesting the health records;
341.29 	(2) the identity of the patient;
342.1 	(3) the health records requested; and
342.2 	(4) the date the health records were requested.

342.3 	EFFECTIVE DATE. This section is effective the day following final enactment and 
342.4 	applies to health records released on or after that date.

342.5 	Sec. 11. Minnesota Statutes 2022, section 144.293, subdivision 10, is amended to read:
342.6 		Subd. 10.Warranties regarding consents, requests, and disclosures. (a) When 
342.7 	requesting health records using consent, a person warrants that the consent:
342.8 	(1) contains no information known to the person to be false; and
342.9 	(2) accurately states the patient's desire to have health records disclosed or that there is 
342.10 	specific authorization in Minnesota law.
342.11 	(b) When requesting health records using consent, or a representation of holding a 
342.12 	consent, a provider warrants that the request:
342.13 	(1) contains no information known to the provider to be false;
342.14 	(2) accurately states the patient's desire to have health records disclosed or that there is 
342.15 	specific authorization in Minnesota law; and
342.16 	(3) does not exceed any limits imposed by the patient in the consent.
342.17 	(c) When disclosing health records, a person releasing health records warrants that the 
342.18 	person:
342.19 	(1) has complied with the requirements of this section regarding disclosure of health 
342.20 	records;
342.21 	(2) knows of no information related to the request that is false; and
342.22 	(3) has complied with the limits set by the patient in the consent.

342.23 	EFFECTIVE DATE. This section is effective the day following final enactment and 
342.24 	applies to health records released on or after that date.

342.25 	Sec. 12. Minnesota Statutes 2023 Supplement, section 245.991, subdivision 1, is amended 
342.26 	to read:
342.27 		Subdivision 1.Establishment. The commissioner of human services must establish the 
342.28 	projects for assistance in transition from homelessness program to prevent or end 
342.29 	homelessness for people with serious mental illness, substance use disorder, or co-occurring 
343.1 	substance use disorder and ensure the commissioner achieves the goals of the housing 
343.2 	mission statement in section 245.461, subdivision 4.

343.3 	Sec. 13. Minnesota Statutes 2023 Supplement, section 245C.31, subdivision 1, is amended 
343.4 	to read:
343.5 		Subdivision 1.Board determines disciplinary or corrective action. (a) The 
343.6 	commissioner shall notify a health-related licensing board as defined in section 214.01, 
343.7 	subdivision 2, if the commissioner determines that an individual who is licensed by the 
343.8 	health-related licensing board and who is included on the board's roster list provided in 
343.9 	accordance with subdivision 3a is responsible for substantiated maltreatment under section 
343.10 	626.557 or chapter 260E, in accordance with subdivision 2. Upon receiving notification
343.11 	Except as provided in paragraph (b), the health-related licensing board shall make a 
343.12 	determination as to whether to impose disciplinary or corrective action under chapter 214, 
343.13 	rather than the commissioner making the decision regarding disqualification.
343.14 	(b) The prohibition on disqualification in paragraph (a) does not apply to a background 
343.15 	study of an individual regulated by a health-related licensing board if the individual's study 
343.16 	is related to child foster care, adult foster care, or family child care licensure.

343.17 	Sec. 14. Minnesota Statutes 2022, section 256.01, is amended by adding a subdivision to 
343.18 	read:
343.19 		Subd. 2c.Grant consultation. The commissioner must consult with the commissioner 
343.20 	of management and budget to create, review, and revise grant program performance measures 
343.21 	and to evaluate grant programs administered by the commissioner in accordance with section 
343.22 	16A.055, subdivisions 1a and 1b.

343.23 	Sec. 15. Minnesota Statutes 2022, section 256.01, subdivision 41, is amended to read:
343.24 		Subd. 41.Reports on interagency agreements and intra-agency transfers. (a) 
343.25 	Beginning October 31, 2024, and annually thereafter, the commissioner of human services 
343.26 	shall provide quarterly reportsa report to the chairs and ranking minority members of the 
343.27 	legislative committees with jurisdiction over health and human services policy and finance 
343.28 	on:
343.29 	(1) interagency agreements or service-level agreements and any renewals or extensions 
343.30 	of existing interagency or service-level agreements with a state department under section 
343.31 	15.01, state agency under section 15.012, or the Department of Information Technology 
344.1 	Services, with a value of more than $100,000, or related agreements with the same department 
344.2 	or agency with a cumulative value of more than $100,000; and
344.3 	(2) transfers of appropriations of more than $100,000 between accounts within or between 
344.4 	agencies.
344.5 	The report must include the statutory citation authorizing the agreement, transfer or dollar 
344.6 	amount, purpose, and effective date of the agreement, the duration of the agreement, and a 
344.7 	copy of the agreement.
344.8 	(b) This subdivision expires December 31, 2034.

344.9 	Sec. 16. Minnesota Statutes 2022, section 256B.795, is amended to read:
344.10 	256B.795 MATERNAL AND INFANT HEALTH REPORT.
344.11 	(a) The commissioner of human services, in consultation with the commissioner of 
344.12 	health, shall submit a biennial report beginning April 15, 2022, to the chairs and ranking 
344.13 	minority members of the legislative committees with jurisdiction over health policy and 
344.14 	finance on the effectiveness of state maternal and infant health policies and programs 
344.15 	addressing health disparities in prenatal and postpartum health outcomes. For each reporting 
344.16 	period, the commissioner shall determine the number of women enrolled in the medical 
344.17 	assistance program who are pregnant or are in the 12-month postpartum period of eligibility 
344.18 	and the percentage of women in that group who, during each reporting period:
344.19 	(1) received prenatal services;
344.20 	(2) received doula services;
344.21 	(3) gave birth by primary cesarean section;
344.22 	(4) gave birth to an infant who received care in the neonatal intensive care unit;
344.23 	(5) gave birth to an infant who was premature or who had a low birth weight;
344.24 	(6) experienced postpartum hemorrhage;
344.25 	(7) received postpartum care within six weeks of giving birth; and
344.26 	(8) received a prenatal and postpartum follow-up home visit from a public health nurse.
344.27 	(b) These measurements must be determined through an analysis of the utilization data 
344.28 	from claims submitted during each reporting period and by any other appropriate means. 
344.29 	The measurements for each metric must be determined in the aggregate stratified by race 
344.30 	and ethnicity.
345.1 	(c) The commissioner shall establish a baseline for the metrics described in paragraph 
345.2 	(a) using calendar year 2017. The initial report due April 15, 2022, must contain the baseline 
345.3 	metrics and the metrics data for calendar years 2019 and 2020. The following reports due 
345.4 	biennially thereafter must contain the metrics for the preceding two calendar years.
345.5 	(d) This section expires December 31, 2034.

345.6 	Sec. 17. Minnesota Statutes 2022, section 256K.45, subdivision 2, is amended to read:
345.7 		Subd. 2.Homeless youth report. (a) The commissioner shall prepare a biennial report, 
345.8 	beginning in February 2015 February 1, 2025, which provides meaningful information to 
345.9 	the chairs and ranking minority members of the legislative committees having with
345.10 	jurisdiction over the issue of homeless youth, that includes, but is not limited to: (1) a list 
345.11 	of the areas of the state with the greatest need for services and housing for homeless youth, 
345.12 	and the level and nature of the needs identified; (2) details about grants made, including 
345.13 	shelter-linked youth mental health grants under section 256K.46; (3) the distribution of 
345.14 	funds throughout the state based on population need; (4) follow-up information, if available, 
345.15 	on the status of homeless youth and whether they have stable housing two years after services 
345.16 	are provided; and (5) any other outcomes for populations served to determine the 
345.17 	effectiveness of the programs and use of funding.
345.18 	(b) This subdivision expires December 31, 2034.

345.19 	Sec. 18. Minnesota Statutes 2023 Supplement, section 260.761, is amended by adding a 
345.20 	subdivision to read:
345.21 		Subd. 8.Missing child notification. A child-placing agency or individual petitioner 
345.22 	shall notify an Indian child's Tribe or Tribes by telephone and by email or facsimile 
345.23 	immediately but no later than 24 hours after receiving information on a missing child as 
345.24 	defined under section 260C.212, subdivision 13, paragraph (a).

345.25 	Sec. 19. 2024 H.F. No. 5237, article 22, section 2, subdivision 4, if enacted, is amended 
345.26 	to read:

345.27	Subd. 4.Central Office; Health Care
 		(3,216,000)
		3,216,000
	
345.28 	The appropriation in fiscal year 2025 is a 
345.29 	onetime appropriation.

346.1 	Sec. 20. 2024 H.F. No. 5237, article 22, section 2, subdivision 5, if enacted, is amended 
346.2 	to read:

346.3
346.4	Subd. 5.Central Office; Behavioral Health, Deaf 
and Hard-of-Hearing, and Housing Services
 		(136,000)
		136,000
	
346.5 	The appropriation in fiscal year 2025 is a 
346.6 	onetime appropriation.
346.7 	Extended Availability. $136,000 of the 
346.8 	general fund appropriation in fiscal year 2025 
346.9 	is available until June 30, 2027.

346.10 	Sec. 21. ANNUAL REPORT TO LEGISLATURE; USE OF APPROPRIATION 
346.11 	FUNDS.
 346.12 	By January 15, 2025, and every year thereafter, the Board of Regents of the University 
346.13 	of Minnesota must submit a report to the chairs and ranking minority members of the 
346.14 	legislative committees with primary jurisdiction over higher education and health and human 
346.15 	services policy and finance on the use of all appropriations for the benefit of the University 
346.16 	of Minnesota's health sciences schools and colleges, including:
346.17 	(1) changes to the University of Minnesota's anticipated uses of each appropriation;
346.18 	(2) the results of the performance measures required by Minnesota Statutes, section 
346.19 	137.095, subdivision 2, clause (6); and
346.20 	(3) current and anticipated achievement of the goals, outcomes, and purposes of each 
346.21 	appropriation.

346.22 	Sec. 22. DIRECTION TO COMMISSIONER OF HEALTH; HEALTH 
346.23 	PROFESSIONS WORKFORCE ADVISORY COUNCIL.
 346.24 		Subdivision 1.Health professions workforce advisory council. The commissioner of 
346.25 	health, in consultation with the University of Minnesota and the Minnesota State HealthForce 
346.26 	Center of Excellence, shall provide recommendations to the legislature for the creation of 
346.27 	a health professions workforce advisory council to:
346.28 	(1) research and advise the legislature and the Minnesota Office of Higher Education 
346.29 	on the status of the health workforce who are in training and on the need for additional or 
346.30 	different training opportunities;
347.1 	(2) provide information and analysis on health workforce needs and trends, upon request, 
347.2 	to the legislature, any state department, or any other entity the advisory council deems 
347.3 	appropriate;
347.4 	(3) review and comment on legislation relevant to Minnesota's health workforce; and
347.5 	(4) study and provide recommendations regarding the following:
347.6 	(i) health workforce supply, including:
347.7 	(A) employment trends and demand;
347.8 	(B) strategies that entities in Minnesota are using or may use to address health workforce 
347.9 	shortages, recruitment, and retention; and
347.10 	(C) future investments to increase the supply of health care professionals, with particular 
347.11 	focus on critical areas of need within Minnesota;
347.12 	(ii) options for training and educating the health workforce, including:
347.13 	(A) increasing the diversity of health professions workers to reflect Minnesota's 
347.14 	communities;
347.15 	(B) addressing the maldistribution of primary, mental health, nursing, and dental providers 
347.16 	in greater Minnesota and in underserved communities in metropolitan areas;
347.17 	(C) increasing interprofessional training and clinical practice;
347.18 	(D) addressing the need for increased quality faculty to train an increased workforce; 
347.19 	and
347.20 	(E) developing advancement paths or career ladders for health care professionals;
347.21 	(iii) increasing funding for strategies to diversify and address gaps in the health workforce, 
347.22 	including:
347.23 	(A) increasing access to financing for graduate medical education;
347.24 	(B) expanding pathway programs to increase awareness of the health care professions 
347.25 	among high school, undergraduate, and community college students and engaging the current 
347.26 	health workforce in those programs;
347.27 	(C) reducing or eliminating tuition for entry-level health care positions that offer 
347.28 	opportunities for future advancement in high-demand settings and expanding other existing 
347.29 	financial support programs such as loan forgiveness and scholarship programs;
348.1 	(D) incentivizing recruitment from greater Minnesota and recruitment and retention for 
348.2 	providers practicing in greater Minnesota and in underserved communities in metropolitan 
348.3 	areas; and
348.4 	(E) expanding existing programs, or investing in new programs, that provide wraparound 
348.5 	support services to the existing health care workforce, especially people of color and 
348.6 	professionals from other underrepresented identities, to acquire training and advance within 
348.7 	the health care workforce; and
348.8 	(iv) other Minnesota health workforce priorities as determined by the advisory council.
348.9 		Subd. 2.Report to the legislature. On or before February 1, 2025, the commissioner 
348.10 	of health shall submit a report to the chairs and ranking minority members of the legislative 
348.11 	committees with jurisdiction over health and human services and higher education finance 
348.12 	and policy with recommendations for the creation of a health professions workforce advisory 
348.13 	council as described in subdivision 1. The report must include recommendations regarding:
348.14 	(1) membership of the advisory council;
348.15 	(2) funding sources and estimated costs for the advisory council;
348.16 	(3) existing sources of workforce data for the advisory council to perform its duties;
348.17 	(4) necessity for and options to obtain new data for the advisory council to perform its 
348.18 	duties;
348.19 	(5) additional duties of the advisory council;
348.20 	(6) proposed legislation to establish the advisory council;
348.21 	(7) similar health workforce advisory councils in other states; and
348.22 	(8) advisory council reporting requirements.

348.23 	Sec. 23. REQUEST FOR INFORMATION; EVALUATION OF STATEWIDE 
348.24 	HEALTH CARE NEEDS AND CAPACITY AND PROJECTIONS OF FUTURE 
348.25 	HEALTH CARE NEEDS.
 348.26 	(a) By November 1, 2024, the commissioner of health must publish a request for 
348.27 	information to assist the commissioner in a future comprehensive evaluation of current 
348.28 	health care needs and capacity in the state and projections of future health care needs in the 
348.29 	state based on population and provider characteristics. The request for information:
349.1 	(1) must provide guidance on defining the scope of the study and assist in answering 
349.2 	methodological questions that will inform the development of a request for proposals to 
349.3 	contract for performance of the study; and
349.4 	(2) may address topics that include but are not limited to how to define health care 
349.5 	capacity, expectations for capacity by geography or service type, how to consider health 
349.6 	centers that have areas of particular expertise or services that generally have a higher margin, 
349.7 	how hospital-based services should be considered as compared with evolving 
349.8 	nonhospital-based services, the role of technology in service delivery, health care workforce 
349.9 	supply issues, and other issues related to data or methods.
349.10 	(b) By February 1, 2025, the commissioner must submit a report to the chairs and ranking 
349.11 	minority members of the legislative committees with jurisdiction over health care, with the 
349.12 	results of the request for information and recommendations regarding conducting a 
349.13 	comprehensive evaluation of current health care needs and capacity in the state and 
349.14 	projections of future health care needs in the state.

349.15 	Sec. 24. REPEALER.
 349.16 	Minnesota Statutes 2022, section 256B.79, subdivision 6, is repealed.

349.17 	ARTICLE 14
349.18 	APPROPRIATIONS

349.19	Section 1. HEALTH AND HUMAN SERVICES APPROPRIATIONS.
 	
349.20 	The sums shown in the columns marked "Appropriations" are added to or, if shown in 
349.21 	parentheses, subtracted from the appropriations in Laws 2023, chapter 61, article 9; Laws 
349.22 	2023, chapter 70, article 20; and Laws 2023, chapter 74, section 6, to the agencies and for 
349.23 	the purposes specified in this article. The appropriations are from the general fund or other 
349.24 	named fund and are available for the fiscal years indicated for each purpose. The figures 
349.25 	"2024" and "2025" used in this article mean that the addition to or subtraction from the 
349.26 	appropriation listed under them is available for the fiscal year ending June 30, 2024, or June 
349.27 	30, 2025, respectively. Base adjustments mean the addition to or subtraction from the base 
349.28 	level adjustment set in Laws 2023, chapter 61, article 9; Laws 2023, chapter 70, article 20; 
349.29 	and Laws 2023, chapter 74, section 6. Supplemental appropriations and reductions to 
349.30 	appropriations for the fiscal year ending June 30, 2024, are effective the day following final 
349.31 	enactment unless a different effective date is explicit.

349.32				APPROPRIATIONS
	
349.33				Available for the Year
	
350.1				Ending June 30
	
350.2					2024
		2025

350.3
350.4	Sec. 2. COMMISSIONER OF HUMAN 
SERVICES

350.5	Subdivision 1.Total Appropriation
 	$
	(22,695,000)
	$
	23,032,000

350.6	Appropriations by Fund
	
350.7		2024
	2025
	
350.8	General
	(22,695,000)
	23,132,000
	
350.9	Health Care Access
	-0-
	(100,000)
	
350.10 	The amounts that may be spent for each 
350.11 	purpose are specified in the following 
350.12 	subdivisions.

350.13	Subd. 2.Central Office; Operations
 		-0-
		(1,907,000)
	
350.14 	Base Level Adjustment. The general fund 
350.15 	base is increased by $239,000 in fiscal year 
350.16 	2026 and increased by $181,000 in fiscal year 
350.17 	2027.

350.18	Subd. 3.Central Office; Health Care

350.19	Appropriations by Fund
	
350.20	General
	-0-
	540,000
	
350.21	Health Care Access
	(1,000,000)
	-0-
	
350.22 	Base Level Adjustment. The general fund 
350.23 	base is increased by $1,063,000 in fiscal year 
350.24 	2026 and increased by $1,063,000 in fiscal 
350.25 	year 2027.

350.26
350.27	Subd. 4.Central Office; Behavioral Health, Deaf 
and Hard-of-Hearing, and Housing Services
 		-0-
		2,036,000
	
350.28 	(a) The appropriation in fiscal year 2025 is a 
350.29 	onetime appropriation.
350.30 	(b) Medical Assistance Mental Health 
350.31 	Benefit Development. $1,227,000 in fiscal 
350.32 	year 2025 is to: (1) conduct an analysis to 
350.33 	identify existing or pending Medicaid 
350.34 	Clubhouse benefits in other states, federal 
351.1 	authorities used, populations served, service 
351.2 	and reimbursement design, and accreditation 
351.3 	standards; (2) consult with providers, 
351.4 	advocates, Tribal Nations, counties, people 
351.5 	with lived experience as or with a child in a 
351.6 	mental health crisis, and other interested 
351.7 	community members to develop a covered 
351.8 	benefit under medical assistance to provide 
351.9 	residential mental health crisis stabilization 
351.10 	for children; and (3) develop a First Episode 
351.11 	Psychosis Coordinated Specialty Care 
351.12 	(FEP-CSC) medical assistance benefit. This 
351.13 	is a onetime appropriation and is available 
351.14 	until June 30, 2027.

351.15	Subd. 5.Forecasted Programs; MinnesotaCare
 		-0-
		343,000
	
351.16 	(a) This appropriation is from the health care 
351.17 	access fund.
351.18 	(b) Base Level Adjustment. The health care 
351.19 	access fund base is increased by $1,165,000 
351.20 	in fiscal year 2026 and increased by 
351.21 	$1,713,000 in fiscal year 2027.

351.22
351.23	Subd. 6.Forecasted Programs; Medical 
Assistance

351.24	Appropriations by Fund
	
351.25	General
	-0-
	6,527,000
	
351.26	Health Care Access
	1,000,000
	(443,000)
	
351.27 	(a) Additional Payment for Behavioral 
351.28 	Health Services Provided by Hospitals.
351.29 	$5,814,000 in fiscal year 2025 is from the 
351.30 	general fund for behavioral health services 
351.31 	provided by hospitals under Minnesota 
351.32 	Statutes, section 256.969, subdivision 2b, 
351.33 	paragraph (a), clause (4). The increase in 
351.34 	payments shall be made by increasing the 
351.35 	adjustment under Minnesota Statutes, section 
352.1 	256.969, subdivision 2b, paragraph (e), clause 
352.2 	(2).
352.3 	(b) Base Level Adjustment. The health care 
352.4 	access fund base is decreased by $1,265,000 
352.5 	in fiscal year 2026 and decreased by 
352.6 	$1,813,000 in fiscal year 2027.

352.7
352.8	Subd. 7.Forecasted Programs; Behavioral 
Health Fund
 		-0-
		127,000

352.9352.10
	Subd. 8.Grant Programs; Adult Mental Health 
Grants
 		(22,695,000)
		14,568,000
	
352.11 	(a) Youable Emotional Health. $300,000 in 
352.12 	fiscal year 2025 is for a grant to Youable 
352.13 	Emotional Health for day treatment 
352.14 	transportation costs on nonschool days, student 
352.15 	nutrition, and student learning experiences 
352.16 	such as technology, arts, and outdoor activity. 
352.17 	This is a onetime appropriation. 
352.18 	Notwithstanding Minnesota Statutes, section 
352.19 	16B.98, subdivision 14, the amount for 
352.20 	administrative costs under this paragraph is 
352.21 	$0.
352.22 	(b) Comunidades Latinas Unidas En 
352.23 	Servercio Certified Community Behavioral 
352.24 	Health Clinic Services. $1,500,000 in fiscal 
352.25 	year 2025 is for a payment to Comunidades 
352.26 	Latinas Unidas En Servercio (CLUES) to 
352.27 	provide comprehensive integrated health care 
352.28 	through the certified community behavioral 
352.29 	health clinic (CCBHC) model of service 
352.30 	delivery as required under Minnesota Statutes, 
352.31 	section 245.735. Funds must be used to 
352.32 	provide evidence-based services under the 
352.33 	CCBHC service model and must not be used 
352.34 	to supplant available medical assistance 
352.35 	funding. By June 30, 2026, CLUES must 
353.1 	report to the commissioner of human services 
353.2 	on:
353.3 	(1) the number of people served;
353.4 	(2) outcomes for people served; and
353.5 	(3) whether the funding reduced behavioral 
353.6 	health racial and ethnic disparities.
353.7 	This is a onetime appropriation and is 
353.8 	available until June 30, 2026. Notwithstanding 
353.9 	Minnesota Statutes, section 16B.98, 
353.10 	subdivision 14, the amount for administrative 
353.11 	costs under this paragraph is $0.
353.12 	(c) Grant to PFund Foundation. $1,000,000 
353.13 	in fiscal year 2025 is for a payment to the 
353.14 	PFund Foundation for grants in Minnesota to 
353.15 	support the medical, mental health, and social 
353.16 	service needs of LGBTQIA2S+ individuals. 
353.17 	This is a onetime appropriation.
353.18 	(d) Adult Mental Health Initiative 
353.19 	Appropriation Cancellation and 
353.20 	Appropriation. $11,768,000 of the fiscal year 
353.21 	2024 appropriation for the adult mental health 
353.22 	initiative is canceled and $11,768,000 in fiscal 
353.23 	year 2025 is for the adult mental health 
353.24 	initiative. This is a onetime appropriation.

353.25
353.26	Subd. 9.Grant Programs; Child Mental Health 
Grants
 		-0-
		7,350,000
	
353.27 	(a) School-Linked Behavioral Health 
353.28 	Grants. $3,000,000 in fiscal year 2025 is for 
353.29 	school-linked behavioral health grants under 
353.30 	Minnesota Statutes, section 245.4901. This is 
353.31 	a onetime appropriation and is available until 
353.32 	June 30, 2027. Notwithstanding Minnesota 
353.33 	Statutes, section 16B.98, subdivision 14, the 
354.1 	amount for administrative costs under this 
354.2 	paragraph is $0.
354.3 	(b) Respite Care Services. $2,650,000 in 
354.4 	fiscal year 2025 is for respite care services 
354.5 	under Minnesota Statutes, section 245.4889, 
354.6 	subdivision 1, paragraph (b), clause (3). This 
354.7 	is a onetime appropriation and is available 
354.8 	until June 30, 2027. Notwithstanding 
354.9 	Minnesota Statutes, section 16B.98, 
354.10 	subdivision 14, the amount for administrative 
354.11 	costs under this paragraph is $515,000.
354.12 	(c) Grant to Volunteers of America.
354.13 	$1,700,000 in fiscal year 2025 is for a grant 
354.14 	to Volunteers of America for program 
354.15 	consolidation, workforce training, and the 
354.16 	development of a trauma-informed locked 
354.17 	setting environment. This is a onetime 
354.18 	appropriation and is available until June 30, 
354.19 	2027. Notwithstanding Minnesota Statutes, 
354.20 	section 16B.98, subdivision 14, the amount 
354.21 	for administrative costs under this paragraph 
354.22 	is $0.

354.23
354.24	Subd. 10.Direct Care and Treatment; Mental 
Health and Substance Abuse
 		-0-
		(6,109,000)
	
354.25 	Base Level Adjustments. The general fund 
354.26 	base is decreased by $7,566,000 in fiscal year 
354.27 	2026 and decreased by $7,566,000 in fiscal 
354.28 	year 2027.

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

354.30	Sec. 3. COMMISSIONER OF HEALTH

354.31	Subdivision 1.Total Appropriation
 	$
	(2,690,000)
	$
	(251,000)

354.32	Appropriations by Fund
	
354.33		2024
	2025
	
355.1	General
	(2,694,000)
	2,485,000
	
355.2
355.3	State Government 
Special Revenue
	4,000
	(2,736,000)
	
355.4 	The amount that may be spent for each 
355.5 	purpose is specified in the following 
355.6 	subdivisions.

355.7	Subd. 2.Health Improvement
 		(2,694,000)
		2,075,000
	
355.8 	(a) Stillbirth Prevention Grant. $210,000 in 
355.9 	fiscal year 2025 is for a grant to Healthy Birth 
355.10 	Day, Inc., to operate a stillbirth prevention 
355.11 	through tracking fetal movement pilot 
355.12 	program. This is a onetime appropriation and 
355.13 	is available until June 30, 2028. In accordance 
355.14 	with Minnesota Statutes, section 16B.98, 
355.15 	subdivision 14, the commissioner may use 
355.16 	$10,000 of this appropriation for 
355.17 	administrative costs.
355.18 	(b) Grant to Chosen Vessels Midwifery 
355.19 	Services. $263,000 in fiscal year 2025 is for 
355.20 	a grant to Chosen Vessels Midwifery Services 
355.21 	for a program to provide education, support, 
355.22 	and encouragement for African American 
355.23 	mothers to breastfeed their infants for the first 
355.24 	year of life or longer. Chosen Vessel 
355.25 	Midwifery Services must combine the midwife 
355.26 	model of care with the cultural tradition of 
355.27 	mutual aid to inspire African American 
355.28 	women to breastfeed their infants and to 
355.29 	provide support to those who do. This is a 
355.30 	onetime appropriation and is available until 
355.31 	June 30, 2026. In accordance with Minnesota 
355.32 	Statutes, section 16B.98, subdivision 14, the 
355.33 	commissioner may use $13,000 of this 
355.34 	appropriation for administrative costs.
356.1 	(c) American Indian Birth Center Planning 
356.2 	Grant. $368,000 in fiscal year 2025 is for a 
356.3 	grant to the Birth Justice Collaborative to plan 
356.4 	for and engage the community in the 
356.5 	development of an American Indian-focused 
356.6 	birth center to improve access to culturally 
356.7 	centered prenatal and postpartum care with 
356.8 	the goal of improving maternal and child 
356.9 	health outcomes. The Birth Justice 
356.10 	Collaborative must report to the commissioner 
356.11 	on the plan to develop an American 
356.12 	Indian-focused birth center. This is a onetime 
356.13 	appropriation. In accordance with Minnesota 
356.14 	Statutes, section 16B.98, subdivision 14, the 
356.15 	commissioner may use $18,000 of this 
356.16 	appropriation for administrative costs.
356.17 	(d) Grant to Birth Justice Collaborative for 
356.18 	African American-Focused Homeplace 
356.19 	Model. $263,000 in fiscal year 2025 is for a 
356.20 	grant to the Birth Justice Collaborative for 
356.21 	planning and community engagement to 
356.22 	develop a replicable African 
356.23 	American-focused Homeplace model. The 
356.24 	model's purpose must be to improve access to 
356.25 	culturally centered healing and care during 
356.26 	pregnancy and the postpartum period, with 
356.27 	the goal of improving maternal and child 
356.28 	health outcomes. The Birth Justice 
356.29 	Collaborative must report to the commissioner 
356.30 	on the needs of and plan to develop an African 
356.31 	American-focused Homeplace model in 
356.32 	Hennepin County. The report must outline 
356.33 	potential state and public partnerships and 
356.34 	financing strategies and must provide a 
356.35 	timeline for development. This is a onetime 
356.36 	appropriation. In accordance with Minnesota 
357.1 	Statutes, section 16B.98, subdivision 14, the 
357.2 	commissioner may use $13,000 of this 
357.3 	appropriation for administrative costs.
357.4 	(e) Request for Information; Evaluation of 
357.5 	Statewide Health Care Needs and Capacity.
357.6 	$250,000 in fiscal year 2025 is for a request 
357.7 	for information for a future evaluation of 
357.8 	statewide health care needs and capacity and 
357.9 	projections of future health care needs. This 
357.10 	is a onetime appropriation.
357.11 	(f) Reports on Prior Authorization 
357.12 	Requests. $191,000 in fiscal year 2025 is for 
357.13 	the purposes of Minnesota Statutes, section 
357.14 	62M.19. This appropriation is available until 
357.15 	June 30, 2027. The base for this appropriation 
357.16 	is $21,000 in fiscal year 2026 and $22,000 in 
357.17 	fiscal year 2027.
357.18 	(g) Base Level Adjustment. The general fund 
357.19 	base is increased by $247,000 in fiscal year 
357.20 	2026 and increased by $318,000 in fiscal year 
357.21 	2027.

357.22	Subd. 3.Health Protection

357.23	Appropriations by Fund
	
357.24	General
	-0-
	410,000
	
357.25
357.26	State Government 
Special Revenue
	4,000
	(2,736,000)
	
357.27 	(a) Translation of Competency Evaluation 
357.28 	for Nursing Assistant Registry. $20,000 in 
357.29 	fiscal year 2025 is from the general fund for 
357.30 	translation of competency evaluation materials 
357.31 	for the nursing assistant registry. This is a 
357.32 	onetime appropriation.
357.33 	(b) Hospital Closure, Relocation, or Service 
357.34 	Cessation. $9,000 in fiscal year 2025 is from 
358.1 	the general fund for activities under Minnesota 
358.2 	Statutes, section 144.555.
358.3 	(c) Natural Organic Reduction. $140,000 in 
358.4 	fiscal year 2025 is from the state government 
358.5 	special revenue fund for the licensure of 
358.6 	natural organic reduction facilities. The base 
358.7 	for this appropriation is $85,000 in fiscal year 
358.8 	2026 and $16,000 in fiscal year 2027.
358.9 	(d) Groundwater Thermal Exchange Device 
358.10 	Permitting. $4,000 in fiscal year 2024 and 
358.11 	$4,000 in fiscal year 2025 are from the state 
358.12 	government special revenue fund for costs 
358.13 	related to issuing permits for groundwater 
358.14 	thermal exchange devices.
358.15 	(e) Base Level Adjustment. The general fund 
358.16 	base is increased by $390,000 in fiscal year 
358.17 	2026 and increased by $185,000 in fiscal year 
358.18 	2027. The state government special revenue 
358.19 	fund base is decreased by $2,791,000 in fiscal 
358.20 	year 2026 and decreased by $2,860,000 in 
358.21 	fiscal year 2027.

358.22	Sec. 4. BOARD OF PHARMACY

358.23	Appropriations by Fund
	
358.24	General
	1,500,000
	-0-
	
358.25
358.26	State Government 
Special Revenue
	-0-
	27,000
	
358.27 	(a) Legal Costs. $1,500,000 in fiscal year 
358.28 	2024 is from the general fund for legal costs. 
358.29 	This is a onetime appropriation.
358.30 	(b) Base Level Adjustment. The state 
358.31 	government special revenue fund base is 
358.32 	increased by $27,000 in fiscal year 2026 and 
358.33 	increased by $27,000 in fiscal year 2027.

359.1
359.2	Sec. 5. RARE DISEASE ADVISORY 
COUNCIL
 	$
	-0-
	$
	342,000
	
359.3 	This is a onetime appropriation and is 
359.4 	available until June 30, 2027.

359.5
359.6	Sec. 6. COMMISSIONER OF MANAGEMENT 
AND BUDGET

359.7	Appropriations by Fund
	
359.8		2024
	2025
	
359.9	General
	-0-
	(232,000)
	
359.10	Health Care Access
	-0-
	100,000
	
359.11 	(a) Insulin safety net program. $100,000 in 
359.12 	fiscal year 2025 is from the health care access 
359.13 	fund for the insulin safety net program in 
359.14 	Minnesota Statutes, section 151.74.
359.15 	(b) Transfer. The commissioner must transfer 
359.16 	from the health care access fund to the insulin 
359.17 	safety net program account in the special 
359.18 	revenue fund the amount certified by the 
359.19 	commissioner of administration under 
359.20 	Minnesota Statutes, section 151.741, 
359.21 	subdivision 5, paragraph (b), estimated to be 
359.22 	$100,000 in fiscal year 2025, for 
359.23 	reimbursement to manufacturers for insulin 
359.24 	dispensed under the insulin safety net program 
359.25 	in Minnesota Statutes, section 151.74. The 
359.26 	base for this transfer is estimated to be 
359.27 	$100,000 in fiscal year 2026 and $100,000 in 
359.28 	fiscal year 2027.
359.29 	(c) Base Level Adjustment. The health care 
359.30 	access fund base is increased by $100,000 in 
359.31 	fiscal year 2026 and increased by $100,000 in 
359.32 	fiscal year 2027.

359.33	Sec. 7. BOARD OF DIRECTORS OF MNSURE
 	$
	-0-
	$
	2,330,000
	
360.1 	(a) Information Technology to Implement 
360.2 	Federal Deferred Action for Childhood 
360.3 	Arrivals Regulatory Requirements.
360.4 	$2,330,000 in fiscal year 2025 is for 
360.5 	information technology to implement federal 
360.6 	Deferred Action for Childhood Arrivals 
360.7 	regulatory requirements. This is a onetime 
360.8 	appropriation and is available until June 30, 
360.9 	2027.
360.10 	(b) Transfer to Enterprise Account. The 
360.11 	Board of Directors of MNsure must transfer 
360.12 	$2,330,000 in fiscal year 2025 from the 
360.13 	general fund to the enterprise account under 
360.14 	Minnesota Statutes, section 62V.07. This is a 
360.15 	onetime transfer.

360.16	Sec. 8. COMMISSIONER OF COMMERCE
 	$
	-0-
	$
	149,000
	
360.17 	(a) Defrayal of Costs for Mandated 
360.18 	Coverage of Orthotic and Prosthetic 
360.19 	Devices. The general fund base is increased 
360.20 	by $558,000 in fiscal year 2026 and increased 
360.21 	by $539,000 in fiscal year 2027. The base 
360.22 	includes $520,000 in fiscal year 2026 and 
360.23 	$540,000 in fiscal year 2027 for the estimated 
360.24 	amount of defrayal costs for mandated 
360.25 	coverage of orthotic and prosthetic devices 
360.26 	and $38,000 in fiscal year 2026 and $19,000 
360.27 	in fiscal year 2027 for administrative costs to 
360.28 	implement mandated coverage of orthotic and 
360.29 	prosthetic devices.
360.30 	(b) Defrayal of Costs for Mandated 
360.31 	Coverage of Abortions and 
360.32 	Abortion-Related Services. The general fund 
360.33 	base is increased by $338,000 in fiscal year 
360.34 	2026 and increased by $319,000 in fiscal year 
360.35 	2027. The base includes $300,000 in fiscal 
361.1 	year 2026 and $300,000 in fiscal year 2027 
361.2 	for the estimated amount of defrayal costs for 
361.3 	mandated coverage of abortions and 
361.4 	abortion-related services and $38,000 in fiscal 
361.5 	year 2026 and $19,000 in fiscal year 2027 for 
361.6 	administrative costs to implement mandated 
361.7 	coverage of abortions and abortion-related 
361.8 	services.
361.9 	(c) Defrayal Costs for Mandated Coverage 
361.10 	of Rapid Whole Genome Sequencing. The 
361.11 	general fund base is increased by $838,000 in 
361.12 	fiscal year 2026 and increased by $819,000 in 
361.13 	fiscal year 2027. The base includes $800,000 
361.14 	in fiscal year 2026 and $800,000 in fiscal year 
361.15 	2027 for the estimated amount of defrayal 
361.16 	costs for rapid whole genome sequencing and 
361.17 	$38,000 in fiscal year 2026 and $19,000 in 
361.18 	fiscal year 2027 for administrative costs to 
361.19 	implement mandated coverage of rapid whole 
361.20 	genome sequencing.
361.21 	(d) Oversight of Nonprofit Health Coverage 
361.22 	Entity Conversion Transactions. $149,000 
361.23 	in fiscal year 2025 is for oversight of nonprofit 
361.24 	health coverage entity conversion transactions 
361.25 	under Minnesota Statutes, sections 145D.30 
361.26 	to 145D.37. The base for this appropriation is 
361.27 	$149,000 in fiscal year 2026 and $0 in fiscal 
361.28 	year 2027.
361.29 	(e) Base Level Adjustment. The general fund 
361.30 	base is increased by $149,000 in fiscal year 
361.31 	2026 and increased by $0 in fiscal year 2027.

361.32	Sec. 9. ATTORNEY GENERAL
 	$
	-0-
	$
	53,000
	
361.33 	(a) Nonprofit Health Coverage Entity 
361.34 	Conversion Transactions. $53,000 in fiscal 
362.1 	year 2025 is for review and related 
362.2 	investigatory and enforcement actions for 
362.3 	conversion transactions under Minnesota 
362.4 	Statutes, sections 145D.30 to 145D.37.
362.5 	(b) Base Level Adjustment. The general fund 
362.6 	base is increased by $53,000 in fiscal year 
362.7 	2026 and increased by $53,000 in fiscal year 
362.8 	2027.

362.9 	Sec. 10. Laws 2023, chapter 22, section 4, subdivision 2, is amended to read:
362.10 		Subd. 2.Grants to navigators.
 362.11 	(a) $1,936,000 in fiscal year 2024 is 
362.12 	appropriated from the health care access fund 
362.13 	to the commissioner of human services for 
362.14 	grants to organizations with a MNsure grant 
362.15 	services navigator assister contract in good 
362.16 	standing as of the date of enactment. The grant 
362.17 	payment to each organization must be in 
362.18 	proportion to the number of medical assistance 
362.19 	and MinnesotaCare enrollees each 
362.20 	organization assisted that resulted in a 
362.21 	successful enrollment in the second quarter of 
362.22 	fiscal years 2020 and 2023, as determined by 
362.23 	MNsure's navigator payment process. This is 
362.24 	a onetime appropriation and is available until 
362.25 	June 30, 2025.
362.26 	(b) $3,000,000 in fiscal year 2024 is 
362.27 	appropriated from the health care access fund 
362.28 	to the commissioner of human services for 
362.29 	grants to organizations with a MNsure grant 
362.30 	services navigator assister contract for 
362.31 	successful enrollments in medical assistance 
362.32 	and MinnesotaCare. This is a onetime 
362.33 	appropriation and is available until June 30, 
362.34 	2025.

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

363.2 	Sec. 11. Laws 2023, chapter 57, article 1, section 6, is amended to read:
363.3 	Sec. 6. PREMIUM SECURITY ACCOUNT TRANSFER; OUT.
 363.4 	$275,775,000 $284,605,000 in fiscal year 2026 is transferred from the premium security 
363.5 	plan account under Minnesota Statutes, section 62E.25, subdivision 1, to the general fund. 
363.6 	This is a onetime transfer.

363.7 	Sec. 12. Laws 2023, chapter 70, article 20, section 2, subdivision 5, is amended to read:

363.8	Subd. 5.Central Office; Health Care

363.9	Appropriations by Fund
	
363.10	General
	35,807,000
	31,349,000
	
363.11	Health Care Access
	30,668,000
	50,168,000
	
363.12 	(a) Medical assistance and MinnesotaCare 
363.13 	accessibility improvements. $4,000,000 in 
363.14 	fiscal year 2024 is from the general fund for 
363.15 	interactive voice response upgrades and 
363.16 	translation services for medical assistance and 
363.17 	MinnesotaCare enrollees with limited English 
363.18 	proficiency. This appropriation is available 
363.19 	until June 30, 2025.
363.20 	(b) Transforming service delivery. $155,000 
363.21 	in fiscal year 2024 and $180,000 in fiscal year 
363.22 	2025 are from the general fund for 
363.23 	transforming service delivery projects.
363.24 	(c) Improving the Minnesota eligibility 
363.25 	technology system functionality. $1,604,000 
363.26 	in fiscal year 2024 and $711,000 in fiscal year 
363.27 	2025 are from the general fund for improving 
363.28 	the Minnesota eligibility technology system 
363.29 	functionality. The base for this appropriation 
363.30 	is $1,421,000 in fiscal year 2026 and $0 in 
363.31 	fiscal year 2027.
364.1 	(d) Actuarial and economic analyses.
364.2 	$2,500,000 is from the health care access fund 
364.3 	for actuarial and economic analyses and to 
364.4 	prepare and submit a state innovation waiver 
364.5 	under section 1332 of the federal Affordable 
364.6 	Care Act for a Minnesota public option health 
364.7 	care plan. This is a onetime appropriation and 
364.8 	is available until June 30, 2025.
364.9 	(e) Contingent appropriation for Minnesota 
364.10 	public option health care plan.$22,000,000
364.11 	$21,000,000 in fiscal year 2025 is from the 
364.12 	health care access fund to implement a 
364.13 	Minnesota public option health care plan. This 
364.14 	is a onetime appropriation and is available 
364.15 	upon approval of a state innovation waiver 
364.16 	under section 1332 of the federal Affordable 
364.17 	Care Act. This appropriation is available until 
364.18 	June 30, 2027.
364.19 	(f) Carryforward authority. Notwithstanding 
364.20 	Minnesota Statutes, section 16A.28, 
364.21 	subdivision 3, $2,367,000 of the appropriation 
364.22 	in fiscal year 2024 is available until June 30, 
364.23 	2027.
364.24 	(g) Base level adjustment. The general fund 
364.25 	base is $32,315,000 in fiscal year 2026 and 
364.26 	$27,536,000 in fiscal year 2027. The health 
364.27 	care access fund base is $28,168,000 in fiscal 
364.28 	year 2026 and $28,168,000 in fiscal year 2027.

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

365.1 	Sec. 13. Laws 2023, chapter 70, article 20, section 2, subdivision 31, as amended by Laws 
365.2 	2023, chapter 75, section 12, is amended to read:

365.3
365.4	Subd. 31.Direct Care and Treatment - Mental 
Health and Substance Abuse
 		-0-
		6,109,000
	
365.5 	(a) Keeping Nurses at the Bedside Act; 
365.6 	contingent appropriation. The appropriation 
365.7 	in this subdivision is contingent upon 
365.8 	legislative enactment by the 93rd Legislature 
365.9 	of provisions substantially similar to 2023 S.F. 
365.10 	No. 1561, the second engrossment, article 2.
365.11 	(b)Base level adjustment. The general fund 
365.12 	base is increased by $7,566,000 in fiscal year 
365.13 	2026 and increased by $7,566,000 in fiscal 
365.14 	year 2027.

365.15 	Sec. 14. Laws 2023, chapter 70, article 20, section 3, subdivision 2, is amended to read:

365.16	Subd. 2.Health Improvement

365.17	Appropriations by Fund
	
365.18	General
	229,600,000
	210,030,000
	
365.19
365.20	State Government 
Special Revenue
	12,392,000
	12,682,000
	
365.21	Health Care Access
	49,051,000
	53,290,000
	
365.22	Federal TANF
	11,713,000
	11,713,000
	
365.23 	(a) Studies of telehealth expansion and 
365.24 	payment parity. $1,200,000 in fiscal year 
365.25 	2024 is from the general fund for studies of 
365.26 	telehealth expansion and payment parity. This 
365.27 	is a onetime appropriation and is available 
365.28 	until June 30, 2025.
365.29 	(b) Advancing equity through capacity 
365.30 	building and resource allocation grant 
365.31 	program. $916,000 in fiscal year 2024 and 
365.32 	$916,000 in fiscal year 2025 are from the 
365.33 	general fund for grants under Minnesota 
366.1 	Statutes, section 144.9821. This is a onetime 
366.2 	appropriation.
366.3 	(c) Grant to Minnesota Community Health 
366.4 	Worker Alliance. $971,000 in fiscal year 
366.5 	2024 and $971,000 in fiscal year 2025 are 
366.6 	from the general fund for Minnesota Statutes, 
366.7 	section 144.1462.
366.8 	(d) Community solutions for healthy child 
366.9 	development grants. $2,730,000 in fiscal year 
366.10 	2024 and $2,730,000 in fiscal year 2025 are 
366.11 	from the general fund for grants under 
366.12 	Minnesota Statutes, section 145.9257. The 
366.13 	base for this appropriation is $2,415,000 in 
366.14 	fiscal year 2026 and $2,415,000 in fiscal year 
366.15 	2027.
366.16 	(e) Comprehensive Overdose and Morbidity 
366.17 	Prevention Act. $9,794,000 in fiscal year 
366.18 	2024 and $10,458,000 in fiscal year 2025 are 
366.19 	from the general fund for comprehensive 
366.20 	overdose and morbidity prevention strategies 
366.21 	under Minnesota Statutes, section 144.0528. 
366.22 	The base for this appropriation is $10,476,000 
366.23 	in fiscal year 2026 and $10,476,000 in fiscal 
366.24 	year 2027.
366.25 	(f) Emergency preparedness and response.
366.26 	$10,486,000 in fiscal year 2024 and 
366.27 	$14,314,000 in fiscal year 2025 are from the 
366.28 	general fund for public health emergency 
366.29 	preparedness and response, the sustainability 
366.30 	of the strategic stockpile, and COVID-19 
366.31 	pandemic response transition. The base for 
366.32 	this appropriation is $11,438,000 in fiscal year 
366.33 	2026 and $11,362,000 in fiscal year 2027.
367.1 	(g) Healthy Beginnings, Healthy Families.
367.2 	(1) $8,440,000 in fiscal year 2024 and 
367.3 	$7,305,000 in fiscal year 2025 are from the 
367.4 	general fund for grants under Minnesota 
367.5 	Statutes, sections 145.9571 to 145.9576. The 
367.6 	base for this appropriation is $1,500,000 in 
367.7 	fiscal year 2026 and $1,500,000 in fiscal year 
367.8 	2027. (2) Of the amount in clause (1), 
367.9 	$400,000 in fiscal year 2024 is to support the 
367.10 	transition from implementation of activities 
367.11 	under Minnesota Statutes, section 145.4235, 
367.12 	to implementation of activities under 
367.13 	Minnesota Statutes, sections 145.9571 to 
367.14 	145.9576. The commissioner shall award four 
367.15 	sole-source grants of $100,000 each to Face 
367.16 	to Face, Cradle of Hope, Division of Indian 
367.17 	Work, and Minnesota Prison Doula Project. 
367.18 	The amount in this clause is a onetime 
367.19 	appropriation.
367.20 	(h) Help Me Connect. $463,000 in fiscal year 
367.21 	2024 and $921,000 in fiscal year 2025 are 
367.22 	from the general fund for the Help Me 
367.23 	Connect program under Minnesota Statutes, 
367.24 	section 145.988.
367.25 	(i) Home visiting. $2,000,000 in fiscal year 
367.26 	2024 and $2,000,000 in fiscal year 2025 are 
367.27 	from the general fund for home visiting under 
367.28 	Minnesota Statutes, section 145.87, to provide 
367.29 	home visiting to priority populations under 
367.30 	Minnesota Statutes, section 145.87, 
367.31 	subdivision 1, paragraph (e).
367.32 	(j) No Surprises Act enforcement.
367.33 	$1,210,000 in fiscal year 2024 and $1,090,000 
367.34 	in fiscal year 2025 are from the general fund 
367.35 	for implementation of the federal No Surprises 
368.1 	Act under Minnesota Statutes, section 
368.2 	62Q.021, and an assessment of the feasibility 
368.3 	of a statewide provider directory. The general 
368.4 	fund base for this appropriation is $855,000 
368.5 	in fiscal year 2026 and $855,000 in fiscal year 
368.6 	2027.
368.7 	(k) Office of African American Health.
368.8 	$1,000,000 in fiscal year 2024 and $1,000,000 
368.9 	in fiscal year 2025 are from the general fund 
368.10 	for grants under the authority of the Office of 
368.11 	African American Health under Minnesota 
368.12 	Statutes, section 144.0756.
368.13 	(l) Office of American Indian Health.
368.14 	$1,000,000 in fiscal year 2024 and $1,000,000 
368.15 	in fiscal year 2025 are from the general fund 
368.16 	for grants under the authority of the Office of 
368.17 	American Indian Health under Minnesota 
368.18 	Statutes, section 144.0757.
368.19 	(m) Public health system transformation 
368.20 	grants. (1) $9,844,000 in fiscal year 2024 and 
368.21 	$9,844,000 in fiscal year 2025 are from the 
368.22 	general fund for grants under Minnesota 
368.23 	Statutes, section 145A.131, subdivision 1, 
368.24 	paragraph (f).
368.25 	(2) $535,000 in fiscal year 2024 and $535,000 
368.26 	in fiscal year 2025 are from the general fund 
368.27 	for grants under Minnesota Statutes, section 
368.28 	145A.14, subdivision 2b.
368.29 	(3) $321,000 in fiscal year 2024 and $321,000 
368.30 	in fiscal year 2025 are from the general fund 
368.31 	for grants under Minnesota Statutes, section 
368.32 	144.0759.
368.33 	(n) Health care workforce. (1) $1,010,000 
368.34 	in fiscal year 2024 and $2,550,000 in fiscal 
369.1 	year 2025 are from the health care access fund 
369.2 	for rural training tracks and rural clinicals 
369.3 	grants under Minnesota Statutes, sections 
369.4 	144.1505 and 144.1507. The base for this 
369.5 	appropriation is $4,060,000 in fiscal year 2026 
369.6 	and $3,600,000 in fiscal year 2027.
369.7 	(2) $420,000 in fiscal year 2024 and $420,000 
369.8 	in fiscal year 2025 are from the health care 
369.9 	access fund for immigrant international 
369.10 	medical graduate training grants under 
369.11 	Minnesota Statutes, section 144.1911.
369.12 	(3) $5,654,000 in fiscal year 2024 and 
369.13 	$5,550,000 in fiscal year 2025 are from the 
369.14 	health care access fund for site-based clinical 
369.15 	training grants under Minnesota Statutes, 
369.16 	section 144.1508. The base for this 
369.17 	appropriation is $4,657,000 in fiscal year 2026 
369.18 	and $3,451,000 in fiscal year 2027.
369.19 	(4) $1,000,000 in fiscal year 2024 and 
369.20 	$1,000,000 in fiscal year 2025 are from the 
369.21 	health care access fund for mental health for 
369.22 	health care professional grants. This is a 
369.23 	onetime appropriation and is available until 
369.24 	June 30, 2027.
369.25 	(5) $502,000 in fiscal year 2024 and $502,000 
369.26 	in fiscal year 2025 are from the health care 
369.27 	access fund for workforce research and data 
369.28 	analysis of shortages, maldistribution of health 
369.29 	care providers in Minnesota, and the factors 
369.30 	that influence decisions of health care 
369.31 	providers to practice in rural areas of 
369.32 	Minnesota.
369.33 	(o) School health. $800,000 in fiscal year 
369.34 	2024 and $1,300,000 in fiscal year 2025 are 
370.1 	from the general fund for grants under 
370.2 	Minnesota Statutes, section 145.903. The base 
370.3 	for this appropriation is $2,300,000 in fiscal 
370.4 	year 2026 and $2,300,000 in fiscal year 2027.
370.5 	(p) Long COVID. $3,146,000 in fiscal year 
370.6 	2024 and $3,146,000 in fiscal year 2025 are 
370.7 	from the general fund for grants and to 
370.8 	implement Minnesota Statutes, section 
370.9 	145.361.
370.10 	(q) Workplace safety grants. $4,400,000 in 
370.11 	fiscal year 2024 is from the general fund for 
370.12 	grants to health care entities to improve 
370.13 	employee safety or security. This is a onetime 
370.14 	appropriation and is available until June 30, 
370.15 	2027. The commissioner may use up to ten 
370.16 	percent of this appropriation for 
370.17 	administration.
370.18 	(r) Clinical dental education innovation 
370.19 	grants. $1,122,000 in fiscal year 2024 and 
370.20 	$1,122,000 in fiscal year 2025 are from the 
370.21 	general fund for clinical dental education 
370.22 	innovation grants under Minnesota Statutes, 
370.23 	section 144.1913.
370.24 	(s) Emmett Louis Till Victims Recovery 
370.25 	Program. $500,000 in fiscal year 2024 is from 
370.26 	the general fund for a grant to the Emmett 
370.27 	Louis Till Victims Recovery Program. The 
370.28 	commissioner must not use any of this 
370.29 	appropriation for administration. This is a 
370.30 	onetime appropriation and is available until 
370.31 	June 30, 2025.
370.32 	(t) Center for health care affordability.
370.33 	$2,752,000 in fiscal year 2024 and $3,989,000 
370.34 	in fiscal year 2025 are from the general fund 
371.1 	to establish a center for health care 
371.2 	affordability and to implement Minnesota 
371.3 	Statutes, section 62J.312. The general fund 
371.4 	base for this appropriation is $3,988,000 in 
371.5 	fiscal year 2026 and $3,988,000 in fiscal year 
371.6 	2027.
371.7 	(u) Federally qualified health centers 
371.8 	apprenticeship program. $690,000 in fiscal 
371.9 	year 2024 and $690,000 in fiscal year 2025 
371.10 	are from the general fund for grants under 
371.11 	Minnesota Statutes, section 145.9272.
371.12 	(v) Alzheimer's public information 
371.13 	program. $80,000 in fiscal year 2024 and 
371.14 	$80,000 in fiscal year 2025 are from the 
371.15 	general fund for grants to community-based 
371.16 	organizations to co-create culturally specific 
371.17 	messages to targeted communities and to 
371.18 	promote public awareness materials online 
371.19 	through diverse media channels.
371.20 	(w) Keeping Nurses at the Bedside Act; 
371.21 	contingent appropriation Nurse and Patient 
371.22 	Safety Act.The appropriations in this 
371.23 	paragraph are contingent upon legislative 
371.24 	enactment of 2023 Senate File 1384 by the 
371.25 	93rd Legislature. The appropriations in this 
371.26 	paragraph are available until June 30, 2027.
371.27 	(1) $5,317,000 in fiscal year 2024 and 
371.28 	$5,317,000 in fiscal year 2025 are from the 
371.29 	general fund for loan forgiveness under 
371.30 	Minnesota Statutes, section 144.1501, for 
371.31 	eligible nurses who have agreed to work as 
371.32 	hospital nurses in accordance with Minnesota 
371.33 	Statutes, section 144.1501, subdivision 2, 
371.34 	paragraph (a), clause (7).
372.1 	(2) $66,000 in fiscal year 2024 and $66,000 
372.2 	in fiscal year 2025 are from the general fund 
372.3 	for loan forgiveness under Minnesota Statutes, 
372.4 	section 144.1501, for eligible nurses who have 
372.5 	agreed to teach in accordance with Minnesota 
372.6 	Statutes, section 144.1501, subdivision 2, 
372.7 	paragraph (a), clause (3).
372.8 	(3) $545,000 in fiscal year 2024 and $879,000 
372.9 	in fiscal year 2025 are from the general fund 
372.10 	to administer Minnesota Statutes, section 
372.11 	144.7057; to perform the evaluation duties 
372.12 	described in Minnesota Statutes, section 
372.13 	144.7058; to continue prevention of violence 
372.14 	in health care program activities; to analyze 
372.15 	potential links between adverse events and 
372.16 	understaffing; to convene stakeholder groups 
372.17 	and create a best practices toolkit; and for a 
372.18 	report on the current status of the state's 
372.19 	nursing workforce employed by hospitals. The 
372.20 	base for this appropriation is $624,000 in fiscal 
372.21 	year 2026 and $454,000 in fiscal year 2027.
372.22 	(x) Supporting healthy development of 
372.23 	babies. $260,000 in fiscal year 2024 and 
372.24 	$260,000 in fiscal year 2025 are from the 
372.25 	general fund for a grant to the Amherst H. 
372.26 	Wilder Foundation for the African American 
372.27 	Babies Coalition initiative. The base for this 
372.28 	appropriation is $520,000 in fiscal year 2026 
372.29 	and $0 in fiscal year 2027. Any appropriation 
372.30 	in fiscal year 2026 is available until June 30, 
372.31 	2027. This paragraph expires on June 30, 
372.32 	2027.
372.33 	(y) Health professional education loan 
372.34 	forgiveness. $2,780,000 in fiscal year 2024 
372.35 	is from the general fund for eligible mental 
373.1 	health professional loan forgiveness under 
373.2 	Minnesota Statutes, section 144.1501. This is 
373.3 	a onetime appropriation. The commissioner 
373.4 	may use up to ten percent of this appropriation 
373.5 	for administration.
373.6 	(z) Primary care residency expansion grant 
373.7 	program. $400,000 in fiscal year 2024 and 
373.8 	$400,000 in fiscal year 2025 are from the 
373.9 	general fund for a psychiatry resident under 
373.10 	Minnesota Statutes, section 144.1506.
373.11 	(aa) Pediatric primary care mental health 
373.12 	training grant program. $1,000,000 in fiscal 
373.13 	year 2024 and $1,000,000 in fiscal year 2025 
373.14 	are from the general fund for grants under 
373.15 	Minnesota Statutes, section 144.1509. The 
373.16 	commissioner may use up to ten percent of 
373.17 	this appropriation for administration.
373.18 	(bb) Mental health cultural community 
373.19 	continuing education grant program. 
373.20 	$500,000 in fiscal year 2024 and $500,000 in 
373.21 	fiscal year 2025 are from the general fund for 
373.22 	grants under Minnesota Statutes, section 
373.23 	144.1511. The commissioner may use up to 
373.24 	ten percent of this appropriation for 
373.25 	administration.
373.26 	(cc) Labor trafficking services grant 
373.27 	program. $500,000 in fiscal year 2024 and 
373.28 	$500,000 in fiscal year 2025 are from the 
373.29 	general fund for grants under Minnesota 
373.30 	Statutes, section 144.3885.
373.31 	(dd) Palliative Care Advisory Council. 
373.32 	$40,000 $44,000 in fiscal year 2024 and 
373.33 	$40,000 $44,000 in fiscal year 2025 are from 
374.1 	the general fund for grants under Minnesota 
374.2 	Statutes, section 144.059.
374.3 	(ee) Analysis of a universal health care 
374.4 	financing system. $1,815,000 in fiscal year 
374.5 	2024 and $580,000 in fiscal year 2025 are 
374.6 	from the general fund to the commissioner to 
374.7 	contract for an analysis of the benefits and 
374.8 	costs of a legislative proposal for a universal 
374.9 	health care financing system and a similar 
374.10 	analysis of the current health care financing 
374.11 	system. The base for this appropriation is 
374.12 	$580,000 in fiscal year 2026 and $0 in fiscal 
374.13 	year 2027. This appropriation is available until 
374.14 	June 30, 2027.
374.15 	(ff) Charitable assets public interest review.
374.16 	(1) The appropriations under this paragraph 
374.17 	are contingent upon legislative enactment of 
374.18 	2023 House File 402 by the 93rd Legislature.
374.19 	(2) $1,584,000 in fiscal year 2024 and 
374.20 	$769,000 in fiscal year 2025 are from the 
374.21 	general fund to review certain health care 
374.22 	entity transactions; to conduct analyses of the 
374.23 	impacts of health care transactions on health 
374.24 	care cost, quality, and competition; and to 
374.25 	issue public reports on health care transactions 
374.26 	in Minnesota and their impacts. The base for 
374.27 	this appropriation is $710,000 in fiscal year 
374.28 	2026 and $710,000 in fiscal year 2027.
374.29 	(gg) Study of the development of a statewide 
374.30 	registry for provider orders for 
374.31 	life-sustaining treatment.$365,000 $225,000
374.32 	in fiscal year 2024 and $365,000 in fiscal year 
374.33 	2025 are is from the general fund for a study 
374.34 	of the development of a statewide registry for 
375.1 	provider orders for life-sustaining treatment. 
375.2 	This is a onetime appropriation.
375.3 	(hh) Task Force on Pregnancy Health and 
375.4 	Substance Use Disorders. $199,000 in fiscal 
375.5 	year 2024 and $100,000 in fiscal year 2025 
375.6 	are from the general fund for the Task Force 
375.7 	on Pregnancy Health and Substance Use 
375.8 	Disorders. This is a onetime appropriation and 
375.9 	is available until June 30, 2025.
375.10 	(ii) 988 Suicide and crisis lifeline. $4,000,000 
375.11 	in fiscal year 2024 is from the general fund 
375.12 	for 988 national suicide prevention lifeline 
375.13 	grants under Minnesota Statutes, section 
375.14 	145.561. This is a onetime appropriation.
375.15 	(jj) Equitable Health Care Task Force.
375.16 	$779,000 in fiscal year 2024 and $749,000 in 
375.17 	fiscal year 2025 are from the general fund for 
375.18 	the Equitable Health Care Task Force. This is 
375.19 	a onetime appropriation.
375.20 	(kk) Psychedelic Medicine Task Force.
375.21 	$338,000 in fiscal year 2024 and $171,000 in 
375.22 	fiscal year 2025 are from the general fund for 
375.23 	the Psychedelic Medicine Task Force. This is 
375.24 	a onetime appropriation.
375.25 	(ll) Medical education and research costs.
375.26 	$300,000 in fiscal year 2024 and $300,000 in 
375.27 	fiscal year 2025 are from the general fund for 
375.28 	the medical education and research costs 
375.29 	program under Minnesota Statutes, section 
375.30 	62J.692.
375.31 	(mm) Special Guerilla Unit Veterans grant 
375.32 	program. $250,000 in fiscal year 2024 and 
375.33 	$250,000 in fiscal year 2025 are from the 
375.34 	general fund for a grant to the Special 
376.1 	Guerrilla Units Veterans and Families of the 
376.2 	United States of America to offer 
376.3 	programming and culturally specific and 
376.4 	specialized assistance to support the health 
376.5 	and well-being of Special Guerilla Unit 
376.6 	Veterans. The base for this appropriation is 
376.7 	$500,000 in fiscal year 2026 and $0 in fiscal 
376.8 	year 2027. Any amount appropriated in fiscal 
376.9 	year 2026 is available until June 30, 2027. 
376.10 	This paragraph expires June 30, 2027.
376.11 	(nn) Safe harbor regional navigator. 
376.12 	$300,000 in fiscal year 2024 and $300,000 in 
376.13 	fiscal year 2025 are for a regional navigator 
376.14 	in northwestern Minnesota. The commissioner 
376.15 	may use up to ten percent of this appropriation 
376.16 	for administration.
376.17 	(oo) Network adequacy. $798,000 in fiscal 
376.18 	year 2024 and $491,000 in fiscal year 2025 
376.19 	are from the general fund for reviews of 
376.20 	provider networks under Minnesota Statutes, 
376.21 	section 62K.10, to determine network 
376.22 	adequacy.
376.23 	(pp) Grant to Minnesota Alliance for 
376.24 	Volunteer Advancement. $278,000 in fiscal 
376.25 	year 2024 is from the general fund for a grant 
376.26 	to the Minnesota Alliance for Volunteer 
376.27 	Advancement to administer needs-based 
376.28 	volunteerism subgrants targeting 
376.29 	underresourced nonprofit organizations in 
376.30 	greater Minnesota. Subgrants must be used to 
376.31 	support the ongoing efforts of selected 
376.32 	organizations to address and minimize 
376.33 	disparities in access to human services through 
376.34 	increased volunteerism. Subgrant applicants 
376.35 	must demonstrate that the populations to be 
377.1 	served by the subgrantee are underserved or 
377.2 	suffer from or are at risk of homelessness, 
377.3 	hunger, poverty, lack of access to health care, 
377.4 	or deficits in education. The Minnesota 
377.5 	Alliance for Volunteer Advancement must 
377.6 	give priority to organizations that are serving 
377.7 	the needs of vulnerable populations. This is a 
377.8 	onetime appropriation and is available until 
377.9 	June 30, 2025.
377.10 	(pp) (qq)(1) TANF Appropriations. TANF 
377.11 	funds must be used as follows:
377.12 	(i) $3,579,000 in fiscal year 2024 and 
377.13 	$3,579,000 in fiscal year 2025 are from the 
377.14 	TANF fund for home visiting and nutritional 
377.15 	services listed under Minnesota Statutes, 
377.16 	section 145.882, subdivision 7, clauses (6) and 
377.17 	(7). Funds must be distributed to community 
377.18 	health boards according to Minnesota Statutes, 
377.19 	section 145A.131, subdivision 1;
377.20 	(ii) $2,000,000 in fiscal year 2024 and 
377.21 	$2,000,000 in fiscal year 2025 are from the 
377.22 	TANF fund for decreasing racial and ethnic 
377.23 	disparities in infant mortality rates under 
377.24 	Minnesota Statutes, section 145.928, 
377.25 	subdivision 7;
377.26 	(iii) $4,978,000 in fiscal year 2024 and 
377.27 	$4,978,000 in fiscal year 2025 are from the 
377.28 	TANF fund for the family home visiting grant 
377.29 	program under Minnesota Statutes, section 
377.30 	145A.17. $4,000,000 of the funding in fiscal 
377.31 	year 2024 and $4,000,000 in fiscal year 2025 
377.32 	must be distributed to community health 
377.33 	boards under Minnesota Statutes, section 
377.34 	145A.131, subdivision 1. $978,000 of the 
377.35 	funding in fiscal year 2024 and $978,000 in 
378.1 	fiscal year 2025 must be distributed to Tribal 
378.2 	governments under Minnesota Statutes, section 
378.3 	145A.14, subdivision 2a;
378.4 	(iv) $1,156,000 in fiscal year 2024 and 
378.5 	$1,156,000 in fiscal year 2025 are from the 
378.6 	TANF fund for sexual and reproductive health 
378.7 	services grants under Minnesota Statutes, 
378.8 	section 145.925; and
378.9 	(v) the commissioner may use up to 6.23 
378.10 	percent of the funds appropriated from the 
378.11 	TANF fund each fiscal year to conduct the 
378.12 	ongoing evaluations required under Minnesota 
378.13 	Statutes, section 145A.17, subdivision 7, and 
378.14 	training and technical assistance as required 
378.15 	under Minnesota Statutes, section 145A.17, 
378.16 	subdivisions 4 and 5.
378.17 	(2) TANF Carryforward. Any unexpended 
378.18 	balance of the TANF appropriation in the first 
378.19 	year does not cancel but is available in the 
378.20 	second year.
378.21 	(qq) (rr)Base level adjustments. The general 
378.22 	fund base is $197,644,000 in fiscal year 2026 
378.23 	and $195,714,000 in fiscal year 2027. The 
378.24 	health care access fund base is $53,354,000 
378.25 	in fiscal year 2026 and $50,962,000 in fiscal 
378.26 	year 2027.

378.27 	EFFECTIVE DATE. This section is effective the day following final enactment, except 
378.28 	paragraph (pp) is effective retroactively from July 1, 2023.

378.29 	Sec. 15. Laws 2023, chapter 70, article 20, section 12, as amended by Laws 2023, chapter 
378.30 	75, section 13, is amended to read:

378.31
378.32	Sec. 12. COMMISSIONER OF 
MANAGEMENT AND BUDGET
 	$
	12,932,000
	$
	3,412,000
	
379.1 	(a) Outcomes and evaluation consultation. 
379.2 	$450,000 in fiscal year 2024 and $450,000 in 
379.3 	fiscal year 2025 are for outcomes and 
379.4 	evaluation consultation requirements.
379.5 	(b) Department of Children, Youth, and 
379.6 	Families. $11,931,000 in fiscal year 2024 and 
379.7 	$2,066,000 in fiscal year 2025 are to establish 
379.8 	the Department of Children, Youth, and 
379.9 	Families. This is a onetime appropriation.
379.10 	(c) Keeping Nurses at the Bedside Act 
379.11 	impact evaluation; contingent 
379.12 	appropriation. $232,000 in fiscal year 2025 
379.13 	is for the Keeping Nurses at the Bedside Act 
379.14 	impact evaluation. This appropriation is 
379.15 	contingent upon legislative enactment by the 
379.16 	93rd Legislature of a provision substantially 
379.17 	similar to the impact evaluation provision in 
379.18 	2023 S.F. No. 2995, the third engrossment, 
379.19 	article 3, section 22. This is a onetime 
379.20 	appropriation and is available until June 30, 
379.21 	2029.
379.22 	(d) (c)Health care subcabinet. $551,000 in 
379.23 	fiscal year 2024 and $664,000 in fiscal year 
379.24 	2025 are to hire an executive director for the 
379.25 	health care subcabinet and to provide staffing 
379.26 	and administrative support for the health care 
379.27 	subcabinet.
379.28 	(e) (d)Base level adjustment. The general 
379.29 	fund base is $1,114,000 in fiscal year 2026 
379.30 	and $1,114,000 in fiscal year 2027.

379.31 	Sec. 16. APPROPRIATIONS GIVEN EFFECT ONCE.
 379.32 	If an appropriation or transfer in this article is enacted more than once during the 2024 
379.33 	regular session, the appropriation or transfer must be given effect once.

380.1 	Sec. 17. EXPIRATION OF UNCODIFIED LANGUAGE.
 380.2 	All uncodified language contained in this article expires on June 30, 2025, unless a 
380.3 	different expiration date is explicit.
380.4 	Delete the title and insert:
380.5 	A bill for an act
380.6 	relating to state government; modifying provisions governing the Department of 
380.7 	Human Services, human services health care policy, health care finance, and 
380.8 	licensing policy; modifying provisions governing the Department of Health, health 
380.9 	policy, health insurance, and health care; modifying provisions governing pharmacy 
380.10 	practice and behavioral health; establishing an Office of Emergency Medical 
380.11 	Services and making conforming changes, specifying and transferring office duties, 
380.12 	establishing advisory councils, and modifying provisions relating to ambulance 
380.13 	service personnel and emergency medical responders; establishing consultation 
380.14 	and report requirements for certain state-funded grants and appropriations; 
380.15 	modifying health record copy charges; establishing expirations of certain reports; 
380.16 	making technical changes; requiring reports, information, and recommendations; 
380.17 	appropriating money;amending Minnesota Statutes 2022, sections 16A.055, 
380.18 	subdivision 1a, by adding a subdivision; 43A.24, by adding a subdivision; 
380.19 	62A.0411; 62A.15, subdivision 4, by adding a subdivision; 62A.28, subdivision 
380.20 	2; 62D.02, subdivision 7; 62D.04, subdivision 5; 62D.12, subdivision 19; 62D.14, 
380.21 	subdivision 1; 62D.20, subdivision 1; 62D.22, subdivision 5, by adding a 
380.22 	subdivision; 62J.49, subdivision 1; 62J.61, subdivision 5; 62M.01, subdivision 3; 
380.23 	62M.02, subdivisions 1a, 5, 11, 12, 21, by adding a subdivision; 62M.04, 
380.24 	subdivision 1; 62M.05, subdivision 3a; 62M.07, subdivisions 2, 4, by adding a 
380.25 	subdivision; 62M.10, subdivisions 7, 8; 62M.17, subdivision 2; 62Q.097, by adding 
380.26 	a subdivision; 62Q.14; 62Q.19, subdivisions 3, 5, by adding a subdivision; 62Q.73, 
380.27 	subdivision 2; 62V.05, subdivision 12; 62V.08; 62V.11, subdivision 4; 103I.621, 
380.28 	subdivisions 1, 2; 144.05, subdivisions 6, 7, by adding a subdivision; 144.058; 
380.29 	144.0724, subdivisions 2, 3a, 4, 6, 7, 8, 9, 11; 144.1464, subdivisions 1, 2, 3; 
380.30 	144.1501, subdivision 5; 144.1911, subdivision 2; 144.212, by adding a subdivision; 
380.31 	144.216, subdivision 2, by adding subdivisions; 144.218, by adding a subdivision; 
380.32 	144.292, subdivision 6; 144.293, subdivisions 2, 4, 9, 10; 144.493, by adding a 
380.33 	subdivision; 144.494, subdivision 2; 144.551, subdivision 1; 144.555, subdivisions 
380.34 	1a, 1b, 2, by adding subdivisions; 144.605, by adding a subdivision; 144.7067, 
380.35 	subdivision 2; 144.99, subdivision 3; 144A.10, subdivisions 15, 16; 144A.471, by 
380.36 	adding a subdivision; 144A.474, subdivision 13; 144A.61, subdivision 3a; 144A.70, 
380.37 	subdivisions 3, 5, 6, 7; 144A.71, subdivision 2, by adding a subdivision; 144A.72, 
380.38 	subdivision 1; 144A.73; 144E.001, subdivision 3a, by adding subdivisions; 
380.39 	144E.101, by adding a subdivision; 144E.16, subdivisions 5, 7; 144E.19, 
380.40 	subdivision 3; 144E.27, subdivisions 3, 5, 6; 144E.28, subdivisions 3, 5, 6, 8; 
380.41 	144E.285, subdivisions 1, 2, 4, 6, by adding subdivisions; 144E.287; 144E.305, 
380.42 	subdivision 3; 144G.08, subdivision 29; 144G.10, by adding a subdivision; 
380.43 	144G.16, subdivision 6; 146B.03, subdivision 7a; 146B.10, subdivisions 1, 3; 
380.44 	149A.02, subdivisions 3, 3b, 16, 23, 26a, 27, 35, 37c, by adding subdivisions; 
380.45 	149A.03; 149A.65; 149A.70, subdivisions 1, 2, 3, 5; 149A.71, subdivisions 2, 4; 
380.46 	149A.72, subdivisions 3, 9; 149A.73, subdivision 1; 149A.74, subdivision 1; 
380.47 	149A.93, subdivision 3; 149A.94, subdivisions 1, 3, 4; 149A.97, subdivision 2; 
380.48 	151.01, subdivisions 23, 27; 151.065, by adding subdivisions; 151.066, subdivisions 
380.49 	1, 2, 3; 151.212, by adding a subdivision; 151.37, by adding a subdivision; 151.74, 
380.50 	subdivision 6; 214.025; 214.04, subdivision 2a; 214.29; 214.31; 214.355; 245.462, 
380.51 	subdivision 6; 245.4663, subdivision 2; 245A.043, subdivisions 2, 4, by adding 
380.52 	subdivisions; 245A.07, subdivision 6; 245C.05, subdivision 5; 245C.10, subdivision 
380.53 	18; 245C.14, subdivision 1, by adding a subdivision; 245C.15, subdivisions 3, 4; 
380.54 	245C.22, subdivision 4; 245C.24, subdivisions 2, 5; 245C.30, by adding a 
381.1 	subdivision; 245F.09, subdivision 2; 245F.14, by adding a subdivision; 245F.17; 
381.2 	245G.07, subdivision 4; 245G.08, subdivisions 5, 6; 245G.10, by adding a 
381.3 	subdivision; 245G.22, subdivisions 6, 7; 245I.02, subdivisions 17, 19; 245I.04, 
381.4 	subdivision 6; 245I.10, subdivision 9; 245I.11, subdivision 1, by adding a 
381.5 	subdivision; 245I.20, subdivision 4; 245I.23, subdivision 14; 256.01, subdivision 
381.6 	41, by adding a subdivision; 256.9657, subdivision 8, by adding a subdivision; 
381.7 	256.969, by adding subdivisions; 256B.035; 256B.056, subdivisions 1a, 10; 
381.8 	256B.0622, subdivisions 2a, 3a, 7a, 7d; 256B.0623, subdivision 5; 256B.0625, 
381.9 	subdivisions 10, 12, 32, 39, by adding subdivisions; 256B.0757, subdivisions 4a, 
381.10 	4d; 256B.0943, subdivisions 3, 12; 256B.0947, subdivision 5; 256B.69, subdivision 
381.11 	2; 256B.76, subdivision 6; 256B.795; 256I.04, subdivision 2f; 256K.45, subdivision 
381.12 	2; 256L.12, subdivision 7; 256R.02, subdivision 20; 259.52, subdivisions 2, 4; 
381.13 	260E.33, subdivision 2, as amended; 317A.811, subdivision 1; 524.3-801, as 
381.14 	amended; Minnesota Statutes 2023 Supplement, sections 15A.0815, subdivision 
381.15 	2; 43A.08, subdivision 1a; 62J.84, subdivision 10; 62Q.46, subdivision 1; 62Q.473, 
381.16 	by adding subdivisions; 142A.03, by adding a subdivision; 144.0526, subdivision 
381.17 	1; 144.1501, subdivision 2; 144.1505, subdivision 2; 144.651, subdivision 10a; 
381.18 	144A.4791, subdivision 10; 144E.101, subdivisions 6, 7, as amended; 145.561, 
381.19 	subdivision 4; 145D.01, subdivision 1; 151.555, subdivisions 1, 4, 5, 6, 7, 8, 9, 
381.20 	11, 12; 151.74, subdivision 3; 152.126, subdivision 6; 245.4889, subdivision 1; 
381.21 	245.735, subdivision 3; 245.991, subdivision 1; 245A.03, subdivision 2, as 
381.22 	amended; 245A.043, subdivision 3; 245A.07, subdivision 1, as amended; 245A.11, 
381.23 	subdivision 7; 245A.16, subdivision 1, as amended; 245A.211, subdivision 4; 
381.24 	245A.242, subdivision 2; 245C.02, subdivision 13e; 245C.08, subdivision 1; 
381.25 	245C.15, subdivisions 2, 4a; 245C.31, subdivision 1; 245G.22, subdivisions 2, 17; 
381.26 	254B.04, subdivision 1a; 256.0471, subdivision 1, as amended; 256.9631; 256.969, 
381.27 	subdivision 2b; 256B.0622, subdivisions 7b, 8; 256B.0625, subdivisions 3a, 5m, 
381.28 	9, 13e, as amended, 13f, 13k, 16; 256B.064, subdivision 4; 256B.0671, subdivisions 
381.29 	3, 5; 256B.0701, subdivision 6; 256B.0947, subdivision 7; 256B.764; 256D.01, 
381.30 	subdivision 1a; 256I.05, subdivisions 1a, 11; 256L.03, subdivision 1; 256L.04, 
381.31 	subdivision 10; 260.761, by adding a subdivision; 2024 H.F. No. 5237, article 22, 
381.32 	section 2, subdivisions 4, if enacted, 5, if enacted; Laws 2020, chapter 73, section 
381.33 	8; Laws 2023, chapter 22, section 4, subdivision 2; Laws 2023, chapter 57, article 
381.34 	1, section 6; Laws 2023, chapter 70, article 1, section 35; article 20, sections 2, 
381.35 	subdivisions 5, 31; 3, subdivision 2; 12, as amended; Laws 2024, chapter 80, article 
381.36 	2, sections 6, subdivisions 2, 3, by adding subdivisions; 10, subdivision 1; proposing 
381.37 	coding for new law in Minnesota Statutes, chapters 62A; 62C; 62D; 62J; 62M; 
381.38 	62Q; 137; 144; 144A; 144E; 145D; 149A; 151; 214; 245C; 256B; repealing 
381.39 	Minnesota Statutes 2022, sections 62A.041, subdivision 3; 144.218, subdivision 
381.40 	3; 144.497; 144E.001, subdivision 5; 144E.01; 144E.123, subdivision 5; 144E.27, 
381.41 	subdivisions 1, 1a; 144E.50, subdivision 3; 151.74, subdivision 16; 245C.125; 
381.42 	256B.79, subdivision 6; 256D.19, subdivisions 1, 2; 256D.20, subdivisions 1, 2, 
381.43 	3, 4; 256D.23, subdivisions 1, 2, 3; 256R.02, subdivision 46; Minnesota Statutes 
381.44 	2023 Supplement, sections 62J.312, subdivision 6; 62Q.522, subdivisions 3, 4; 
381.45 	245C.08, subdivision 2; Laws 2024, chapter 80, article 2, section 6, subdivision 
381.46 	4.

382.1	We request the adoption of this report and repassage of the bill.
	
382.2	Senate Conferees:
........			
382.3	........
		........
	
382.4	Melissa Wiklund
		Alice Mann
	
382.5	........
			
382.6	Robert Kupec
			
382.7	House Conferees:
........			
382.8	........
		........
	
382.9	Tina Liebling
		Robert Bierman
	
382.10	........
			
382.11	Liz Reyer