Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15769

STATE OF MINNESOTA

 

Journal of the House

 

NINETY-THIRD SESSION - 2024

 

_____________________

 

ONE HUNDRED THIRTEENTH DAY

 

Saint Paul, Minnesota, Tuesday, May 7, 2024

 

 

      The House of Representatives convened at 11:00 a.m. and was called to order by Mark Wiens, Speaker pro tempore.

 

      Prayer was offered by Joshua Foster, Minister for Church Ambassador Network, St. Paul, Minnesota.

 

      The members of the House gave the pledge of allegiance to the flag of the United States of America.

 

      The roll was called and the following members were present:

 


Acomb

Agbaje

Altendorf

Anderson, P. E.

Anderson, P. H.

Backer

Bahner

Bakeberg

Baker

Becker-Finn

Bennett

Berg

Bierman

Bliss

Brand

Burkel

Carroll

Cha

Clardy

Coulter

Curran

Davis

Demuth

Dotseth

Edelson

Elkins

Engen

Feist

Finke

Fischer

Fogelman

Franson

Frazier

Frederick

Freiberg

Garofalo

Gillman

Gomez

Greenman

Grossell

Hansen, R.

Hanson, J.

Harder

Hassan

Heintzeman

Hemmingsen-Jaeger

Her

Hicks

Hill

Hollins

Hornstein

Howard

Hudson

Huot

Hussein

Igo

Jacob

Johnson

Jordan

Joy

Keeler

Kiel

Klevorn

Knudsen

Koegel

Kotyza-Witthuhn

Kozlowski

Koznick

Kraft

Kresha

Lawrence

Lee, F.

Lee, K.

Liebling

Lillie

Lislegard

Long

McDonald

Mekeland

Mueller

Murphy

Myers

Nadeau

Nash

Nelson, M.

Nelson, N.

Neu Brindley

Newton

Niska

Noor

Norris

Novotny

Olson, B.

Olson, L.

Pelowski

Pérez-Vega

Perryman

Petersburg

Pfarr

Pinto

Pryor

Pursell

Quam

Rarick

Rehm

Reyer

Robbins

Schomacker

Scott

Sencer-Mura

Smith

Stephenson

Swedzinski

Tabke

Torkelson

Urdahl

Vang

Virnig

West

Wiener

Wiens

Witte

Wolgamott

Xiong

Youakim

Zeleznikar

Spk. Hortman


 

      A quorum was present.

 

      Daniels, Davids, Hudella, Schultz and Skraba were excused.

 

      Moller was excused until 12:35 p.m.  O'Driscoll was excused until 1:35 p.m.

 

      Speaker pro tempore Wiens called Her to the Chair.

 

      The Chief Clerk proceeded to read the Journal of the preceding day.  There being no objection, further reading of the Journal was dispensed with and the Journal was approved as corrected by the Chief Clerk.


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15770

REPORTS OF CHIEF CLERK

 

      S. F. No. 4942 and H. F. No. 4975, which had been referred to the Chief Clerk for comparison, were examined and found to be not identical.

 

      Acomb moved that S. F. No. 4942 be substituted for H. F. No. 4975 and that the House File be indefinitely postponed.  The motion prevailed.

 

 

PETITIONS AND COMMUNICATIONS

 

 

      The following communications were received:

 

 

STATE OF MINNESOTA

OFFICE OF THE GOVERNOR

SAINT PAUL 55155

 

May 6, 2024

 

The Honorable Melissa Hortman

Speaker of the House of Representatives

The State of Minnesota

 

Dear Speaker Hortman:

 

      Please be advised that I have received, approved, signed, and deposited in the Office of the Secretary of State the following House Files:

 

H. F. No. 3376, relating to natural resources; allowing the use of a digital image as proof of possession of certain passes and licenses; providing for using electronic devices to display documents.

 

H. F. No. 3868, relating to commerce; adopting amendments to the Uniform Commercial Code to accommodate emerging technologies.

 

 

                                                                                                                                Sincerely,

 

                                                                                                                                Tim Walz

                                                                                                                                Governor


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15771

STATE OF MINNESOTA

OFFICE OF THE SECRETARY OF STATE

ST. PAUL 55155

 

The Honorable Melissa Hortman

Speaker of the House of Representatives

 

The Honorable Bobby Joe Champion

President of the Senate

 

      I have the honor to inform you that the following enrolled Acts of the 2024 Session of the State Legislature have been received from the Office of the Governor and are deposited in the Office of the Secretary of State for preservation, pursuant to the State Constitution, Article IV, Section 23:

 

 

S. F.

No.

 

H. F.

No.

 

Session Laws

Chapter No.

Time and

Date Approved

2024

 

Date Filed

2024

 

                                3376                       92                                           9:32 a.m.  May 6                                 May 6

                                3868                       93                                           9:33 a.m.  May 6                                 May 6

      3204                                                95                                           9:36 a.m.  May 6                                 May 6

 

 

                                                                                                                                Sincerely,

 

                                                                                                                                Steve Simon

                                                                                                                                Secretary of State

 

 

REPORTS OF STANDING COMMITTEES AND DIVISIONS

 

 

Olson, L., from the Committee on Ways and Means to which was referred:

 

H. F. No. 912, A bill for an act relating to human services; establishing the Layla Jackson Law; modifying child welfare provisions; establishing the African American Child Well-Being Advisory Council; requiring reports; appropriating money; amending Minnesota Statutes 2022, section 260C.329, subdivisions 3, 8; proposing coding for new law in Minnesota Statutes, chapter 260.

 

Reported the same back with the following amendments:

 

Delete everything after the enacting clause and insert:

 

"Section 1.  [260.61] CITATION.

 

Sections 260.61 to 260.693 may be cited as the "Minnesota African American Family Preservation and Child Welfare Disproportionality Act."

 

EFFECTIVE DATE.  This section is effective July 1, 2027, except as provided under section 20.


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15772

Sec. 2.  [260.62] PURPOSES.

 

(a) The purposes of the Minnesota African American Family Preservation and Child Welfare Disproportionality Act are to:

 

(1) protect the best interests of African American and disproportionately represented children;

 

(2) promote the stability and security of African American and disproportionately represented children and their families by establishing minimum standards to prevent the arbitrary and unnecessary removal of African American and disproportionately represented children from their families; and

 

(3) improve permanency outcomes, including family reunification, for African American and disproportionately represented children.

 

(b) Nothing in this legislation is intended to interfere with the protections of the Indian Child Welfare Act of 1978, United States Code, title 25, sections 1901 to 1963, or the Minnesota Indian Family Preservation Act, sections 260.751 to 260.835.

 

EFFECTIVE DATE.  This section is effective July 1, 2027, except as provided under section 20.

 

Sec. 3.  [260.63] DEFINITIONS.

 

Subdivision 1.  Scope.  The definitions in this section apply to sections 260.61 to 260.693.

 

Subd. 2.  Active efforts.  "Active efforts" means a rigorous and concerted level of effort that the responsible social services agency must continuously make throughout the time that the responsible social services agency is involved with an African American or a disproportionately represented child and the child's family.  To provide active efforts to preserve an African American or a disproportionately represented child's family, the responsible social services agency must continuously involve an African American or a disproportionately represented child's family in all services for the family, including case planning and choosing services and providers, and inform the family of the ability to file a report of noncompliance with this act with the commissioner through the child welfare compliance and feedback portal.  When providing active efforts, a responsible social services agency must consider an African American or a disproportionately represented child's family's social and cultural values at all times while providing services to the African American or disproportionately represented child and the child's family.  Active efforts includes continuous efforts to preserve an African American or a disproportionately represented child's family and to prevent the out-of-home placement of an African American or a disproportionately represented child.  If an African American or a disproportionately represented child enters out-of-home placement, the responsible social services agency must make active efforts to reunify the African American or disproportionately represented child with the child's family as soon as possible.  Active efforts sets a higher standard for the responsible social services agency than reasonable efforts to preserve the child's family, prevent the child's out-of-home placement, and reunify the child with the child's family.  Active efforts includes the provision of reasonable efforts as required by Title IV-E of the Social Security Act, United States Code, title 42, sections 670 to 679c.

 

Subd. 3.  Adoptive placement.  "Adoptive placement" means the permanent placement of an African American or a disproportionately represented child made by the responsible social services agency upon a fully executed adoption placement agreement, including the signatures of the adopting parent, the responsible social services agency, and the commissioner of human services according to section 260C.613, subdivision 1.

 

Subd. 4.  African American child.  "African American child" means a child having origins in Africa, including a child of two or more races who has at least one parent with origins in Africa.  Whether a child or parent has origins in Africa is based upon self-identification or identification of the child's origins by the parent or guardian.


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15773

Subd. 5.  Best interests of the African American or disproportionately represented child.  The "best interests of the African American or disproportionately represented child" means providing a culturally informed practice lens that acknowledges, utilizes, and embraces the African American or disproportionately represented child's community and cultural norms and allows the child to remain safely at home with the child's family.  The best interests of the African American or disproportionately represented child support the child's sense of belonging to the child's family, extended family, kin, and cultural community.

 

Subd. 6.  Child placement proceeding.  (a) "Child placement proceeding" means any judicial proceeding that could result in:

 

(1) an adoptive placement;

 

(2) a foster care placement;

 

(3) a preadoptive placement; or

 

(4) a termination of parental rights.

 

(b) Judicial proceedings under this subdivision include a child's placement based upon a child's juvenile status offense but do not include a child's placement based upon:

 

(1) an act which if committed by an adult would be deemed a crime; or

 

(2) an award of child custody in a divorce proceeding to one of the child's parents.

 

Subd. 7.  Commissioner.  "Commissioner" means the commissioner of human services or the commissioner's designee.

 

Subd. 8.  Custodian.  "Custodian" means any person who is under a legal obligation to provide care and support for an African American or a disproportionately represented child, or who is in fact providing daily care and support for an African American or a disproportionately represented child.  This subdivision does not impose a legal obligation upon a person who is not otherwise legally obligated to provide a child with necessary food, clothing, shelter, education, or medical care.

 

Subd. 9.  Disproportionality.  "Disproportionality" means the overrepresentation of African American children and other disproportionately represented children in Minnesota's child welfare system population as compared to the representation of those children in Minnesota's total child population.

 

Subd. 10.  Disproportionately represented child.  "Disproportionately represented child" means a child whose race, culture, ethnicity, disability status, or low-income socioeconomic status is disproportionately encountered, engaged, or identified in the child welfare system as compared to the representation in the state's total child population.  Disproportionately represented child includes members of unique cultural groups belonging to larger ethnic or cultural categories used in federal, state, or local demographic data when the members are known to be disproportionately affected.

 

Subd. 11.  Egregious harm.  "Egregious harm" has the meaning given in section 260E.03, subdivision 5.

 

Subd. 12.  Foster care placement.  "Foster care placement" means the court-ordered removal of an African American or a disproportionately represented child from the child's home with the child's parent or legal custodian and the temporary placement of the child in a foster home, in shelter care or a facility, or in the home of a guardian, when the parent or legal custodian cannot have the child returned upon demand, but the parent's parental rights have


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15774

not been terminated.  A foster care placement includes a placement in foster care following an order placing the child under the guardianship of the commissioner, pursuant to section 260C.325, prior to an adoption being finalized.

 

Subd. 13.  Imminent physical damage or harm.  "Imminent physical damage or harm" means that a child is threatened with immediate and present conditions that are life-threatening or likely to result in abandonment, sexual abuse, or serious physical injury.  The existence of community or family poverty, isolation, single parenthood, age of the parent, crowded or inadequate housing, substance use, prenatal drug or alcohol exposure, mental illness, disability or special needs of the parent or child, or nonconforming social behavior does not by itself constitute imminent physical damage or harm.

 

Subd. 14.  Responsible social services agency.  "Responsible social services agency" has the meaning given in section 260C.007, subdivision 27a.

 

Subd. 15.  Parent.  "Parent" means the biological parent of an African American or a disproportionately represented child or any person who has legally adopted an African American or a disproportionately represented child.  Parent includes an unmarried father whose paternity has been acknowledged or established and a putative father.  Paternity has been acknowledged when an unmarried father takes any action to hold himself out as the biological father of a child.

 

Subd. 16.  Preadoptive placement.  "Preadoptive placement" means a responsible social services agency's placement of an African American or a disproportionately represented child when the child is under the guardianship of the commissioner for the purpose of adoption but an adoptive placement agreement for the child has not been fully executed.

 

Subd. 17.  Relative.  "Relative" has the meaning given in section 260C.007, subdivision 27.

 

Subd. 18.  Safety network.  "Safety network" means a group of individuals identified by the parent and child, when appropriate, that is accountable for developing, implementing, sustaining, supporting, or improving a safety plan to protect the safety and well-being of a child.

 

Subd. 19.  Sexual abuse.  "Sexual abuse" has the meaning given in section 260E.03, subdivision 20.

 

Subd. 20.  Termination of parental rights.  "Termination of parental rights" means an action resulting in the termination of the parent-child relationship under section 260C.301.

 

EFFECTIVE DATE.  This section is effective July 1, 2027, except as provided under section 20.

 

Sec. 4.  [260.64] DUTY TO PREVENT OUT-OF-HOME PLACEMENT AND PROMOTE FAMILY REUNIFICATION.

 

Subdivision 1.  Active efforts.  A responsible social services agency shall make active efforts to prevent the out‑of-home placement of an African American or a disproportionately represented child, eliminate the need for a child's removal from the child's home, and reunify an African American or a disproportionately represented child with the child's family as soon as practicable.


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15775

Subd. 2.  Safety plan.  (a) Prior to petitioning the court to remove an African American or a disproportionately represented child from the child's home under section 260.66, a responsible social services agency must work with the child's family to allow the child to remain in the child's home while implementing a safety plan based on the family's needs.  The responsible social services agency must:

 

(1) make active efforts to engage the child's parent or custodian and the child, when appropriate;

 

(2) assess the family's cultural and economic needs and, if applicable, needs and services related to the child's disability;

 

(3) hold a family group consultation meeting and connect the family with supports to establish a safety network for the family; and

 

(4) provide support, guidance, and input to assist the family and the family's safety network with developing the safety plan.

 

(b) The safety plan must:

 

(1) address the specific allegations impacting the child's safety in the home.  If neglect is alleged, the safety plan must incorporate economic services and supports for the child and the child's family, if eligible, to address the family's specific needs and prevent neglect;

 

(2) incorporate family and community support to ensure the child's safety while keeping the family intact; and

 

(3) be adjusted as needed to address the child's and family's ongoing needs and support.

 

(c) The responsible social services agency is not required to establish a safety plan:

 

(1) in a case with allegations of sexual abuse or egregious harm;

 

(2) when the parent is not willing to follow a safety plan;

 

(3) when the parent has abandoned the child or is unavailable to follow a safety plan; or

 

(4) when the parent has chronic substance abuse issues and is unable to parent the child.

 

Subd. 3.  Out-of-home placement prohibited.  Unless the court finds by clear and convincing evidence that the child would be at risk of serious emotional damage or serious physical damage if the child were to remain in the child's home, a court shall not order a foster care or permanent out-of-home placement of an African American or a disproportionately represented child alleged to be in need of protection or services.  At each hearing regarding an African American or a disproportionately represented child who is alleged or adjudicated to be in need of child protective services, the court shall review whether the responsible social services agency has provided active efforts to the child and the child's family and shall require the responsible social services agency to provide evidence and documentation that demonstrate that the agency is providing culturally informed, strength-based, community‑involved, and community-based services to the child and the child's family.

 

Subd. 4.  Required findings that active efforts were provided.  When determining whether the responsible social services agency has made active efforts to preserve the child's family, the court shall make findings regarding whether the responsible social services agency made appropriate and meaningful services available to the child's family based upon the family's specific needs.  If a court determines that the responsible social services agency did not make active efforts to preserve the family as required by this section, the court shall order the responsible social services agency to immediately provide active efforts to the child and child's family to preserve the family.

 

EFFECTIVE DATE.  This section is effective July 1, 2027, except as provided under section 20.


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15776

Sec. 5.  [260.641] ENSURING FREQUENT VISITATION FOR AFRICAN AMERICAN AND DISPROPORTIONATELY REPRESENTED CHILDREN IN OUT-OF-HOME PLACEMENT.

 

A responsible social services agency must engage in best practices related to visitation when an African American or a disproportionately represented child is in out-of-home placement.  When the child is in out-of-home placement, the responsible social services agency shall make active efforts to facilitate regular and frequent visitation between the child and the child's parents or custodians, the child's siblings, and the child's relatives.  If visitation is infrequent between the child and the child's parents, custodians, siblings, or relatives, the responsible social services agency shall make active efforts to increase the frequency of visitation and address any barriers to visitation.

 

EFFECTIVE DATE.  This section is effective July 1, 2027, except as provided under section 20.

 

Sec. 6.  [260.65] NONCUSTODIAL PARENTS.

 

(a) Prior to or within 48 hours of the removal of an African American or a disproportionately represented child from the child's home, the responsible social services agency must make active efforts to identify and locate the child's noncustodial or nonadjudicated parent and the child's relatives to notify the child's parent and relatives that the child is or will be placed in foster care, and provide the child's parent and relatives with a list of legal resources.  The notice to the child's noncustodial or nonadjudicated parent and relatives must also include the information required under section 260C.221, subdivision 2, paragraph (b).  The responsible social services agency must maintain detailed records of the agency's efforts to notify parents and relatives under this section.

 

(b) Notwithstanding the provisions of section 260C.219, the responsible social services agency must assess an African American or a disproportionately represented child's noncustodial or nonadjudicated parent's ability to care for the child before placing the child in foster care.  If a child's noncustodial or nonadjudicated parent is willing and able to provide daily care for the African American or disproportionately represented child temporarily or permanently, the court shall order that the child be placed in the home of the noncustodial or nonadjudicated parent pursuant to section 260C.178 or 260C.201, subdivision 1.  The responsible social services agency must make active efforts to assist a noncustodial or nonadjudicated parent with remedying any issues that may prevent the child from being placed with the noncustodial or nonadjudicated parent.

 

EFFECTIVE DATE.  This section is effective July 1, 2027, except as provided under section 20.

 

Sec. 7.  [260.66] EMERGENCY REMOVAL.

 

Subdivision 1.  Emergency removal or placement permitted.  Nothing in this section shall be construed to prevent the emergency removal of an African American or a disproportionately represented child's parent or custodian or the emergency placement of the child in a foster setting in order to prevent imminent physical damage or harm to the child.

 

Subd. 2.  Petition for emergency removal; placement requirements.  A petition for a court order authorizing the emergency removal or continued emergency placement of an African American or a disproportionately represented child or the petition's accompanying documents must contain a statement of the risk of imminent physical damage or harm to the African American or disproportionately represented child and any evidence that the emergency removal or placement continues to be necessary to prevent imminent physical damage or harm to the child.  The petition or its accompanying documents must also contain the following information:

 

(1) the name, age, and last known address of the child;


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15777

(2) the name and address of the child's parents and custodians or, if unknown, a detailed explanation of efforts made to locate and contact them;

 

(3) the steps taken to provide notice to the child's parents and custodians about the emergency proceeding;

 

(4) a specific and detailed account of the circumstances that led the agency responsible for the emergency removal of the child to take that action; and

 

(5) a statement of the efforts that have been taken to assist the child's parents or custodians so that the child may safely be returned to their custody.

 

Subd. 3.  Emergency proceeding requirements.  (a) The court shall hold a hearing no later than 72 hours, excluding weekends and holidays, after the emergency removal of the African American or disproportionately represented child.  The court shall determine whether the emergency removal continues to be necessary to prevent imminent physical damage or harm to the child and whether, after considering the child's particular circumstances, the imminent physical damage or harm to the child outweighs the harm that the child will experience as a result of continuing the emergency removal.

 

(b) The court shall hold additional hearings whenever new information indicates that the emergency situation has ended.  The court shall consider all such new information at any court hearing after the emergency proceeding to determine whether the emergency removal or placement is no longer necessary to prevent imminent physical damage or harm to the child.

 

(c) Notwithstanding section 260C.163, subdivision 3, and the provisions of Minnesota Rules of Juvenile Protection Procedure, rule 25, a parent or custodian of an African American or a disproportionately represented child who is subject to an emergency hearing under this section and Minnesota Rules of Juvenile Protection Procedure, rule 30, has a right to counsel appointed by the court.  The court must appoint qualified counsel to represent a parent if the parent meets the eligibility requirements in section 611.17.

 

Subd. 4.  Termination of emergency removal or placement.  (a) An emergency removal or placement of an African American or a disproportionately represented child must immediately terminate once the responsible social services agency or court possesses sufficient evidence to determine that the emergency removal or placement is no longer necessary to prevent imminent physical damage or harm to the child and the child shall be immediately returned to the custody of the child's parent or custodian.  The responsible social services agency or court shall ensure that the emergency removal or placement terminates immediately when the removal or placement is no longer necessary to prevent imminent physical damage or harm to the African American or disproportionately represented child.

 

(b) An emergency removal or placement ends when the court orders, after service upon the African American or disproportionately represented child's parents or custodians, that the child shall be placed in foster care upon a determination supported by clear and convincing evidence that custody of the child by the child's parent or custodian is likely to result in serious emotional or physical damage to the child.

 

(c) In no instance shall emergency removal or emergency placement of an African American or a disproportionately represented child extend beyond 30 days unless the court finds by a showing of clear and convincing evidence that:

 

(1) continued emergency removal or placement is necessary to prevent imminent physical damage or harm to the child; and


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15778

(2) it has not been possible to initiate a child placement proceeding with all of the protections under sections 260.61 to 260.68.

 

EFFECTIVE DATE.  This section is effective July 1, 2027, except as provided under section 20.

 

Sec. 8.  [260.67] TRANSFER OF PERMANENT LEGAL AND PHYSICAL CUSTODY; TERMINATION OF PARENTAL RIGHTS; CHILD PLACEMENT PROCEEDINGS.

 

Subdivision 1.  Preference for transfer of permanent legal and physical custody.  If an African American or a disproportionately represented child cannot be returned to the child's parent, the court shall consider the requirements of and responsibilities under section 260.012, paragraph (a), and, if possible, transfer permanent legal and physical custody of the child to:

 

(1) a noncustodial parent under section 260C.515, subdivision 4, if the child cannot return to the care of the parent or custodian from whom the child was removed or who had legal custody at the time that the child was placed in foster care; or

 

(2) a willing and able relative, according to the requirements of section 260C.515, subdivision 4, if the court determines that reunification with the child's family is not an appropriate permanency option for the child.  Prior to the court ordering a transfer of permanent legal and physical custody to a relative who is not a parent, the responsible social services agency must inform the relative of Northstar kinship assistance benefits and eligibility requirements, and of the relative's ability to apply for benefits on behalf of the child under chapter 256N.

 

Subd. 2.  Termination of parental rights restrictions.  (a) A court shall not terminate the parental rights of a parent of an African American or a disproportionately represented child based solely on the parent's failure to complete case plan requirements.

 

(b) Except as provided in paragraph (c), a court shall not terminate the parental rights of a parent of an African American or a disproportionately represented child in a child placement proceeding unless the allegations against the parent involve sexual abuse; egregious harm as defined in section 260C.007, subdivision 14; murder in the first, second, or third degree under section 609.185, 609.19, or 609.195; murder of an unborn child in the first, second, or third degree under section 609.2661, 609.2662, or 609.2663; manslaughter of an unborn child in the first or second degree under section 609.2664 or 609.2665; domestic assault by strangulation under section 609.2247; felony domestic assault under section 609.2242 or 609.2243; kidnapping under section 609.25; solicitation, inducement, and promotion of prostitution under section 609.322, subdivision 1, and subdivision 1a if one or more aggravating factors are present; criminal sexual conduct under sections 609.342 to 609.3451; engaging in, hiring, or agreeing to hire a minor to engage in prostitution under section 609.324, subdivision 1; solicitation of children to engage in sexual conduct under section 609.352; possession of pornographic work involving minors under section 617.247; malicious punishment or neglect or endangerment of a child under section 609.377 or 609.378; use of a minor in sexual performance under section 617.246; or failing to protect a child from an overt act or condition that constitutes egregious harm.

 

Subd. 3.  Termination of parental rights; exceptions.  (a) The court may terminate the parental rights of a parent of an African American or a disproportionately represented child if a transfer of permanent legal and physical custody under subdivision 1 is not possible because the child has no willing or able noncustodial parent or relative to whom custody can be transferred, if it finds that one or more of the following conditions exist:

 

(1) that the parent has abandoned the child;


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15779

(2) that a parent is palpably unfit to be a party to the parent and child relationship because of a consistent pattern of specific conduct before the child or of specific conditions directly relating to the parent and child relationship, either of which are determined by the court to be of a duration or nature that renders the parent unable, for the reasonably foreseeable future, to care appropriately for the ongoing physical, mental, or emotional needs of the child.  It is presumed that a parent is palpably unfit to be a party to the parent and child relationship upon a showing that the parent's parental rights to another child were involuntarily terminated or that the parent's custodial rights to another child have been involuntarily transferred to a relative under section 260C.515, subdivision 4; or a similar law of another jurisdiction;

 

(3) that following the child's placement out of the home, active efforts, under the direction of the court, have failed to correct the conditions leading to the child's placement.  It is presumed that active efforts under this clause have failed upon a showing that:

 

(i) a child has resided out of the parental home under court order for a cumulative period of 12 months within the preceding 22 months.  In the case of a child under age eight at the time that the petition was filed alleging the child to be in need of protection or services, the presumption arises when the child has resided out of the parental home under court order for six months unless the parent has maintained regular contact with the child and the parent is complying with the out-of-home placement plan;

 

(ii) the court has approved the out-of-home placement plan required under section 260C.212 and filed with the court under section 260C.178;

 

(iii) conditions leading to the out-of-home placement have not been corrected.  It is presumed that conditions leading to a child's out-of-home placement have not been corrected upon a showing that the parent or parents have not substantially complied with the court's orders and a reasonable case plan; and

 

(iv) active efforts have been made by the responsible social services agency to rehabilitate the parent and reunite the family; and

 

(4) that a child has experienced egregious harm in the parent's care that is of a nature, duration, or chronicity that indicates a lack of regard for the child's well-being, such that a reasonable person would believe it contrary to the best interests of the child or of any child to be in the parent's care.

 

(b) For purposes of paragraph (a), clause (1), abandonment is presumed when:

 

(1) the parent has had no contact with the child on a regular basis and has not demonstrated consistent interest in the child's well-being for six months and the social services agency has made active efforts to facilitate contact with the parent, unless the parent establishes that an extreme financial or physical hardship or treatment for mental disability or substance use disorder or other good cause prevented the parent from making contact with the child.  This presumption does not apply to children whose custody has been determined under chapter 257 or 518; or

 

(2) the child is an infant under two years of age and has been deserted by the parent under circumstances that show an intent not to return to care for the child.

 

Subd. 4.  Voluntary termination of parental rights.  Nothing in subdivisions 2 and 3 precludes the court from terminating the parental rights of a parent of an African American or a disproportionately represented child if the parent desires to voluntarily terminate the parent's own parental rights for good cause under section 260C.301, subdivision 1, paragraph (a).


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15780

Subd. 5.  Appeals.  Notwithstanding the Minnesota Rules of Juvenile Protection Procedure, rule 47.02, subdivision 2, a parent of an African American or a disproportionately represented child whose parental rights have been terminated may appeal the decision within 90 days of the service of notice by the court administrator of the filing of the court's order.

 

EFFECTIVE DATE.  This section is effective July 1, 2027, except as provided under section 20.

 

Sec. 9.  [260.68] RESPONSIBLE SOCIAL SERVICES AGENCY CONDUCT AND CASE REVIEW.

 

Subdivision 1.  Responsible social services agency conduct.  (a) A responsible social services agency employee who has duties related to child protection shall not knowingly:

 

(1) make untrue statements about any case involving a child alleged to be in need of protection or services;

 

(2) intentionally withhold any information that may be material to a case involving a child alleged to be in need of protection or services; or

 

(3) fabricate or falsify any documentation or evidence relating to a case involving a child alleged to be in need of protection or services.

 

(b) Any of the actions listed in paragraph (a) shall constitute grounds for adverse employment action.

 

Subd. 2.  Case review.  (a) Each responsible social services agency shall conduct a review of all child welfare cases for African American and other disproportionately represented children handled by the agency.  Each responsible social services agency shall create a summary report of trends identified under paragraphs (b) and (c), a remediation plan as provided in paragraph (d), and an update on implementation of any previous remediation plans.  The first report shall be provided to the commissioner and the chairs and ranking minority members of the legislative committees with jurisdiction over child welfare by October 1, 2029, and annually thereafter.  For purposes of determining outcomes in this subdivision, responsible social services agencies shall use guidance from the commissioner.  The commissioner shall provide guidance starting on November 1, 2028, and annually thereafter.

 

(b) The case review must include:

 

(1) the number of African American and disproportionately represented children represented in the county child welfare system;

 

(2) the number and sources of maltreatment reports received and reports screened in for investigation or referred for family assessment and the race of the children and parents or custodians involved in each report;

 

(3) the number and race of children and parents or custodians who receive in-home preventive case management services;

 

(4) the number and race of children whose parents or custodians are referred to community-based, culturally appropriate, strength-based, or trauma-informed services;

 

(5) the number and race of children removed from their homes;

 

(6) the number and race of children reunified with their parents or custodians;

 

(7) the number and race of children whose parents or custodians are offered family group decision-making services;


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15781

(8) the number and race of children whose parents or custodians are offered the parent support outreach program;

 

(9) the number and race of children in foster care or out-of-home placement at the time that the data is gathered;

 

(10) the number and race of children who achieve permanency through a transfer of permanent legal and physical custody to a relative or an adoption; and

 

(11) the number and race of children who are under the guardianship of the commissioner or awaiting a permanency disposition.

 

(c) The required case review must also:

 

(1) identify barriers to reunifying children with their families;

 

(2) identify the family conditions that led to the out-of-home placement;

 

(3) identify any barriers to accessing culturally informed mental health or substance use disorder treatment services for the parents or children;

 

(4) document efforts to identify fathers and maternal and paternal relatives and to provide services to custodial and noncustodial fathers, if appropriate; and

 

(5) document and summarize court reviews of active efforts.

 

(d) Any responsible social services agency that has a case review showing disproportionality and disparities in child welfare outcomes for African American and other disproportionately represented children and the children's families, compared to the agency's overall outcomes, must include in their case review summary report a remediation plan with measurable outcomes to identify, address, and reduce the factors that led to the disproportionality and disparities in the agency's child welfare outcomes.  The remediation plan shall also include information about how the responsible social services agency will achieve and document trauma-informed, positive child well-being outcomes through remediation efforts.

 

Subd. 3.  Noncompliance.  Any responsible social services agency that fails to comply with this section is subject to corrective action and a fine determined by the commissioner.  The commissioner shall use fines received under this subdivision to support compliance with this act but shall not use amounts received to supplant funding for existing services.

 

EFFECTIVE DATE.  This section is effective July 1, 2027, except as provided under section 20.

 

Sec. 10.  [260.69] CULTURAL COMPETENCY TRAINING FOR INDIVIDUALS WORKING WITH AFRICAN AMERICAN AND DISPROPORTIONATELY REPRESENTED CHILDREN.

 

Subdivision 1.  Applicability.  The commissioner of human services must collaborate with the Children's Justice Initiative to ensure that cultural competency training is given to individuals working in the child welfare system, including child welfare workers, supervisors, attorneys, juvenile court judges, and family law judges.

 

Subd. 2.  Training.  (a) The commissioner must develop training content and establish the frequency of trainings.


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15782

(b) The cultural competency training under this section is required prior to or within six months of beginning work with any African American or disproportionately represented child and their family.  A responsible social services agency staff person who is unable to complete the cultural competency training prior to working with African American or disproportionately represented children and their families must work with a qualified staff person within the agency who has completed cultural competency training until the person is able to complete the required training.  The training must be available by January 1, 2027, and must:

 

(1) be provided by an African American individual or individual from a community that is disproportionately represented in the child welfare system who is knowledgeable about African American and other disproportionately represented social and cultural norms and historical trauma;

 

(2) raise awareness and increase a person's competency to value diversity, conduct a self-assessment, manage the dynamics of difference, acquire cultural knowledge, and adapt to diversity and the cultural contexts of communities served;

 

(3) include instruction on effectively developing a safety plan and instruction on engaging a safety network; and

 

(4) be accessible and comprehensive and include the ability to ask questions.

 

(c) The training may be provided in a series of segments, either in person or online.

 

Subd. 3.  Update.  The commissioner must provide an update to the chairs and ranking minority members of the legislative committees with jurisdiction over child protection by July 1, 2028, on the rollout of the training under subdivision 1 and the content and accessibility of the training under subdivision 2.

 

EFFECTIVE DATE.  This section is effective July 1, 2027, except as provided under section 20.

 

Sec. 11.  [260.691] AFRICAN AMERICAN CHILD WELL-BEING ADVISORY COUNCIL.

 

Subdivision 1.  Duties.  The African American Child Well-Being Advisory Council must:

 

(1) review annual reports related to African American children involved in the child welfare system.  The annual reports may include but are not limited to the maltreatment, out-of-home placement, and permanency of African American children;

 

(2) assist with and make recommendations to the commissioner for developing strategies to reduce maltreatment determinations, prevent unnecessary out-of-home placement, promote culturally appropriate foster care and shelter or facility placement decisions and settings for African American children in need of out-of-home placement, ensure timely achievement of permanency, and improve child welfare outcomes for African American children and their families;

 

(3) review summary reports on targeted case reviews prepared by the commissioner to ensure that responsible social services agencies meet the needs of African American children and their families.  Based on data collected from those reviews, the council shall assist the commissioner with developing strategies needed to improve any identified child welfare outcomes, including but not limited to maltreatment, out-of-home placement, and permanency for African American children;

 

(4) assist the Cultural and Ethnic Communities Leadership Council with making recommendations to the commissioner and the legislature for public policy and statutory changes that specifically consider the needs of African American children and their families involved in the child welfare system;


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15783

(5) advise the commissioner on stakeholder engagement strategies and actions that the commissioner and responsible social services agencies may take to improve child welfare outcomes for African American children and their families;

 

(6) assist the commissioner with developing strategies for public messaging and communication related to racial disproportionality and disparities in child welfare outcomes for African American children and their families;

 

(7) assist the commissioner with identifying and developing internal and external partnerships to support adequate access to services and resources for African American children and their families, including but not limited to housing assistance, employment assistance, food and nutrition support, health care, child care assistance, and educational support and training; and

 

(8) assist the commissioner with developing strategies to promote the development of a culturally diverse and representative child welfare workforce in Minnesota that includes professionals who are reflective of the community served and who have been directly impacted by lived experiences within the child welfare system.  The council must also assist the commissioner with exploring strategies and partnerships to address education and training needs, hiring, recruitment, retention, and professional advancement practices.

 

Subd. 2.  Annual report.  By January 1, 2026, and annually thereafter, the council shall report to the chairs and ranking minority members of the legislative committees with jurisdiction over child protection on the council's activities under subdivision 1 and other issues on which the council chooses to report.  The report may include recommendations for statutory changes to improve the child protection system and child welfare outcomes for African American children and families.

 

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

 

Sec. 12.  [260.692] AFRICAN AMERICAN CHILD WELL-BEING UNIT.

 

Subdivision 1.  Duties.  The African American Child Well-Being Unit, currently being established by the commissioner, must:

 

(1) assist with the development of African American cultural competency training and review child welfare curriculum in the Minnesota Child Welfare Training Academy to ensure that responsible social services agency staff and other child welfare professionals are appropriately prepared to engage with African American children and their families and to support family preservation and reunification;

 

(2) provide technical assistance, including on-site technical assistance, and case consultation to responsible social services agencies to assist agencies with implementing and complying with the Minnesota African American Family Preservation and Child Welfare Disproportionality Act;

 

(3) monitor individual county and statewide disaggregated and nondisaggregated data to identify trends and patterns in child welfare outcomes, including but not limited to reporting, maltreatment, out-of-home placement, and permanency of African American children and develop strategies to address disproportionality and disparities in the child welfare system;

 

(4) develop and implement a system for conducting case reviews when the commissioner receives reports of noncompliance with the Minnesota African American Family Preservation and Child Welfare Disproportionality Act or when requested by the parent or custodian of an African American child.  Case reviews may include but are not limited to a review of placement prevention efforts, safety planning, case planning and service provision by the responsible social services agency, relative placement consideration, and permanency planning;


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15784

(5) establish and administer a request for proposals process for African American and disproportionately represented family preservation grants under section 260.693, monitor grant activities, and provide technical assistance to grantees;

 

(6) in coordination with the African American Child Well-Being Advisory Council, coordinate services and create internal and external partnerships to support adequate access to services and resources for African American children and their families, including but not limited to housing assistance, employment assistance, food and nutrition support, health care, child care assistance, and educational support and training; and

 

(7) develop public messaging and communication to inform the public about racial disparities in child welfare outcomes, current efforts and strategies to reduce racial disparities, and resources available to African American children and their families involved in the child welfare system.

 

Subd. 2.  Case reviews.  (a) The African American Child Well-Being Unit must conduct systemic case reviews to monitor targeted child welfare outcomes, including but not limited to maltreatment, out-of-home placement, and permanency of African American children.

 

(b) The reviews under this subdivision must be conducted using a random sampling of representative child welfare cases stratified for certain case-related factors, including but not limited to case type, maltreatment type, if the case involves out-of-home placement, and other demographic variables.  In conducting the reviews, unit staff may use court records and documents, information from the social services information system, and other available case file information to complete the case reviews.

 

(c) The frequency of the reviews and the number of cases, child welfare outcomes, and selected counties reviewed shall be determined by the unit in consultation with the African American Child Well-Being Advisory Council, with consideration given to the availability of unit resources needed to conduct the reviews.

 

(d) The unit must monitor all case reviews and use the collective case review information and data to generate summary case review reports, ensure compliance with the Minnesota African American Family Preservation and Child Welfare Disproportionality Act, and identify trends or patterns in child welfare outcomes for African American children.

 

(e) The unit must review information from members of the public received through the compliance and feedback portal, including policy and practice concerns related to individual child welfare cases.  After assessing a case concern, the unit may determine if further necessary action should be taken, which may include coordinating case remediation with other relevant child welfare agencies in accordance with data privacy laws, including the African American Child Well-Being Advisory Council, and offering case consultation and technical assistance to the responsible local social services agency as needed or requested by the agency.

 

Subd. 3.  Reports.  (a) The African American Child Well-Being Unit must provide regular updates on unit activities, including summary reports of case reviews, to the African American Child Well-Being Advisory Council and must publish an annual census of African American children in out-of-home placements statewide.  The annual census must include data on the types of placements, age and sex of the children, how long the children have been in out-of-home placements, and other relevant demographic information.

 

(b) The African American Child Well-Being Unit shall gather summary data about the practice and policy inquiries and individual case concerns received through the compliance and feedback portal under subdivision 2, paragraph (e).  The unit shall provide regular reports of the nonidentifying compliance and feedback portal summary data to the African American Child Well-Being Advisory Council to identify child welfare trends and patterns to assist with developing policy and practice recommendations to support eliminating disparity and disproportionality for African American children.

 

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


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15785

Sec. 13.  [260.693] AFRICAN AMERICAN AND DISPROPORTIONATELY REPRESENTED FAMILY PRESERVATION GRANTS.

 

Subdivision 1.  Primary support grants.  The commissioner shall establish direct grants to organizations, service providers, and programs owned and led by African Americans and other individuals from communities disproportionately represented in the child welfare system to provide services and support for African American and disproportionately represented children and their families involved in Minnesota's child welfare system, including supporting existing eligible services and facilitating the development of new services and providers, to create a more expansive network of service providers available for African American and disproportionately represented children and their families.

 

Subd. 2.  Eligible services.  (a) Services eligible for grants under this section include but are not limited to:

 

(1) child out-of-home placement prevention and reunification services;

 

(2) family-based services and reunification therapy;

 

(3) culturally specific individual and family counseling;

 

(4) court advocacy;

 

(5) training for and consultation to responsible social services agencies and private social services agencies regarding this act;

 

(6) development and promotion of culturally informed, affirming, and responsive community-based prevention and family preservation services that target the children, youth, families, and communities of African American and African heritage experiencing the highest disparities, disproportionality, and overrepresentation in the Minnesota child welfare system;

 

(7) culturally affirming and responsive services that work with children and families in their communities to address their needs and ensure child and family safety and well-being within a culturally appropriate lens and framework;

 

(8) services to support informal kinship care arrangements; and

 

(9) other activities and services approved by the commissioner that further the goals of the Minnesota African American Family Preservation and Child Welfare Disproportionality Act, including but not limited to the recruitment of African American staff and staff from other communities disproportionately represented in the child welfare system to work for responsible social services agencies and licensed child-placing agencies.

 

(b) The commissioner may specify the priority of an activity and service based on its success in furthering these goals.  The commissioner shall give preference to programs and service providers that are located in or serve counties with the highest rates of child welfare disproportionality for African American and other disproportionately represented children and their families and employ staff who represent the population primarily served.

 

Subd. 3.  Ineligible services.  Grant money may not be used to supplant funding for existing services or for the following purposes:

 

(1) child day care that is necessary solely because of the employment or training for employment of a parent or another relative with whom the child is living;


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15786

(2) foster care maintenance or difficulty of care payments;

 

(3) residential treatment facility payments;

 

(4) adoption assistance or Northstar kinship assistance payments under chapter 259A or 256N;

 

(5) public assistance payments for Minnesota family investment program assistance, supplemental aid, medical assistance, general assistance, general assistance medical care, or community health services; or

 

(6) administrative costs for income maintenance staff.

 

Subd. 4.  Requests for proposals.  The commissioner shall request proposals for grants under subdivisions 1, 2, and 3 and specify the information and criteria required.

 

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

 

Sec. 14.  Minnesota Statutes 2022, section 260C.329, subdivision 3, is amended to read:

 

Subd. 3.  Petition.  The county attorney or, a parent whose parental rights were terminated under a previous order of the court, a child who is ten years of age or older, the responsible social services agency, or a guardian ad litem may file a petition for the reestablishment of the legal parent and child relationship.  A parent filing a petition under this section shall pay a filing fee in the amount required under section 357.021, subdivision 2, clause (1).  The filing fee may be waived pursuant to chapter 563.  A petition for the reestablishment of the legal parent and child relationship may be filed when:

 

(1) in cases where the county attorney is the petitioning party, both the responsible social services agency and the county attorney agree that reestablishment of the legal parent and child relationship is in the child's best interests;

 

(2) (1) the parent has corrected the conditions that led to an order terminating parental rights;

 

(3) (2) the parent is willing and has the capability to provide day-to-day care and maintain the health, safety, and welfare of the child;

 

(4) (3) the child has been in foster care for at least 48 24 months after the court issued the order terminating parental rights;

 

(5) (4) the child has not been adopted; and

 

(6) (5) the child is not the subject of a written adoption placement agreement between the responsible social services agency and the prospective adoptive parent, as required under Minnesota Rules, part 9560.0060, subpart 2.

 

EFFECTIVE DATE.  This section is effective July 1, 2027, except as provided under section 20.

 

Sec. 15.  Minnesota Statutes 2022, section 260C.329, subdivision 8, is amended to read:

 

Subd. 8.  Hearing.  The court may grant the petition ordering the reestablishment of the legal parent and child relationship only if it finds by clear and convincing evidence that:

 

(1) reestablishment of the legal parent and child relationship is in the child's best interests;

 

(2) the child has not been adopted;


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15787

(3) the child is not the subject of a written adoption placement agreement between the responsible social services agency and the prospective adoptive parent, as required under Minnesota Rules, part 9560.0060, subpart 2;

 

(4) at least 48 24 months have elapsed following a final order terminating parental rights and the child remains in foster care;

 

(5) the child desires to reside with the parent;

 

(6) the parent has corrected the conditions that led to an order terminating parental rights; and

 

(7) the parent is willing and has the capability to provide day-to-day care and maintain the health, safety, and welfare of the child.

 

EFFECTIVE DATE.  This section is effective July 1, 2027, except as provided under section 20.

 

Sec. 16.  DIRECTION TO COMMISSIONER OF HUMAN SERVICES; DISAGGREGATE DATA.

 

The commissioner of human services must establish a process to improve the disaggregation of data to monitor child welfare outcomes for African American and other disproportionately represented children in the child welfare system.  The commissioner must begin disaggregating data by January 1, 2027.

 

EFFECTIVE DATE.  This section is effective July 1, 2027.

 

Sec. 17.  CHILD WELFARE COMPLIANCE AND FEEDBACK PORTAL.

 

The commissioner of human services shall develop, maintain, and administer a publicly accessible online compliance and feedback portal to receive reports of noncompliance with the Minnesota African American Family Preservation and Child Welfare Disproportionality Act under Minnesota Statutes, sections 260.61 to 260.693, and other statutes related to child maltreatment, safety, and placement.  Reports received through the portal must be transferred for review and further action to the appropriate unit or department within the Department of Human Services, including but not limited to the African American Child Well-Being Unit.

 

EFFECTIVE DATE.  This section is effective July 1, 2027, except as provided under section 20.

 

Sec. 18.  DIRECTION TO COMMISSIONER; MAINTAINING CONNECTIONS IN FOSTER CARE BEST PRACTICES.

 

The commissioner of human services shall develop and publish guidance on best practices for ensuring that African American and disproportionately represented children in foster care maintain connections and relationships with their parents, custodians, and extended relatives.  The commissioner shall also develop and publish best practice guidance on engaging and assessing noncustodial and nonadjudicated parents to care for their African American or disproportionately represented children who cannot remain with the children's custodial parents.

 

EFFECTIVE DATE.  This section is effective July 1, 2027, except as provided under section 20.

 

Sec. 19.  DIRECTION TO COMMISSIONER; COMPLIANCE SYSTEM REVIEW DEVELOPMENT.

 

(a) By January 1, 2026, the commissioner of human services, in consultation with counties and the working group established under section 21, must develop a system to review county compliance with the Minnesota African American Family Preservation and Child Welfare Disproportionality Act.  The system may include but is not limited to the cases to be reviewed, the criteria to be reviewed to demonstrate compliance, the rate of noncompliance and the coordinating penalty, the program improvement plan, and training.


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15788

(b) By January 1, 2026, the commissioner of human services must provide a report to the chairs and ranking minority members of the legislative committees with jurisdiction over child welfare on the proposed compliance system review process and language to codify that process in statute.

 

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

 

Sec. 20.  MINNESOTA AFRICAN AMERICAN FAMILY PRESERVATION AND CHILD WELFARE DISPROPORTIONALITY ACT; PHASE-IN PROGRAM.

 

(a) The commissioner of human services must establish a phase-in program that implements sections 1 to 17 in Hennepin and Ramsey Counties.  The commissioner may allow additional counties to participate in the phase-in program upon the request of the counties.

 

(b) The commissioner of human services must report on the outcomes of the phase-in program, including the number of participating families, the rate of children in out-of-home placement, and the measures taken to prevent out-of-home placement for each participating family, to the chairs and ranking minority members of the legislative committees with jurisdiction over child welfare.

 

(c) Sections 1 to 17 are effective July 1, 2024, for purposes of this phase-in program.

 

(d) This section expires July 1, 2027.

 

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

 

Sec. 21.  MINNESOTA AFRICAN AMERICAN FAMILY PRESERVATION AND CHILD WELFARE DISPROPORTIONALITY ACT; WORKING GROUP.

 

(a) The commissioner of human services must establish a working group to provide guidance and oversight for the Minnesota African American Family Preservation and Child Welfare Disproportionality Act phase-in program.

 

(b) The members of the working group must include representatives from the Minnesota Association of County Social Service Administrators, the Association of Minnesota Counties, Hennepin County, Ramsey County, the Department of Human Services, and community organizations with experience in child welfare.  The legislature may provide recommendations to the commissioner on the selection of the representatives from the community organizations.

 

(c) The working group must provide oversight of the phase-in program and evaluate the cost of the phase-in program.  The working group must also assess future costs of implementing the Minnesota African American Family Preservation and Child Welfare Disproportionality Act statewide.

 

(d) By June 30, 2026, the working group must develop an implementation plan and best practices for the Minnesota African American Family Preservation and Child Welfare Disproportionality Act to go into effect statewide.

 

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

 

Sec. 22.  DIRECTION TO COMMISSIONER; IMPLEMENTATION COSTS.

 

The commissioner of human services must handle any administrative or implementation costs for the Minnesota African American Family Preservation and Child Welfare Disproportionality Act within the limits of existing funding.


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15789

Sec. 23.  APPROPRIATION; MINNESOTA AFRICAN AMERICAN FAMILY PRESERVATION AND CHILD WELFARE DISPROPORTIONALITY ACT PHASE-IN PROGRAM GRANTS.

 

$5,000,000 in fiscal year 2025 is appropriated from the general fund to the commissioner of human services for grants to Hennepin and Ramsey Counties to implement the Minnesota African American Family Preservation and Child Welfare Disproportionality Act phase-in program.  Of this amount, $2,500,000 must be provided to Hennepin County and $2,500,000 must be provided to Ramsey County.  The commissioner must handle any administrative or implementation costs for the phase-in program within the limits of existing funding.  This is a onetime appropriation and is available until June 30, 2026."

 

Amend the title as follows:

 

Page 1, line 2, delete "Layla Jackson Law" and insert "Minnesota African American Family Preservation and Child Welfare Disproportionality Act"

 

 

With the recommendation that when so amended the bill be placed on the General Register.

 

      The report was adopted.

 

 

Olson, L., from the Committee on Ways and Means to which was referred:

 

H. F. No. 4822, A bill for an act relating to taxation; property; modifying distribution of excess proceeds from sales of tax-forfeited property; appropriating money; amending Minnesota Statutes 2022, sections 281.23, subdivision 2; 282.241, subdivision 1; proposing coding for new law in Minnesota Statutes, chapter 282.

 

Reported the same back with the following amendments:

 

Page 3, line 12, delete the first "the" and insert "any party with an interest in the real estate including but not limited to an" and after "property" insert ", a lienholder,"

 

Page 3, line 16, delete "the product of (i) 1.05, and (ii)"

 

Page 3, line 17, delete "levied" and insert "assessed"

 

Page 7, after line 23, insert:

 

"Sec. 4.  Minnesota Statutes 2022, section 282.01, subdivision 6, is amended to read:

 

Subd. 6.  Duties of commissioner after sale.  (a) When any sale has been made by the county auditor under sections 282.01 282.005 to 282.13, the auditor shall immediately certify to the commissioner of revenue such information relating to such sale, on such forms as the commissioner of revenue may prescribe as will enable the commissioner of revenue to prepare an appropriate deed if the sale is for cash, or keep necessary records if the sale is on terms; and not later than October 31 of each year the county auditor shall submit to the commissioner of revenue a statement of all instances wherein any payment of principal, interest, or current taxes on lands held under certificate, due or to be paid during the preceding calendar years, are still outstanding at the time such certificate is made.  When such statement shows that a purchaser or the purchaser's assignee is in default, the commissioner of revenue may instruct the county board of the county in which the land is located to cancel said certificate of sale in the manner provided by subdivision 5, provided that upon recommendation of the county board, and where the circumstances are such that the commissioner of revenue after investigation is satisfied that the purchaser has made


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15790

every effort reasonable to make payment of both the annual installment and said taxes, and that there has been no willful neglect on the part of the purchaser in meeting these obligations, then the commissioner of revenue may extend the time for the payment for such period as the commissioner may deem warranted, not to exceed one year.  On payment in full of the purchase price, appropriate conveyance in fee, in such form as may be prescribed by the attorney general, shall be issued by the commissioner of revenue, which conveyance must be recorded by the county and shall have the force and effect of a patent from the state subject to easements and restrictions of record at the date of the tax judgment sale, including, but without limitation, permits for telephone and electric power lines either by underground cable or conduit or otherwise, sewer and water lines, highways, railroads, and pipe lines for gas, liquids, or solids in suspension.

 

(b) The commissioner of revenue shall issue an appropriate conveyance in fee when approval from the county auditor is given based upon written confirmation from a licensed closing agent, title insurer, or title insurance agent as specified in section 82.641.  For purposes of this paragraph, "written confirmation" means a written commitment or approval that the funding for the conveyance is held in an escrow account available for disbursement upon delivery of a conveyance.  The county recorder or registrar of titles must not record or file a conveyance issued under this paragraph unless the conveyance contains a certification signed by the county auditor where the land is located stating that the recorder or registrar of titles can accept the conveyance for recording or filing.  The conveyance issued by the commissioner of revenue shall not be effective as a conveyance until it is recorded.  The conveyance shall be issued to the county auditor where the land is located.  Upon receipt of the conveyance, the county auditor shall hold the conveyance until the conveyance is requested from a licensed closing agent, title insurer, or title insurance agent to settle and close on the conveyance.  If a request for the conveyance is not made within 30 days of the date the conveyance is issued by the commissioner of revenue, the county auditor shall return the conveyance to the commissioner.  If the conveyance is delivered to the licensed closing agent, title insurer, or title insurance agent and the closing does not occur within ten days of the request, the licensed closing agent, title insurer, or title insurance agent shall immediately return the conveyance to the county auditor and, upon receipt, the county auditor shall return the conveyance to the commissioner of revenue.  The commissioner of revenue shall cancel and destroy all conveyances returned by the county auditor pursuant to this subdivision.  The licensed closing agent, title insurer, or title insurance agent must promptly record the conveyance after the closing and must deliver an attested or certified copy to the county auditor and to the grantee or grantees named on the conveyance."

 

Page 8, after line 17, insert:

 

"Sec. 6.  Minnesota Statutes 2022, section 282.301, is amended to read:

 

282.301 RECEIPTS FOR PAYMENTS; CERTIFICATION BY COUNTY AUDITOR.

 

When any sale has been made under sections 282.005, 282.012, and 282.241 to 282.324, the purchaser shall receive from the county auditor at the time of repurchase a receipt, in such form as may be prescribed by the attorney general.  When the purchase price of a parcel of land shall be paid in full, the following facts shall be certified by the county auditor to the commissioner of revenue of the state of Minnesota:  the description of land and the date when the final installment of the purchase price was paid."

 

Page 8, lines 19 and 21, delete "$3,762,000" and insert "$1,537,000"

 

Page 8, after line 22, insert:

 

"Sec. 8.  EFFECTIVE DATE.


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15791

Section 1 is effective for notices provided after the day following final enactment.  Sections 2 to 6 are effective for forfeitures occurring after December 31, 2023."

 

Renumber the sections in sequence

 

Correct the title numbers accordingly

 

 

With the recommendation that when so amended the bill be placed on the General Register.

 

      The report was adopted.

 

 

Olson, L., from the Committee on Ways and Means to which was referred:

 

H. F. No. 5246, A bill for an act relating to state finance; establishing a tax-forfeited lands settlement account; transferring money; requiring reports; appropriating money.

 

Reported the same back with the following amendments:

 

Page 2, line 24, before "Nonparticipating" insert "Deemed election to become participating county;" and before "A" insert "A county that does not affirmatively notify the claims administrator by August 1, 2024, in writing, that it is not a participating county, will be deemed to have elected to become a participating county."

 

 

With the recommendation that when so amended the bill be placed on the General Register.

 

      The report was adopted.

 

 

Long from the Committee on Rules and Legislative Administration to which was referred:

 

S. F. No. 37, A bill for an act relating to state government; proposing an amendment to the Minnesota Constitution, article I, by adding a section; providing for equality under the law.

 

Reported the same back with the following amendments:

 

Delete everything after the enacting clause and insert:

 

"Section 1.  CONSTITUTIONAL AMENDMENT PROPOSED.

 

An amendment to the Minnesota Constitution is proposed to the people.  If the amendment is adopted, a section shall be added to article I, to read:

 

Sec. 18. 

 

All persons shall be guaranteed equal rights under the laws of this state.  The state shall not discriminate against any person in intent or effect on account of one or more of the following:

 

(a) race;

 

(b) color;


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15792

(c) national origin;

 

(d) ancestry;

 

(e) disability; or

 

(f) sex, including but not limited to:

 

(i) making and effectuating decisions about all matters relating to one's own pregnancy or decision whether to become or remain pregnant;

 

(ii) gender identity or gender expression; or

 

(iii) sexual orientation.

 

Any action by the state that denies an individual's equal rights shall be invalid unless, at a minimum, it is the least restrictive means of achieving a compelling governmental interest.

 

For purposes of this section, state means the state or any agency or political subdivision of the state.

 

This section is self-executing.  This section does not limit or narrow existing rights in this constitution.  Nothing in this section shall invalidate or prevent the adoption of any law, regulation, program, practice, or benefit designed to prevent or remedy discrimination on the basis of characteristics listed in this section.

 

Sec. 2.  SUBMISSION TO VOTERS.

 

(a) The proposed amendment must be submitted to the people at the 2026 general election.  If ratified, the amendment is effective January 1, 2027.  The question submitted must be:

 

"Shall the Minnesota Constitution be amended to say that all persons shall be guaranteed equal rights under the laws of this state, and shall not be discriminated against on account of race, color, national origin, ancestry, disability, or sex, including pregnancy, gender, and sexual orientation?

 

                                                                                                                                Yes ...............................

                                                                                                                                No ................................  "

 

(b) The title required under Minnesota Statutes, section 204D.15, subdivision 1, for the question submitted to the people under paragraph (a) shall be:  "Minnesota Equal Rights Amendment.""

 

Delete the title and insert:

 

"A bill for an act relating to state government; proposing an amendment to the Minnesota Constitution, article I, by adding a section; providing for equal rights under the law and prohibiting discrimination based on the listed characteristics."

 

 

With the recommendation that when so amended the bill be placed on the General Register.

 

      The report was adopted.


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15793

Olson, L., from the Committee on Ways and Means to which was referred:

 

S. F. No. 4699, A bill for an act relating to state government; modifying provisions governing health care, health insurance, health policy, emergency medical services, the Department of Health, the Department of Human Services, MNsure, health care workforce, health-related licensing boards, health care affordability and delivery, background studies, child protection and welfare, child care licensing, behavioral health, economic assistance, housing and homelessness, human services policy, the Minnesota Indian Family Preservation Act, and the Department of Children, Youth, and Families; establishing the Office of Emergency Medical Services; establishing the Minnesota African American Family Preservation and Child Welfare Disproportionality Act; making technical and conforming changes; requiring reports; imposing penalties; providing appointments; making forecast adjustments; appropriating money; amending Minnesota Statutes 2022, sections 16A.055, subdivision 1a, by adding a subdivision; 16A.103, by adding a subdivision; 62A.0411; 62A.15, subdivision 4, by adding a subdivision; 62A.28, subdivision 2; 62D.02, subdivisions 4, 7; 62D.03, subdivision 1; 62D.05, subdivision 1; 62D.06, subdivision 1; 62D.14, subdivision 1; 62D.19; 62D.20, subdivision 1; 62D.22, subdivision 5; 62E.02, subdivision 3; 62J.49, subdivision 1; 62J.61, subdivision 5; 62M.01, subdivision 3; 62Q.097, by adding a subdivision; 62Q.14; 62V.05, subdivision 12; 62V.08; 62V.11, subdivision 4; 103I.621, subdivisions 1, 2; 121A.15, subdivision 3, by adding a subdivision; 144.05, subdivision 6, by adding a subdivision; 144.058; 144.0724, subdivisions 2, 3a, 4, 6, 7, 8, 9, 11; 144.1464, subdivisions 1, 2, 3; 144.1501, subdivision 5; 144.1911, subdivision 2; 144.212, by adding a subdivision; 144.216, subdivision 2, by adding subdivisions; 144.218, by adding a subdivision; 144.292, subdivision 6; 144.293, subdivisions 2, 4, 9, 10; 144.493, by adding a subdivision; 144.494, subdivision 2; 144.551, subdivision 1; 144.555, subdivisions 1a, 1b, 2, by adding subdivisions; 144.605, by adding a subdivision; 144.99, subdivision 3; 144A.10, subdivisions 15, 16; 144A.471, by adding a subdivision; 144A.474, subdivision 13; 144A.61, subdivision 3a; 144A.70, subdivisions 3, 5, 6, 7; 144A.71, subdivision 2, by adding a subdivision; 144A.72, subdivision 1; 144A.73; 144E.001, subdivision 3a, by adding subdivisions; 144E.101, by adding a subdivision; 144E.16, subdivisions 5, 7; 144E.19, subdivision 3; 144E.27, subdivisions 3, 5, 6; 144E.28, subdivisions 3, 5, 6, 8; 144E.285, subdivisions 1, 2, 4, 6, by adding subdivisions; 144E.287; 144E.305, subdivision 3; 144G.08, subdivision 29; 144G.10, by adding a subdivision; 144G.16, subdivision 6; 146B.03, subdivision 7a; 146B.10, subdivisions 1, 3; 148.235, subdivision 10; 149A.02, subdivisions 3, 3b, 16, 23, 26a, 27, 35, 37c, by adding subdivisions; 149A.03; 149A.65; 149A.70, subdivisions 1, 2, 3, 5; 149A.71, subdivisions 2, 4; 149A.72, subdivisions 3, 9; 149A.73, subdivision 1; 149A.74, subdivision 1; 149A.93, subdivision 3; 149A.94, subdivisions 1, 3, 4; 149A.97, subdivision 2; 151.01, subdivisions 23, 27; 151.065, by adding subdivisions; 151.066, subdivisions 1, 2, 3; 151.212, by adding a subdivision; 151.37, by adding a subdivision; 151.74, subdivision 6; 152.22, subdivision 14, by adding a subdivision; 152.25, subdivision 2; 152.27, subdivisions 2, 6, by adding a subdivision; 176.175, subdivision 2; 214.025; 214.04, subdivision 2a; 214.29; 214.31; 214.355; 243.166, subdivision 7, as amended; 245.096; 245.462, subdivision 6; 245.4663, subdivision 2; 245A.04, subdivision 10, by adding a subdivision; 245A.043, subdivisions 2, 4, by adding subdivisions; 245A.07, subdivision 6; 245A.10, subdivisions 1, as amended, 2, as amended; 245A.14, subdivision 17; 245A.144; 245A.175; 245A.52, subdivision 2, by adding a subdivision; 245A.66, subdivision 2; 245C.05, subdivision 5; 245C.08, subdivision 4; 245C.10, subdivision 18; 245C.14, subdivision 1, by adding a subdivision; 245C.15, subdivisions 3, 4; 245C.22, subdivision 4; 245C.24, subdivisions 2, 5; 245C.30, by adding a subdivision; 245E.08; 245F.09, subdivision 2; 245F.14, by adding a subdivision; 245F.17; 245G.07, subdivision 4; 245G.08, subdivisions 5, 6; 245G.10, by adding a subdivision; 245G.22, subdivisions 6, 7; 245H.01, by adding subdivisions; 245H.08, subdivision 1; 245H.14, subdivisions 1, 4; 245I.02, subdivisions 17, 19; 245I.10, subdivision 9; 245I.11, subdivision 1, by adding a subdivision; 245I.20, subdivision 4; 245I.23, subdivision 14; 256.01, subdivision 41, by adding a subdivision; 256.029, as amended; 256.045, subdivisions 3b, as amended, 5, as amended, 7, as amended; 256.0451, subdivisions 1, as amended, 22, 24; 256.046, subdivision 2, as amended; 256.9657, subdivision 8, by adding a subdivision; 256.969, by adding subdivisions; 256B.056, subdivisions 1a, 10; 256B.0622, subdivisions 2a, 3a, 7a, 7d; 256B.0623, subdivision 5; 256B.0625, subdivisions 12, 20, 39, by adding subdivisions; 256B.0757, subdivisions 4a, 4d, by adding a subdivision; 256B.0943, subdivision 12; 256B.0947,


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15794

subdivision 5; 256B.76, subdivision 6; 256B.795; 256I.04, subdivision 2f; 256J.08, subdivision 34a; 256J.28, subdivision 1; 256K.45, subdivision 2; 256N.22, subdivision 10; 256N.24, subdivision 10; 256N.26, subdivisions 12, 13, 15, 16, 18, 21, 22; 256P.05, by adding a subdivision; 256R.02, subdivision 20; 259.20, subdivision 2; 259.37, subdivision 2; 259.52, subdivisions 2, 4; 259.53, by adding a subdivision; 259.79, subdivision 1; 259.83, subdivision 4; 260.755, subdivisions 2a, 5, 14, 17a, by adding subdivisions; 260.775; 260.785, subdivisions 1, 3; 260.810, subdivision 3; 260C.007, subdivisions 6, 26b; 260C.141, by adding a subdivision; 260C.178, subdivisions 1, as amended, 7; 260C.202; 260C.209, subdivision 1; 260C.212, subdivisions 1, 2; 260C.301, subdivision 1, as amended; 260C.329, subdivisions 3, 8; 260C.4411, by adding a subdivision; 260C.515, subdivision 4; 260C.607, subdivisions 1, 6; 260C.611; 260C.613, subdivision 1; 260C.615, subdivision 1; 260D.01; 260E.03, subdivision 23, as amended; 260E.30, subdivision 3, as amended; 260E.33, subdivision 2, as amended; 317A.811, subdivisions 1, 2, 4; 393.07, subdivision 10a; 518.17, by adding a subdivision; 519.05; 524.3-801, as amended; Minnesota Statutes 2023 Supplement, sections 13.46, subdivision 4, as amended; 15A.0815, subdivision 2; 43A.08, subdivision 1a; 62J.84, subdivision 10; 62Q.46, subdivision 1; 62Q.473, by adding subdivisions; 62Q.522, subdivision 1; 119B.011, subdivision 15; 119B.16, subdivisions 1a, 1c; 119B.161, subdivision 2; 124D.142, subdivision 2, as amended; 142A.03, by adding a subdivision; 144.0526, subdivision 1; 144.1501, subdivisions 1, 2, 3, 4; 144.1505, subdivision 2; 144.2252, subdivision 2; 144.2253; 144.587, subdivision 4; 144A.4791, subdivision 10; 144E.101, subdivisions 6, 7, as amended; 145.561, subdivision 4; 151.555, subdivisions 1, 4, 5, 6, 7, 8, 9, 11, 12; 151.74, subdivision 3; 152.126, subdivision 6; 152.28, subdivision 1; 245.4889, subdivision 1; 245A.02, subdivision 2c; 245A.03, subdivisions 2, as amended, 7, as amended; 245A.043, subdivision 3; 245A.07, subdivision 1, as amended; 245A.11, subdivision 7; 245A.16, subdivisions 1, as amended, 11; 245A.211, subdivision 4; 245A.242, subdivision 2; 245A.50, subdivisions 3, 4; 245A.66, subdivision 4, as amended; 245C.02, subdivisions 6a, 13e; 245C.033, subdivision 3; 245C.08, subdivision 1; 245C.10, subdivision 15; 245C.15, subdivisions 2, 4a; 245C.31, subdivision 1; 245G.22, subdivisions 2, 17; 245H.06, subdivisions 1, 2; 245H.08, subdivisions 4, 5; 254B.04, subdivision 1a; 256.01, subdivision 12b; 256.043, subdivisions 3, 3a; 256.045, subdivision 3, as amended; 256.046, subdivision 3; 256.0471, subdivision 1, as amended; 256.969, subdivision 2b; 256B.0622, subdivisions 7b, 8; 256B.0625, subdivisions 3a, 5m, 9, 13e, as amended, 13f, 13k, 16; 256B.064, subdivision 4; 256B.0671, subdivision 5; 256B.0701, subdivision 6; 256B.0947, subdivision 7; 256B.764; 256D.01, subdivision 1a; 256E.38, subdivision 4; 256I.05, subdivisions 1a, 11; 256L.03, subdivision 1; 256M.42, by adding a subdivision; 256P.06, subdivision 3; 259.83, subdivisions 1, 1b, 3a; 260.014, by adding a subdivision; 260.755, subdivisions 1a, 3, 3a, 5b, 20, 22; 260.758, subdivisions 2, 4, 5; 260.761; 260.762; 260.763, subdivisions 1, 4, 5; 260.765, subdivisions 2, 3a, 4b; 260.771, subdivisions 1a, 1b, 1c, 2b, 2d, 6, by adding a subdivision; 260.773, subdivisions 1, 2, 3, 4, 5, 10, 11; 260.774, subdivisions 1, 2, 3; 260.781, subdivision 1; 260.786, subdivision 2; 260.795, subdivision 1; 342.01, subdivision 63; 342.52, subdivision 3; 342.53; 342.54, subdivision 2; 342.55, subdivision 2; 518A.42, subdivision 3; Laws 1987, chapter 404, section 18, subdivision 1; Laws 2023, chapter 22, section 4, subdivision 2; Laws 2023, chapter 57, article 1, section 6; Laws 2023, chapter 70, article 1, section 35; article 11, section 13, subdivision 8; article 12, section 30, subdivisions 2, 3; article 14, section 42, subdivision 6; article 20, sections 2, subdivisions 5, 22, 24, 29, 31; 3, subdivision 2; 12, as amended; 23; Laws 2024, chapter 80, article 1, sections 38, subdivisions 1, 2, 5, 6, 7, 9; 96; article 2, sections 5, subdivision 21, by adding a subdivision; 6, subdivisions 2, 3, 3a, by adding a subdivision; 7, subdivision 2; 10, subdivisions 1, 6; 16, subdivision 1, by adding a subdivision; 30, subdivision 2; 31; 74; article 4, section 26; article 6, section 4; article 7, section 4; proposing coding for new law in Minnesota Statutes, chapters 62D; 62J; 62Q; 137; 142A; 144; 144A; 144E; 145; 149A; 151; 214; 245C; 245H; 256B; 259; 260; 260D; 260E; 524; proposing coding for new law as Minnesota Statutes, chapters 142B; 142F; 332C; repealing Minnesota Statutes 2022, sections 62A.041, subdivision 3; 144.218, subdivision 3; 144.497; 144E.001, subdivision 5; 144E.01; 144E.123, subdivision 5; 144E.27, subdivisions 1, 1a; 144E.50, subdivision 3; 245A.065; 245C.125; 256.01, subdivisions 12, 12a; 256B.79, subdivision 6; 256D.19, subdivisions 1, 2; 256D.20, subdivisions 1, 2, 3, 4; 256D.23, subdivisions 1, 2, 3; 256R.02, subdivision 46; 260.755, subdivision 13; Minnesota Statutes 2023 Supplement, sections 62J.312, subdivision 6; 62Q.522, subdivisions 3, 4; 144.0528, subdivision 5; 245C.08, subdivision 2; Laws 2023, chapter 25, section 190, subdivision 10; Laws 2024, chapter 80, article 1, sections 38,


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15795

subdivisions 3, 4, 11; 39; 43, subdivision 2; article 2, sections 1, subdivision 11; 3, subdivision 3; 4, subdivision 4; 6, subdivision 4; 10, subdivision 4; 33; 69; article 7, sections 3; 9; Minnesota Rules, parts 9502.0425, subparts 5, 10; 9545.0805, subpart 1; 9545.0845; 9560.0232, subpart 5.

 

Reported the same back with the following amendments:

 

Delete everything after the enacting clause and insert:

 

"ARTICLE 1

DEPARTMENT OF HUMAN SERVICES HEALTH CARE FINANCE

 

Section 1.  [62V.12] STATE-FUNDED COST-SHARING REDUCTIONS.

 

Subdivision 1.  Establishment.  (a) The board must develop and administer a state-funded cost-sharing reduction program for eligible persons who enroll in a silver level qualified health plan through MNsure.  The board must implement the cost-sharing reduction program for plan years beginning on or after January 1, 2027.

 

(b) For purposes of this section, an "eligible person" is an individual who meets the eligibility criteria to receive a cost-sharing reduction under Code of Federal Regulations, title 45, section 155.305(g).

 

Subd. 2.  Reduction in cost-sharing.  The cost-sharing reduction program must use state money to reduce enrollee cost-sharing by increasing the actuarial value of silver level health plans for eligible persons beyond the 73 percent value established in Code of Federal Regulations, title 45, section 156.420(a)(3)(ii), to an actuarial value of 87 percent. 

 

Subd. 3.  Administration.  The board, when administering the program, must:

 

(1) allow eligible persons to enroll in a silver level health plan with a state-funded cost-sharing reduction;

 

(2) modify the MNsure shopping tool to display the total cost-sharing reduction benefit available to individuals eligible under this section; and

 

(3) reimburse health carriers on a quarterly basis for the cost to the health plan providing the state-funded cost‑sharing reductions.

 

Sec. 2.  Minnesota Statutes 2023 Supplement, section 256.9631, is amended to read:

 

256.9631 DIRECT PAYMENT SYSTEM ALTERNATIVE CARE DELIVERY MODELS FOR MEDICAL ASSISTANCE AND MINNESOTACARE.

 

Subdivision 1.  Direction to the commissioner.  (a) The commissioner, in order to deliver services to eligible individuals, achieve better health outcomes, and reduce the cost of health care for the state, shall develop an implementation plan plans for a direct payment system to deliver services to eligible individuals in order to achieve better health outcomes and reduce the cost of health care for the state.  Under this system, at least three care delivery models that:

 

(1) are alternatives to the use of commercial managed care plans to deliver health care to Minnesota health care program enrollees; and

 

(2) do not shift financial risk to nongovernmental entities.


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15796

(b) One of the alternative models must be a direct payment system under which eligible individuals must receive services through the medical assistance fee-for-service system, county-based purchasing plans, or and county-owned health maintenance organizations.  At least one additional model must include county-based purchasing plans and county-owned health maintenance organizations in their design, and must allow these entities to deliver care in geographic areas on a single plan basis, if:

 

(1) these entities contract with all providers that agree to contract terms for network participation; and

 

(2) the commissioner of human services determines that an entity's provider network is adequate to ensure enrollee access and choice.

 

(c) Before determining the alternative models for which implementation plans will be developed, the commissioner shall consult with the chairs and ranking minority members of the legislative committees with jurisdiction over health care finance and policy.

 

(d) The commissioner shall present an implementation plan plans for the direct payment system selected models to the chairs and ranking minority members of the legislative committees with jurisdiction over health care finance and policy by January 15, 2026.  The commissioner may contract for technical assistance in developing the implementation plan plans and conducting related studies and analyses.

 

(b) For the purposes of the direct payment system, the commissioner shall make the following assumptions:

 

(1) health care providers are reimbursed directly for all medical assistance covered services provided to eligible individuals, using the fee-for-service payment methods specified in chapters 256, 256B, 256R, and 256S;

 

(2) payments to a qualified hospital provider are equivalent to the payments that would have been received based on managed care direct payment arrangements.  If necessary, a qualified hospital provider may use a county-owned health maintenance organization to receive direct payments as described in section 256B.1973; and

 

(3) county-based purchasing plans and county-owned health maintenance organizations must be reimbursed at the capitation rate determined under sections 256B.69 and 256B.692.

 

Subd. 2.  Definitions.  (a) For purposes of this section, the following terms have the meanings given.

 

(b) "Eligible individuals" means qualified all medical assistance enrollees, defined as persons eligible for medical assistance as families and children and adults without children and MinnesotaCare enrollees.

 

(c) "Minnesota health care programs" means the medical assistance and MinnesotaCare programs.

 

(c) (d) "Qualified hospital provider" means a nonstate government teaching hospital with high medical assistance utilization and a level 1 trauma center, and all of the hospital's owned or affiliated health care professionals, ambulance services, sites, and clinics.

 

Subd. 3.  Implementation plan plans.  (a) The Each implementation plan must include:

 

(1) a timeline for the development and recommended implementation date of the direct payment system alternative model.  In recommending a timeline, the commissioner must consider:

 

(i) timelines required by the existing contracts with managed care plans and county-based purchasing plans to sunset existing delivery models;


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15797

(ii) in counties that choose to operate a county-based purchasing plan under section 256B.692, timelines for any new procurements required for those counties to establish a new county-based purchasing plan or participate in an existing county-based purchasing plan;

 

(iii) in counties that choose to operate a county-owned health maintenance organization under section 256B.69, timelines for any new procurements required for those counties to establish a new county-owned health maintenance organization or to continue serving enrollees through an existing county-owned health maintenance organization; and

 

(iv) a recommendation on whether the commissioner should contract with a third-party administrator to administer the direct payment system alternative model, and the timeline needed for procuring an administrator;

 

(2) the procedures to be used to ensure continuity of care for enrollees who transition from managed care to fee‑for-service and any administrative resources needed to carry out these procedures;

 

(3) recommended quality measures for health care service delivery;

 

(4) any changes to fee-for-service payment rates that the commissioner determines are necessary to ensure provider access and high-quality care and to reduce health disparities;

 

(5) recommendations on ensuring effective care coordination under the direct payment system alternative model, especially for enrollees who:

 

(i) are age 65 or older, blind, or have disabilities;

 

(ii) have complex medical conditions, who;

 

(iii) face socioeconomic barriers to receiving care, or who; or

 

(iv) are from underserved populations that experience health disparities;

 

(6) recommendations on whether the direct payment system should provide supplemental payments payment arrangements for care coordination, including:

 

(i) the provider types eligible for supplemental care coordination payments;

 

(ii) procedures to coordinate supplemental care coordination payments with existing supplemental or cost-based payment methods or to replace these existing methods; and

 

(iii) procedures to align care coordination initiatives funded through supplemental payments under this section the alternative model with existing care coordination initiatives;

 

(7) recommendations on whether the direct payment system alternative model should include funding to providers for outreach initiatives to patients who, because of mental illness, homelessness, or other circumstances, are unlikely to obtain needed care and treatment;

 

(8) recommendations for a supplemental payment to qualified hospital providers to offset any potential revenue losses resulting from the shift from managed care payments; and

 

(9) recommendations on whether and how the direct payment system should be expanded to deliver services and care coordination to medical assistance enrollees who are age 65 or older, are blind, or have a disability and to persons enrolled in MinnesotaCare; and


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15798

(10) (9) recommendations for statutory changes necessary to implement the direct payment system alternative model.

 

(b) In developing the each implementation plan, the commissioner shall:

 

(1) calculate the projected cost of a direct payment system the alternative model relative to the cost of the current system;

 

(2) assess gaps in care coordination under the current medical assistance and MinnesotaCare programs;

 

(3) evaluate the effectiveness of approaches other states have taken to coordinate care under a fee-for-service system, including the coordination of care provided to persons who are age 65 or older, are blind, or have disabilities;

 

(4) estimate the loss of revenue and cost savings from other payment enhancements based on managed care plan directed payments and pass-throughs;

 

(5) estimate cost trends under a direct payment system the alternative model for managed care payments to county-based purchasing plans and county-owned health maintenance organizations;

 

(6) estimate the impact of a direct payment system the alternative model on other revenue, including taxes, surcharges, or other federally approved in lieu of services and on other arrangements allowed under managed care;

 

(7) consider allowing eligible individuals to opt out of managed care as an alternative approach;

 

(8) assess the feasibility of a medical assistance outpatient prescription drug benefit carve-out under section 256B.69, subdivision 6d, and in consultation with the commissioners of commerce and health, assess the feasibility of including MinnesotaCare enrollees and private sector enrollees of health plan companies in the drug benefit carve-out.  The assessment of feasibility must address and include recommendations related to the process and terms by which the commissioner would contract with health plan companies to administer prescription drug benefits and develop and manage a drug formulary, and the impact of the drug-benefit carve-out on health care providers, including small pharmacies;

 

(9) (8) consult with the commissioners of health and commerce and the contractor or contractors analyzing the Minnesota Health Plan under section 19 and other health reform models on plan design and assumptions; and

 

(10) (9) conduct other analyses necessary to develop the implementation plan.

 

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

 

Sec. 3.  Minnesota Statutes 2022, section 256.9657, is amended by adding a subdivision to read:

 

Subd. 2a.  Teaching hospital surcharge.  (a) Each teaching hospital shall pay to the medical assistance account a surcharge equal to 0.01 percent of net non-Medicare patient care revenue.  The initial surcharge must be paid 60 days after both this subdivision and section 256.969, subdivision 2g, have received federal approval, and subsequent surcharge payments must be made annually in the form and manner specified by the commissioner.

 

(b) The commissioner shall use revenue from the surcharge only to pay the nonfederal share of the medical assistance supplemental payments described in section 256.969, subdivision 2g, and to supplement, and not supplant, medical assistance reimbursement to teaching hospitals.  The surcharge must comply with Code of Federal Regulations, title 42, section 433.68.


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15799

(c) For purposes of this subdivision, "teaching hospital" means any Minnesota hospital, except facilities of the federal Indian Health Service and regional treatment centers, with a Centers for Medicare and Medicaid Services designation of "teaching hospital" as reported on form CMS-2552-10, worksheet S-2, line 56, that is eligible for reimbursement under section 256.969, subdivision 2g.

 

EFFECTIVE DATE.  This section is effective the later of January 1, 2025, or federal approval of this section and sections 4 and 5.  The commissioner of human services shall notify the revisor of statutes when federal approval is obtained.

 

Sec. 4.  Minnesota Statutes 2023 Supplement, section 256.969, subdivision 2b, is amended to read:

 

Subd. 2b.  Hospital payment rates.  (a) For discharges occurring on or after November 1, 2014, hospital inpatient services for hospitals located in Minnesota shall be paid according to the following:

 

(1) critical access hospitals as defined by Medicare shall be paid using a cost-based methodology;

 

(2) long-term hospitals as defined by Medicare shall be paid on a per diem methodology under subdivision 25;

 

(3) rehabilitation hospitals or units of hospitals that are recognized as rehabilitation distinct parts as defined by Medicare shall be paid according to the methodology under subdivision 12; and

 

(4) all other hospitals shall be paid on a diagnosis-related group (DRG) methodology.

 

(b) For the period beginning January 1, 2011, through October 31, 2014, rates shall not be rebased, except that a Minnesota long-term hospital shall be rebased effective January 1, 2011, based on its most recent Medicare cost report ending on or before September 1, 2008, with the provisions under subdivisions 9 and 23, based on the rates in effect on December 31, 2010.  For rate setting periods after November 1, 2014, in which the base years are updated, a Minnesota long-term hospital's base year shall remain within the same period as other hospitals.

 

(c) Effective for discharges occurring on and after November 1, 2014, payment rates for hospital inpatient services provided by hospitals located in Minnesota or the local trade area, except for the hospitals paid under the methodologies described in paragraph (a), clauses (2) and (3), shall be rebased, incorporating cost and payment methodologies in a manner similar to Medicare.  The base year or years for the rates effective November 1, 2014, shall be calendar year 2012.  The rebasing under this paragraph shall be budget neutral, ensuring that the total aggregate payments under the rebased system are equal to the total aggregate payments that were made for the same number and types of services in the base year.  Separate budget neutrality calculations shall be determined for payments made to critical access hospitals and payments made to hospitals paid under the DRG system.  Only the rate increases or decreases under subdivision 3a or 3c that applied to the hospitals being rebased during the entire base period shall be incorporated into the budget neutrality calculation.

 

(d) For discharges occurring on or after November 1, 2014, through the next rebasing that occurs, the rebased rates under paragraph (c) that apply to hospitals under paragraph (a), clause (4), shall include adjustments to the projected rates that result in no greater than a five percent increase or decrease from the base year payments for any hospital.  Any adjustments to the rates made by the commissioner under this paragraph and paragraph (e) shall maintain budget neutrality as described in paragraph (c).

 

(e) For discharges occurring on or after November 1, 2014, the commissioner may make additional adjustments to the rebased rates, and when evaluating whether additional adjustments should be made, the commissioner shall consider the impact of the rates on the following:

 

(1) pediatric services;


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15800

(2) behavioral health services;

 

(3) trauma services as defined by the National Uniform Billing Committee;

 

(4) transplant services;

 

(5) obstetric services, newborn services, and behavioral health services provided by hospitals outside the seven‑county metropolitan area;

 

(6) outlier admissions;

 

(7) low-volume providers; and

 

(8) services provided by small rural hospitals that are not critical access hospitals.

 

(f) Hospital payment rates established under paragraph (c) must incorporate the following:

 

(1) for hospitals paid under the DRG methodology, the base year payment rate per admission is standardized by the applicable Medicare wage index and adjusted by the hospital's disproportionate population adjustment;

 

(2) for critical access hospitals, payment rates for discharges between November 1, 2014, and June 30, 2015, shall be set to the same rate of payment that applied for discharges on October 31, 2014;

 

(3) the cost and charge data used to establish hospital payment rates must only reflect inpatient services covered by medical assistance; and

 

(4) in determining hospital payment rates for discharges occurring on or after the rate year beginning January 1, 2011, through December 31, 2012, the hospital payment rate per discharge shall be based on the cost-finding methods and allowable costs of the Medicare program in effect during the base year or years.  In determining hospital payment rates for discharges in subsequent base years, the per discharge rates shall be based on the cost‑finding methods and allowable costs of the Medicare program in effect during the base year or years.

 

(g) The commissioner shall validate the rates effective November 1, 2014, by applying the rates established under paragraph (c), and any adjustments made to the rates under paragraph (d) or (e), to hospital claims paid in calendar year 2013 to determine whether the total aggregate payments for the same number and types of services under the rebased rates are equal to the total aggregate payments made during calendar year 2013.

 

(h) Effective for discharges occurring on or after July 1, 2017, and every two years thereafter, payment rates under this section shall be rebased to reflect only those changes in hospital costs between the existing base year or years and the next base year or years.  In any year that inpatient claims volume falls below the threshold required to ensure a statistically valid sample of claims, the commissioner may combine claims data from two consecutive years to serve as the base year.  Years in which inpatient claims volume is reduced or altered due to a pandemic or other public health emergency shall not be used as a base year or part of a base year if the base year includes more than one year.  Changes in costs between base years shall be measured using the lower of the hospital cost index defined in subdivision 1, paragraph (a), or the percentage change in the case mix adjusted cost per claim.  The commissioner shall establish the base year for each rebasing period considering the most recent year or years for which filed Medicare cost reports are available, except that the base years for the rebasing effective July 1, 2023, are calendar years 2018 and 2019.  The estimated change in the average payment per hospital discharge resulting from a scheduled rebasing must be calculated and made available to the legislature by January 15 of each year in which rebasing is scheduled to occur, and must include by hospital the differential in payment rates compared to the individual hospital's costs.


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15801

(i) Effective for discharges occurring on or after July 1, 2015, inpatient payment rates for critical access hospitals located in Minnesota or the local trade area shall be determined using a new cost-based methodology.  The commissioner shall establish within the methodology tiers of payment designed to promote efficiency and cost‑effectiveness.  Payment rates for hospitals under this paragraph shall be set at a level that does not exceed the total cost for critical access hospitals as reflected in base year cost reports.  Until the next rebasing that occurs, the new methodology shall result in no greater than a five percent decrease from the base year payments for any hospital, except a hospital that had payments that were greater than 100 percent of the hospital's costs in the base year shall have their rate set equal to 100 percent of costs in the base year.  The rates paid for discharges on and after July 1, 2016, covered under this paragraph shall be increased by the inflation factor in subdivision 1, paragraph (a).  The new cost-based rate shall be the final rate and shall not be settled to actual incurred costs.  Hospitals shall be assigned a payment tier based on the following criteria:

 

(1) hospitals that had payments at or below 80 percent of their costs in the base year shall have a rate set that equals 85 percent of their base year costs;

 

(2) hospitals that had payments that were above 80 percent, up to and including 90 percent of their costs in the base year shall have a rate set that equals 95 percent of their base year costs; and

 

(3) hospitals that had payments that were above 90 percent of their costs in the base year shall have a rate set that equals 100 percent of their base year costs.

 

(j) The commissioner may refine the payment tiers and criteria for critical access hospitals to coincide with the next rebasing under paragraph (h).  The factors used to develop the new methodology may include, but are not limited to:

 

(1) the ratio between the hospital's costs for treating medical assistance patients and the hospital's charges to the medical assistance program;

 

(2) the ratio between the hospital's costs for treating medical assistance patients and the hospital's payments received from the medical assistance program for the care of medical assistance patients;

 

(3) the ratio between the hospital's charges to the medical assistance program and the hospital's payments received from the medical assistance program for the care of medical assistance patients;

 

(4) the statewide average increases in the ratios identified in clauses (1), (2), and (3);

 

(5) the proportion of that hospital's costs that are administrative and trends in administrative costs; and

 

(6) geographic location.

 

(k) Subject to section 256.969, subdivision 2g, paragraph (i), effective for discharges occurring on or after January 1, 2024, the rates paid to hospitals described in paragraph (a), clauses (2) to (4), must include a rate factor specific to each hospital that qualifies for a medical education and research cost distribution under section 62J.692, subdivision 4, paragraph (a).

 

EFFECTIVE DATE.  This section is effective the later of January 1, 2025, or federal approval of this section and sections 3 and 5.  The commissioner of human services shall notify the revisor of statutes when federal approval is obtained.


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15802

Sec. 5.  Minnesota Statutes 2022, section 256.969, is amended by adding a subdivision to read:

 

Subd. 2g.  Annual supplemental payments; direct and indirect physician graduate medical education.  (a) For discharges occurring on or after January 1, 2025, the commissioner shall determine and pay annual supplemental payments to all eligible hospitals as provided in this subdivision for direct and indirect physician graduate medical education cost reimbursement.  A hospital must be an eligible hospital to receive an annual supplemental payment under this subdivision.

 

(b) The commissioner must use the following information to calculate the total cost of direct graduate medical education incurred by each eligible hospital: 

 

(1) the total allowable direct graduate medical education cost, as calculated by adding form CMS-2552-10, worksheet B, part 1, columns 21 and 22, line 202; and

 

(2) the Medicaid share of total allowable direct graduate medical education cost percentage, representing the allocation of total graduate medical education costs to Medicaid based on the share of all Medicaid inpatient days, as reported on form CMS-2552-10, worksheets S-2 and S-3, divided by the hospital's total inpatient days, as reported on worksheet S-3.

 

(c) The commissioner may obtain the information in paragraph (b) from an eligible hospital upon request by the commissioner or from the eligible hospital's most recently filed form CMS-2552-10.

 

(d) The commissioner must use the following information to calculate the total allowable indirect cost of graduate medical education incurred by each eligible hospital:

 

(1) for eligible hospitals that are not children's hospitals, the indirect graduate medical education amount attributable to Medicaid, calculated based on form CMS-2552-10, worksheet E, part A, including: 

 

(i) the Medicare indirect medical education formula, using Medicaid variables;

 

(ii) Medicaid payments for inpatient services under fee-for-service and managed care, as determined by the commissioner in consultation with each eligible hospital;

 

(iii) total inpatient beds available, as reported on form CMS-2552-10, worksheet E, part A, line 4; and

 

(iv) full-time employees, as determined by adding form CMS-2552-10, worksheet E, part A, lines 10 and 11; and

 

(2) for eligible hospitals that are children's hospitals: 

 

(i) the Medicare indirect medical education formula, using Medicaid variables;

 

(ii) Medicaid payments for inpatient services under fee-for-service and managed care, as determined by the commissioner in consultation with each eligible hospital;

 

(iii) total inpatient beds available, as reported on form CMS-2552-10, worksheet S-3, part 1; and

 

(iv) full-time equivalent interns and residents, as determined by adding form CMS-2552-10, worksheet E-4, lines 6, 10.01, and 15.01.


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15803

(e) The commissioner shall determine each eligible hospital's maximum allowable Medicaid direct graduate medical education supplemental payment amount by calculating the sum of: 

 

(1) the total allowable direct graduate medical education costs determined under paragraph (b), clause (1), multiplied by the Medicaid share of total allowable direct graduate medical education cost percentage in paragraph (b), clause (2); and

 

(2) the total allowable direct graduate medical education costs determined under paragraph (b), clause (1), multiplied by the most recently updated Medicaid utilization percentage from form CMS-2552-10, as submitted to Medicare by each eligible hospital. 

 

(f) The commissioner shall determine each eligible hospital's indirect graduate medical education supplemental payment amount by multiplying the total allowable indirect cost of graduate medical education amount calculated in paragraph (d) by:

 

(1) 0.95 for prospective payment system, for hospitals that are not children's hospitals and have fewer than 50 full-time equivalent trainees;

 

(2) 1.0 for prospective payment system, for hospitals that are not children's hospitals and have equal to or greater than 50 full-time equivalent trainees; and

 

(3) 1.05 for children's hospitals.

 

(g) An eligible hospital's annual supplemental payment under this subdivision equals the sum of the amount calculated for the eligible hospital under paragraph (e) and the amount calculated for the eligible hospital under paragraph (f).

 

(h) The annual supplemental payments under this subdivision are contingent upon federal approval and must conform with the requirements for permissible supplemental payments for direct and indirect graduate medical education under all applicable federal laws. 

 

(i) An eligible hospital is only eligible for reimbursement under section 62J.692 for nonphysician graduate medical education training costs that are not accounted for in the calculation of an annual supplemental payment under this section.  An eligible hospital must not accept reimbursement under section 62J.692 for physician graduate medical education training costs that are accounted for in the calculation of an annual supplemental payment under this section.

 

(j) For purposes of this subdivision, "children's hospital" means a Minnesota hospital designated as a children's hospital under Medicare.

 

(k) For purposes of this subdivision, "eligible hospital" means a hospital located in Minnesota:

 

(1) participating in Minnesota's medical assistance program;

 

(2) that has received fee-for-service medical assistance payments in the payment year; and


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15804

(3) that is either:

 

(i) eligible to receive graduate medical education payments from the Medicare program under Code of Federal Regulations, title 42, section 413.75; or

 

(ii) a children's hospital.

 

EFFECTIVE DATE.  This section is effective the later of January 1, 2025, or federal approval of this section and sections 3 and 4.  The commissioner of human services shall notify the revisor of statutes when federal approval is obtained.

 

Sec. 6.  Minnesota Statutes 2022, section 256.969, is amended by adding a subdivision to read:

 

Subd. 2h.  Alternate inpatient payment rate for a discharge.  (a) Effective retroactively from January 1, 2024, in any rate year in which a children's hospital discharge is included in the federally required disproportionate share hospital payment audit where the patient discharged had resided in a children's hospital for over 20 years, the commissioner shall compute an alternate inpatient rate for the children's hospital.  The alternate payment rate must be the rate computed under this section excluding the disproportionate share hospital payment under subdivision 9, paragraph (d), clause (1), increased by an amount equal to 99 percent of what the disproportionate share hospital payment would have been under subdivision 9, paragraph (d), clause (1), had the discharge been excluded.

 

(b) In any rate year in which payment to a children's hospital is made using this alternate payment rate, payments must not be made to the hospital under subdivisions 2e, 2f, and 9.

 

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

 

Sec. 7.  Minnesota Statutes 2023 Supplement, section 256B.0625, subdivision 13e, as amended by Laws 2024, chapter 85, section 66, is amended to read:

 

Subd. 13e.  Payment rates.  (a) The basis for determining the amount of payment shall be the lower of the ingredient costs of the drugs plus the professional dispensing fee; or the usual and customary price charged to the public.  The usual and customary price means the lowest price charged by the provider to a patient who pays for the prescription by cash, check, or charge account and includes prices the pharmacy charges to a patient enrolled in a prescription savings club or prescription discount club administered by the pharmacy or pharmacy chain.  The amount of payment basis must be reduced to reflect all discount amounts applied to the charge by any third-party provider/insurer agreement or contract for submitted charges to medical assistance programs.  The net submitted charge may not be greater than the patient liability for the service.  The professional dispensing fee shall be $10.77 $11.55 for prescriptions filled with legend drugs meeting the definition of "covered outpatient drugs" according to United States Code, title 42, section 1396r-8(k)(2).  The dispensing fee for intravenous solutions that must be compounded by the pharmacist shall be $10.77 $11.55 per claim.  The professional dispensing fee for prescriptions filled with over-the-counter drugs meeting the definition of covered outpatient drugs shall be $10.77 $11.55 for dispensed quantities equal to or greater than the number of units contained in the manufacturer's original package.  The professional dispensing fee shall be prorated based on the percentage of the package dispensed when the pharmacy dispenses a quantity less than the number of units contained in the manufacturer's original package.  The pharmacy dispensing fee for prescribed over-the-counter drugs not meeting the definition of covered outpatient drugs shall be $3.65 for quantities equal to or greater than the number of units contained in the manufacturer's original package and shall be prorated based on the percentage of the package dispensed when the pharmacy dispenses a quantity less than the number of units contained in the manufacturer's original package.  The National Average Drug Acquisition Cost (NADAC) shall be used to determine the ingredient cost of a drug.  For drugs for which a NADAC is not reported, the commissioner shall estimate the ingredient cost at the wholesale acquisition


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15805

cost minus two percent.  The ingredient cost of a drug for a provider participating in the federal 340B Drug Pricing Program shall be either the 340B Drug Pricing Program ceiling price established by the Health Resources and Services Administration or NADAC, whichever is lower.  Wholesale acquisition cost is defined as the manufacturer's list price for a drug or biological to wholesalers or direct purchasers in the United States, not including prompt pay or other discounts, rebates, or reductions in price, for the most recent month for which information is available, as reported in wholesale price guides or other publications of drug or biological pricing data.  The maximum allowable cost of a multisource drug may be set by the commissioner and it shall be comparable to the actual acquisition cost of the drug product and no higher than the NADAC of the generic product.  Establishment of the amount of payment for drugs shall not be subject to the requirements of the Administrative Procedure Act.

 

(b) Pharmacies dispensing prescriptions to residents of long-term care facilities using an automated drug distribution system meeting the requirements of section 151.58, or a packaging system meeting the packaging standards set forth in Minnesota Rules, part 6800.2700, that govern the return of unused drugs to the pharmacy for reuse, may employ retrospective billing for prescription drugs dispensed to long-term care facility residents.  A retrospectively billing pharmacy must submit a claim only for the quantity of medication used by the enrolled recipient during the defined billing period.  A retrospectively billing pharmacy must use a billing period not less than one calendar month or 30 days.

 

(c) A pharmacy provider using packaging that meets the standards set forth in Minnesota Rules, part 6800.2700, is required to credit the department for the actual acquisition cost of all unused drugs that are eligible for reuse, unless the pharmacy is using retrospective billing.  The commissioner may permit the drug clozapine to be dispensed in a quantity that is less than a 30-day supply.

 

(d) If a pharmacy dispenses a multisource drug, the ingredient cost shall be the NADAC of the generic product or the maximum allowable cost established by the commissioner unless prior authorization for the brand name product has been granted according to the criteria established by the Drug Formulary Committee as required by subdivision 13f, paragraph (a), and the prescriber has indicated "dispense as written" on the prescription in a manner consistent with section 151.21, subdivision 2.

 

(e) The basis for determining the amount of payment for drugs administered in an outpatient setting shall be the lower of the usual and customary cost submitted by the provider, 106 percent of the average sales price as determined by the United States Department of Health and Human Services pursuant to title XVIII, section 1847a of the federal Social Security Act, the specialty pharmacy rate, or the maximum allowable cost set by the commissioner.  If average sales price is unavailable, the amount of payment must be lower of the usual and customary cost submitted by the provider, the wholesale acquisition cost, the specialty pharmacy rate, or the maximum allowable cost set by the commissioner.  The commissioner shall discount the payment rate for drugs obtained through the federal 340B Drug Pricing Program by 28.6 percent.  The payment for drugs administered in an outpatient setting shall be made to the administering facility or practitioner.  A retail or specialty pharmacy dispensing a drug for administration in an outpatient setting is not eligible for direct reimbursement.

 

(f) The commissioner may establish maximum allowable cost rates for specialty pharmacy products that are lower than the ingredient cost formulas specified in paragraph (a).  The commissioner may require individuals enrolled in the health care programs administered by the department to obtain specialty pharmacy products from providers with whom the commissioner has negotiated lower reimbursement rates.  Specialty pharmacy products are defined as those used by a small number of recipients or recipients with complex and chronic diseases that require expensive and challenging drug regimens.  Examples of these conditions include, but are not limited to:  multiple sclerosis, HIV/AIDS, transplantation, hepatitis C, growth hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms of cancer.  Specialty pharmaceutical products include injectable and infusion therapies, biotechnology drugs, antihemophilic factor products, high-cost therapies, and therapies that require complex care.  The commissioner shall consult with the Formulary Committee to develop a list of specialty pharmacy products


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15806

subject to maximum allowable cost reimbursement.  In consulting with the Formulary Committee in developing this list, the commissioner shall take into consideration the population served by specialty pharmacy products, the current delivery system and standard of care in the state, and access to care issues.  The commissioner shall have the discretion to adjust the maximum allowable cost to prevent access to care issues.

 

(g) Home infusion therapy services provided by home infusion therapy pharmacies must be paid at rates according to subdivision 8d.

 

(h) The commissioner shall contract with a vendor to conduct a cost of dispensing survey for all pharmacies that are physically located in the state of Minnesota that dispense outpatient drugs under medical assistance.  The commissioner shall ensure that the vendor has prior experience in conducting cost of dispensing surveys.  Each pharmacy enrolled with the department to dispense outpatient prescription drugs to fee-for-service members must respond to the cost of dispensing survey.  The commissioner may sanction a pharmacy under section 256B.064 for failure to respond.  The commissioner shall require the vendor to measure a single statewide cost of dispensing for specialty prescription drugs and a single statewide cost of dispensing for nonspecialty prescription drugs for all responding pharmacies to measure the mean, mean weighted by total prescription volume, mean weighted by medical assistance prescription volume, median, median weighted by total prescription volume, and median weighted by total medical assistance prescription volume.  The commissioner shall post a copy of the final cost of dispensing survey report on the department's website.  The initial survey must be completed no later than January 1, 2021, and repeated every three years.  The commissioner shall provide a summary of the results of each cost of dispensing survey and provide recommendations for any changes to the dispensing fee to the chairs and ranking minority members of the legislative committees with jurisdiction over medical assistance pharmacy reimbursement.  Notwithstanding section 256.01, subdivision 42, this paragraph does not expire.

 

(i) The commissioner shall increase the ingredient cost reimbursement calculated in paragraphs (a) and (f) by 1.8 percent for prescription and nonprescription drugs subject to the wholesale drug distributor tax under section 295.52.

 

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

 

Sec. 8.  Minnesota Statutes 2022, section 256B.69, is amended by adding a subdivision to read:

 

Subd. 38.  Reimbursement of network providers.  (a) A managed care plan that is a staff model health plan company, when reimbursing network providers for services provided to medical assistance and MinnesotaCare enrollees, must not reimburse network providers who are employees at a higher rate than network providers who provide services under contract for each separate service or grouping of services.  This requirement does not apply to reimbursement:

 

(1) of network providers when participating in value-based purchasing models that are intended to recognize value or outcomes over volume of services, including:

 

(i) total cost of care and risk/gain sharing arrangements under section 256B.0755; and

 

(ii) other pay-for-performance arrangements or service payments, as long as the terms and conditions of the value-based purchasing model are applied uniformly to all participating network providers; and

 

(2) for services furnished by providers who are out-of-network.

 

(b) Any contract or agreement between a managed care plan and a network administrator, for purposes of delivering services to medical assistance and MinnesotaCare enrollees, must require the network administrator to comply with the requirements that apply to a managed care plan that is a staff model health plan company under


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15807

paragraph (a) when reimbursing providers who are employees of the network administrator and providers who provide services under contract with the network administrator.  This provision applies whether or not the managed care plan, network administrator, and providers are under the same corporate ownership.

 

(c) For purposes of this subdivision, "network provider" has the meaning specified in subdivision 37.  For purposes of this subdivision, "network administrator" means any entity that furnishes a provider network for a managed care plan company, or furnishes individual health care providers or provider groups to a managed care plan for inclusion in the managed care plan's provider network.

 

Sec. 9.  COUNTY-ADMINISTERED MEDICAL ASSISTANCE MODEL.

 

Subdivision 1.  Model development.  (a) The commissioner of human services, in collaboration with the Association of Minnesota Counties and county-based purchasing plans, shall develop a county-administered medical assistance (CAMA) model and a detailed plan for implementing the CAMA model.

 

(b) The CAMA model must be designed to achieve the following objectives:

 

(1) provide a distinct county owned and administered alternative to the prepaid medical assistance program;

 

(2) facilitate greater integration of health care and social services to address social determinants of health in rural and nonrural communities, with the degree of integration of social services varying with each county's needs and resources;

 

(3) account for differences between counties in the number of medical assistance enrollees and locally available providers of behavioral health, oral health, specialty and tertiary care, nonemergency medical transportation, and other health care services in rural communities; and

 

(4) promote greater accountability for health outcomes, health equity, customer service, community outreach, and cost of care.

 

Subd. 2.  County participation.  (a) The CAMA model must give each rural and nonrural county the option of applying to participate in the CAMA model as an alternative to participation in the prepaid medical assistance program.  The CAMA model must include a process for the commissioner to determine whether and how a county can participate.

 

(b) The CAMA model may allow a county-administered managed care organization to deliver care on a single‑plan basis to all medical assistance enrollees residing in a county if:

 

(1) the managed care organization contracts with all health care providers that agree to accept the contract terms for network participation; and

 

(2) the commissioner determines that the health care provider network of the managed care organization is adequate to ensure enrollee access to care and enrollee choice of providers.

 

Subd. 3.  Report to the legislature.  (a) The commissioner shall report recommendations and an implementation plan for the CAMA model to the chairs and ranking minority members of the legislative committees with jurisdiction over health care policy and finance by January 15, 2025.  The CAMA model and implementation plan must address the issues and consider the recommendations identified in the document titled "Recommendations Not Contingent on Outcome(s) of Current Litigation," attached to the September 13, 2022, e-filing to the Second Judicial


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15808

District Court (Correspondence for Judicial Approval Index #102), that relates to the final contract decisions of the commissioner of human services regarding South Country Health Alliance v. Minnesota Department of Human Services, No. 62-CV-22-907 (Ramsey Cnty.  Dist.  Ct.  2022).

 

(b) The report must also identify the clarifications, approvals, and waivers that are needed from the Centers for Medicare and Medicaid Services and include any draft legislation necessary to implement the CAMA model.

 

Sec. 10.  REVISOR INSTRUCTION.

 

When the proposed rule published at Federal Register, volume 88, page 25313, becomes effective, the revisor of statutes must change:  (1) the reference in Minnesota Statutes, section 256B.06, subdivision 4, paragraph (d), from Code of Federal Regulations, title 8, section 103.12, to Code of Federal Regulations, title 42, section 435.4; and (2) the reference in Minnesota Statutes, section 256L.04, subdivision 10, paragraph (a), from Code of Federal Regulations, title 8, section 103.12, to Code of Federal Regulations, title 45, section 155.20.  The commissioner of human services shall notify the revisor of statutes when the proposed rule published at Federal Register, volume 88, page 25313, becomes effective.

 

ARTICLE 2

DEPARTMENT OF HUMAN SERVICES HEALTH CARE POLICY

 

Section 1.  Minnesota Statutes 2023 Supplement, section 256.0471, subdivision 1, as amended by Laws 2024, chapter 80, article 1, section 76, is amended to read:

 

Subdivision 1.  Qualifying overpayment.  Any overpayment for state-funded medical assistance under chapter 256B and state-funded MinnesotaCare under chapter 256L granted pursuant to section 256.045, subdivision 10; chapter 256B for state-funded medical assistance; and for assistance granted under chapters 256D, 256I, and 256K, and 256L for state-funded MinnesotaCare except agency error claims, become a judgment by operation of law 90 days after the notice of overpayment is personally served upon the recipient in a manner that is sufficient under rule 4.03(a) of the Rules of Civil Procedure for district courts, or by certified mail, return receipt requested.  This judgment shall be entitled to full faith and credit in this and any other state.

 

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

 

Sec. 2.  Minnesota Statutes 2022, section 256.9657, subdivision 8, is amended to read:

 

Subd. 8.  Commissioner's duties.  (a) Beginning October 1, 2023, the commissioner of human services shall annually report to the chairs and ranking minority members of the legislative committees with jurisdiction over health care policy and finance regarding the provider surcharge program.  The report shall include information on total billings, total collections, and administrative expenditures for the previous fiscal year.  This paragraph expires January 1, 2032.

 

(b) (a) The surcharge shall be adjusted by inflationary and caseload changes in future bienniums to maintain reimbursement of health care providers in accordance with the requirements of the state and federal laws governing the medical assistance program, including the requirements of the Medicaid moratorium amendments of 1991 found in Public Law No. 102-234.

 

(c) (b) The commissioner shall request the Minnesota congressional delegation to support a change in federal law that would prohibit federal disallowances for any state that makes a good faith effort to comply with Public Law 102-234 by enacting conforming legislation prior to the issuance of federal implementing regulations.


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15809

Sec. 3.  Minnesota Statutes 2022, section 256B.056, subdivision 1a, is amended to read:

 

Subd. 1a.  Income and assets generally.  (a)(1) Unless specifically required by state law or rule or federal law or regulation, the methodologies used in counting income and assets to determine eligibility for medical assistance for persons whose eligibility category is based on blindness, disability, or age of 65 or more years, the methodologies for the Supplemental Security Income program shall be used, except as provided under in clause (2) and subdivision 3, paragraph (a), clause (6).

 

(2) State tax credits, rebates, and refunds must not be counted as income.  State tax credits, rebates, and refunds must not be counted as assets for a period of 12 months after the month of receipt.

 

(2) (3) Increases in benefits under title II of the Social Security Act shall not be counted as income for purposes of this subdivision until July 1 of each year.  Effective upon federal approval, for children eligible under section 256B.055, subdivision 12, or for home and community-based waiver services whose eligibility for medical assistance is determined without regard to parental income, child support payments, including any payments made by an obligor in satisfaction of or in addition to a temporary or permanent order for child support, and Social Security payments are not counted as income.

 

(b)(1) The modified adjusted gross income methodology as defined in United States Code, title 42, section 1396a(e)(14), shall be used for eligibility categories based on:

 

(i) children under age 19 and their parents and relative caretakers as defined in section 256B.055, subdivision 3a;

 

(ii) children ages 19 to 20 as defined in section 256B.055, subdivision 16;

 

(iii) pregnant women as defined in section 256B.055, subdivision 6;

 

(iv) infants as defined in sections 256B.055, subdivision 10, and 256B.057, subdivision 1; and

 

(v) adults without children as defined in section 256B.055, subdivision 15.

 

For these purposes, a "methodology" does not include an asset or income standard, or accounting method, or method of determining effective dates.

 

(2) For individuals whose income eligibility is determined using the modified adjusted gross income methodology in clause (1):

 

(i) the commissioner shall subtract from the individual's modified adjusted gross income an amount equivalent to five percent of the federal poverty guidelines; and

 

(ii) the individual's current monthly income and household size is used to determine eligibility for the 12-month eligibility period.  If an individual's income is expected to vary month to month, eligibility is determined based on the income predicted for the 12-month eligibility period.

 

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

 

Sec. 4.  Minnesota Statutes 2022, section 256B.056, subdivision 10, is amended to read:

 

Subd. 10.  Eligibility verification.  (a) The commissioner shall require women who are applying for the continuation of medical assistance coverage following the end of the 12-month postpartum period to update their income and asset information and to submit any required income or asset verification.


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15810

(b) The commissioner shall determine the eligibility of private-sector health care coverage for infants less than one year of age eligible under section 256B.055, subdivision 10, or 256B.057, subdivision 1, paragraph (c), and shall pay for private-sector coverage if this is determined to be cost-effective.

 

(c) The commissioner shall verify assets and income for all applicants, and for all recipients upon renewal.

 

(d) The commissioner shall utilize information obtained through the electronic service established by the secretary of the United States Department of Health and Human Services and other available electronic data sources in Code of Federal Regulations, title 42, sections 435.940 to 435.956, to verify eligibility requirements.  The commissioner shall establish standards to define when information obtained electronically is reasonably compatible with information provided by applicants and enrollees, including use of self-attestation, to accomplish real-time eligibility determinations and maintain program integrity.

 

(e) Each person applying for or receiving medical assistance under section 256B.055, subdivision 7, and any other person whose resources are required by law to be disclosed to determine the applicant's or recipient's eligibility must authorize the commissioner to obtain information from financial institutions to identify unreported accounts verify assets as required in section 256.01, subdivision 18f.  If a person refuses or revokes the authorization, the commissioner may determine that the applicant or recipient is ineligible for medical assistance.  For purposes of this paragraph, an authorization to identify unreported accounts verify assets meets the requirements of the Right to Financial Privacy Act, United States Code, title 12, chapter 35, and need not be furnished to the financial institution.

 

(f) County and tribal agencies shall comply with the standards established by the commissioner for appropriate use of the asset verification system specified in section 256.01, subdivision 18f.

 

Sec. 5.  Minnesota Statutes 2023 Supplement, section 256B.0701, subdivision 6, is amended to read:

 

Subd. 6.  Recuperative care facility rate.  (a) The recuperative care facility rate is for facility costs and must be paid from state money in an amount equal to the medical assistance room and board MSA equivalent rate as defined in section 256I.03, subdivision 11a, at the time the recuperative care services were provided.  The eligibility standards in chapter 256I do not apply to the recuperative care facility rate.  The recuperative care facility rate is only paid when the recuperative care services rate is paid to a provider.  Providers may opt to only receive the recuperative care services rate.

 

(b) Before a recipient is discharged from a recuperative care setting, the provider must ensure that the recipient's medical condition is stabilized or that the recipient is being discharged to a setting that is able to meet that recipient's needs.

 

Sec. 6.  Minnesota Statutes 2022, section 256B.0757, subdivision 4a, is amended to read:

 

Subd. 4a.  Behavioral health home services provider requirements.  A behavioral health home services provider must:

 

(1) be an enrolled Minnesota Health Care Programs provider;

 

(2) provide a medical assistance covered primary care or behavioral health service;

 

(3) utilize an electronic health record;

 

(4) utilize an electronic patient registry that contains data elements required by the commissioner;


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15811

(5) demonstrate the organization's capacity to administer screenings approved by the commissioner for substance use disorder or alcohol and tobacco use;

 

(6) demonstrate the organization's capacity to refer an individual to resources appropriate to the individual's screening results;

 

(7) have policies and procedures to track referrals to ensure that the referral met the individual's needs;

 

(8) conduct a brief needs assessment when an individual begins receiving behavioral health home services.  The brief needs assessment must be completed with input from the individual and the individual's identified supports.  The brief needs assessment must address the individual's immediate safety and transportation needs and potential barriers to participating in behavioral health home services;

 

(9) conduct a health wellness assessment within 60 days after intake that contains all required elements identified by the commissioner;

 

(10) conduct a health action plan that contains all required elements identified by the commissioner.  The plan must be completed within 90 days after intake and must be updated at least once every six months, or more frequently if significant changes to an individual's needs or goals occur;

 

(11) agree to cooperate with and participate in the state's monitoring and evaluation of behavioral health home services; and

 

(12) obtain the individual's written consent to begin receiving behavioral health home services using a form approved by the commissioner.

 

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

 

Sec. 7.  Minnesota Statutes 2022, section 256B.0757, subdivision 4d, is amended to read:

 

Subd. 4d.  Behavioral health home services delivery standards.  (a) A behavioral health home services provider must meet the following service delivery standards:

 

(1) establish and maintain processes to support the coordination of an individual's primary care, behavioral health, and dental care;

 

(2) maintain a team-based model of care, including regular coordination and communication between behavioral health home services team members;

 

(3) use evidence-based practices that recognize and are tailored to the medical, social, economic, behavioral health, functional impairment, cultural, and environmental factors affecting the individual's health and health care choices;

 

(4) use person-centered planning practices to ensure the individual's health action plan accurately reflects the individual's preferences, goals, resources, and optimal outcomes for the individual and the individual's identified supports;

 

(5) use the patient registry to identify individuals and population subgroups requiring specific levels or types of care and provide or refer the individual to needed treatment, intervention, or services;


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15812

(6) utilize the Department of Human Services Partner Portal to identify past and current treatment or services and identify potential gaps in care using a tool approved by the commissioner;

 

(7) deliver services consistent with the standards for frequency and face-to-face contact required by the commissioner;

 

(8) ensure that a diagnostic assessment is completed for each individual receiving behavioral health home services within six months of the start of behavioral health home services;

 

(9) deliver services in locations and settings that meet the needs of the individual;

 

(10) provide a central point of contact to ensure that individuals and the individual's identified supports can successfully navigate the array of services that impact the individual's health and well-being;

 

(11) have capacity to assess an individual's readiness for change and the individual's capacity to integrate new health care or community supports into the individual's life;

 

(12) offer or facilitate the provision of wellness and prevention education on evidenced-based curriculums specific to the prevention and management of common chronic conditions;

 

(13) help an individual set up and prepare for medical, behavioral health, social service, or community support appointments, including accompanying the individual to appointments as appropriate, and providing follow-up with the individual after these appointments;

 

(14) offer or facilitate the provision of health coaching related to chronic disease management and how to navigate complex systems of care to the individual, the individual's family, and identified supports;

 

(15) connect an individual, the individual's family, and identified supports to appropriate support services that help the individual overcome access or service barriers, increase self-sufficiency skills, and improve overall health;

 

(16) provide effective referrals and timely access to services; and

 

(17) establish a continuous quality improvement process for providing behavioral health home services.

 

(b) The behavioral health home services provider must also create a plan, in partnership with the individual and the individual's identified supports, to support the individual after discharge from a hospital, residential treatment program, or other setting.  The plan must include protocols for:

 

(1) maintaining contact between the behavioral health home services team member, the individual, and the individual's identified supports during and after discharge;

 

(2) linking the individual to new resources as needed;

 

(3) reestablishing the individual's existing services and community and social supports; and

 

(4) following up with appropriate entities to transfer or obtain the individual's service records as necessary for continued care.


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15813

(c) If the individual is enrolled in a managed care plan, a behavioral health home services provider must:

 

(1) notify the behavioral health home services contact designated by the managed care plan within 30 days of when the individual begins behavioral health home services; and

 

(2) adhere to the managed care plan communication and coordination requirements described in the behavioral health home services manual.

 

(d) Before terminating behavioral health home services, the behavioral health home services provider must:

 

(1) provide a 60-day notice of termination of behavioral health home services to all individuals receiving behavioral health home services, the commissioner, and managed care plans, if applicable; and

 

(2) refer individuals receiving behavioral health home services to a new behavioral health home services provider.

 

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

 

Sec. 8.  Minnesota Statutes 2023 Supplement, section 256B.764, is amended to read:

 

256B.764 REIMBURSEMENT FOR FAMILY PLANNING SERVICES.

 

(a) Effective for services rendered on or after July 1, 2007, payment rates for family planning services shall be increased by 25 percent over the rates in effect June 30, 2007, when these services are provided by a community clinic as defined in section 145.9268, subdivision 1.

 

(b) Effective for services rendered on or after July 1, 2013, payment rates for family planning services shall be increased by 20 percent over the rates in effect June 30, 2013, when these services are provided by a community clinic as defined in section 145.9268, subdivision 1.  The commissioner shall adjust capitation rates to managed care and county-based purchasing plans to reflect this increase, and shall require plans to pass on the full amount of the rate increase to eligible community clinics, in the form of higher payment rates for family planning services.

 

(c) Effective for services provided on or after January 1, 2024, payment rates for family planning, when such services are provided by an eligible community clinic as defined in section 145.9268, subdivision 1, and abortion services shall be increased by 20 percent.  This increase does not apply to federally qualified health centers, rural health centers, or Indian health services.

 

Sec. 9.  Minnesota Statutes 2023 Supplement, section 256L.03, subdivision 1, is amended to read:

 

Subdivision 1.  Covered health services.  (a) "Covered health services" means the health services reimbursed under chapter 256B, with the exception of special education services, home care nursing services, adult dental care services other than services covered under section 256B.0625, subdivision 9, orthodontic services, nonemergency medical transportation services, personal care assistance and case management services, community first services and supports under section 256B.85, behavioral health home services under section 256B.0757, housing stabilization services under section 256B.051, and nursing home or intermediate care facilities services.

 

(b) Covered health services shall be expanded as provided in this section.

 

(c) For the purposes of covered health services under this section, "child" means an individual younger than 19 years of age.


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15814

Sec. 10.  Minnesota Statutes 2022, section 524.3-801, as amended by Laws 2024, chapter 79, article 9, section 20, is amended to read:

 

524.3-801 NOTICE TO CREDITORS.  (a) Unless notice has already been given under this section, upon appointment of a general personal representative in informal proceedings or upon the filing of a petition for formal appointment of a general personal representative, notice thereof, in the form prescribed by court rule, shall be given under the direction of the court administrator by publication once a week for two successive weeks in a legal newspaper in the county wherein the proceedings are pending giving the name and address of the general personal representative and notifying creditors of the estate to present their claims within four months after the date of the court administrator's notice which is subsequently published or be forever barred, unless they are entitled to further service of notice under paragraph (b) or (c).

 

(b) The personal representative shall, within three months after the date of the first publication of the notice, serve a copy of the notice upon each then known and identified creditor in the manner provided in paragraph (c).  If the decedent or a predeceased spouse of the decedent received assistance for which a claim could be filed under section 246.53, 256B.15, 256D.16, or 261.04, notice to the commissioner of human services or direct care and treatment executive board, as applicable, must be given under paragraph (d) instead of under this paragraph or paragraph (c).  A creditor is "known" if:  (i) the personal representative knows that the creditor has asserted a claim that arose during the decedent's life against either the decedent or the decedent's estate; (ii) the creditor has asserted a claim that arose during the decedent's life and the fact is clearly disclosed in accessible financial records known and available to the personal representative; or (iii) the claim of the creditor would be revealed by a reasonably diligent search for creditors of the decedent in accessible financial records known and available to the personal representative.  Under this section, a creditor is "identified" if the personal representative's knowledge of the name and address of the creditor will permit service of notice to be made under paragraph (c).

 

(c) Unless the claim has already been presented to the personal representative or paid, the personal representative shall serve a copy of the notice required by paragraph (b) upon each creditor of the decedent who is then known to the personal representative and identified either by delivery of a copy of the required notice to the creditor, or by mailing a copy of the notice to the creditor by certified, registered, or ordinary first class mail addressed to the creditor at the creditor's office or place of residence.

 

(d)(1) Effective for decedents dying on or after July 1, 1997, if the decedent or a predeceased spouse of the decedent received assistance for which a claim could be filed under section 246.53, 256B.15, 256D.16, or 261.04, the personal representative or the attorney for the personal representative shall serve the commissioner or executive board, as applicable, with notice in the manner prescribed in paragraph (c), or electronically in a manner prescribed by the commissioner, as soon as practicable after the appointment of the personal representative.  The notice must state the decedent's full name, date of birth, and Social Security number and, to the extent then known after making a reasonably diligent inquiry, the full name, date of birth, and Social Security number for each of the decedent's predeceased spouses.  The notice may also contain a statement that, after making a reasonably diligent inquiry, the personal representative has determined that the decedent did not have any predeceased spouses or that the personal representative has been unable to determine one or more of the previous items of information for a predeceased spouse of the decedent.  A copy of the notice to creditors must be attached to and be a part of the notice to the commissioner or executive board.

 

(2) Notwithstanding a will or other instrument or law to the contrary, except as allowed in this paragraph, no property subject to administration by the estate may be distributed by the estate or the personal representative until 70 days after the date the notice is served on the commissioner or executive board as provided in paragraph (c), unless the local agency consents as provided for in clause (6).  This restriction on distribution does not apply to the personal representative's sale of real or personal property, but does apply to the net proceeds the estate receives from these sales.  The personal representative, or any person with personal knowledge of the facts, may provide an affidavit containing the description of any real or personal property affected by this paragraph and stating facts


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15815

showing compliance with this paragraph.  If the affidavit describes real property, it may be filed or recorded in the office of the county recorder or registrar of titles for the county where the real property is located.  This paragraph does not apply to proceedings under sections 524.3-1203 and 525.31, or when a duly authorized agent of a county is acting as the personal representative of the estate.

 

(3) At any time before an order or decree is entered under section 524.3-1001 or 524.3-1002, or a closing statement is filed under section 524.3-1003, the personal representative or the attorney for the personal representative may serve an amended notice on the commissioner or executive board to add variations or other names of the decedent or a predeceased spouse named in the notice, the name of a predeceased spouse omitted from the notice, to add or correct the date of birth or Social Security number of a decedent or predeceased spouse named in the notice, or to correct any other deficiency in a prior notice.  The amended notice must state the decedent's name, date of birth, and Social Security number, the case name, case number, and district court in which the estate is pending, and the date the notice being amended was served on the commissioner or executive board.  If the amendment adds the name of a predeceased spouse omitted from the notice, it must also state that spouse's full name, date of birth, and Social Security number.  The amended notice must be served on the commissioner or executive board in the same manner as the original notice.  Upon service, the amended notice relates back to and is effective from the date the notice it amends was served, and the time for filing claims arising under section 246.53, 256B.15, 256D.16 or 261.04 is extended by 60 days from the date of service of the amended notice.  Claims filed during the 60-day period are undischarged and unbarred claims, may be prosecuted by the entities entitled to file those claims in accordance with section 524.3-1004, and the limitations in section 524.3-1006 do not apply.  The personal representative or any person with personal knowledge of the facts may provide and file or record an affidavit in the same manner as provided for in clause (1).

 

(4) Within one year after the date an order or decree is entered under section 524.3-1001 or 524.3-1002 or a closing statement is filed under section 524.3-1003, any person who has an interest in property that was subject to administration by the estate may serve an amended notice on the commissioner or executive board to add variations or other names of the decedent or a predeceased spouse named in the notice, the name of a predeceased spouse omitted from the notice, to add or correct the date of birth or Social Security number of a decedent or predeceased spouse named in the notice, or to correct any other deficiency in a prior notice.  The amended notice must be served on the commissioner or executive board in the same manner as the original notice and must contain the information required for amendments under clause (3).  If the amendment adds the name of a predeceased spouse omitted from the notice, it must also state that spouse's full name, date of birth, and Social Security number.  Upon service, the amended notice relates back to and is effective from the date the notice it amends was served.  If the amended notice adds the name of an omitted predeceased spouse or adds or corrects the Social Security number or date of birth of the decedent or a predeceased spouse already named in the notice, then, notwithstanding any other laws to the contrary, claims against the decedent's estate on account of those persons resulting from the amendment and arising under section 246.53, 256B.15, 256D.16, or 261.04 are undischarged and unbarred claims, may be prosecuted by the entities entitled to file those claims in accordance with section 524.3-1004, and the limitations in section 524.3-1006 do not apply.  The person filing the amendment or any other person with personal knowledge of the facts may provide and file or record an affidavit describing affected real or personal property in the same manner as clause (1).

 

(5) After one year from the date an order or decree is entered under section 524.3-1001 or 524.3-1002, or a closing statement is filed under section 524.3-1003, no error, omission, or defect of any kind in the notice to the commissioner or executive board required under this paragraph or in the process of service of the notice on the commissioner or executive board, or the failure to serve the commissioner or executive board with notice as required by this paragraph, makes any distribution of property by a personal representative void or voidable.  The distributee's title to the distributed property shall be free of any claims based upon a failure to comply with this paragraph.


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15816

(6) The local agency may consent to a personal representative's request to distribute property subject to administration by the estate to distributees during the 70-day period after service of notice on the commissioner or executive board.  The local agency may grant or deny the request in whole or in part and may attach conditions to its consent as it deems appropriate.  When the local agency consents to a distribution, it shall give the estate a written certificate evidencing its consent to the early distribution of assets at no cost.  The certificate must include the name, case number, and district court in which the estate is pending, the name of the local agency, describe the specific real or personal property to which the consent applies, state that the local agency consents to the distribution of the specific property described in the consent during the 70-day period following service of the notice on the commissioner or executive board, state that the consent is unconditional or list all of the terms and conditions of the consent, be dated, and may include other contents as may be appropriate.  The certificate must be signed by the director of the local agency or the director's designees and is effective as of the date it is dated unless it provides otherwise.  The signature of the director or the director's designee does not require any acknowledgment.  The certificate shall be prima facie evidence of the facts it states, may be attached to or combined with a deed or any other instrument of conveyance and, when so attached or combined, shall constitute a single instrument.  If the certificate describes real property, it shall be accepted for recording or filing by the county recorder or registrar of titles in the county in which the property is located.  If the certificate describes real property and is not attached to or combined with a deed or other instrument of conveyance, it shall be accepted for recording or filing by the county recorder or registrar of titles in the county in which the property is located.  The certificate constitutes a waiver of the 70-day period provided for in clause (2) with respect to the property it describes and is prima facie evidence of service of notice on the commissioner or executive board.  The certificate is not a waiver or relinquishment of any claims arising under section 246.53, 256B.15, 256D.16, or 261.04, and does not otherwise constitute a waiver of any of the personal representative's duties under this paragraph.  Distributees who receive property pursuant to a consent to an early distribution shall remain liable to creditors of the estate as provided for by law.

 

(7) All affidavits provided for under this paragraph:

 

(i) shall be provided by persons who have personal knowledge of the facts stated in the affidavit;

 

(ii) may be filed or recorded in the office of the county recorder or registrar of titles in the county in which the real property they describe is located for the purpose of establishing compliance with the requirements of this paragraph; and

 

(iii) are prima facie evidence of the facts stated in the affidavit.

 

(8) This paragraph applies to the estates of decedents dying on or after July 1, 1997.  Clause (5) also applies with respect to all notices served on the commissioner of human services before July 1, 1997, under Laws 1996, chapter 451, article 2, section 55.  All notices served on the commissioner before July 1, 1997, pursuant to Laws 1996, chapter 451, article 2, section 55, shall be deemed to be legally sufficient for the purposes for which they were intended, notwithstanding any errors, omissions or other defects.

 

ARTICLE 3

HEALTH CARE

 

Section 1.  [62J.805] DEFINITIONS.

 

Subdivision 1.  Application.  For purposes of sections 62J.805 to 62J.808, the following terms have the meanings given.

 

Subd. 2.  Billing error.  "Billing error" means an error in a bill from a health care provider to a patient for health treatment or services that affects the amount owed by the patient according to that bill.  Billing error includes but is not limited to miscoding of a health treatment or service, an error in whether a health treatment or service is covered under the patient's health plan, or an error in determining the cost-sharing owed by the patient.


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15817

Subd. 3.  Group practice.  "Group practice" has the meaning given to health care provider group practice in section 145D.01, subdivision 1.

 

Subd. 4.  Health care provider.  "Health care provider" means:

 

(1) a health professional who is licensed or registered by the state to provide health treatment and services within the professional's scope of practice and in accordance with state law;

 

(2) a group practice; or

 

(3) a hospital.

 

Subd. 5.  Health plan.  "Health plan" has the meaning given in section 62A.011, subdivision 3.

 

Subd. 6.  Hospital.  "Hospital" means a health care facility licensed as a hospital under sections 144.50 to 144.56.

 

Subd. 7.  Medically necessary.  "Medically necessary" means:

 

(1) safe and effective;

 

(2) not experimental or investigational, except as provided in Code of Federal Regulations, title 42, section 411.15(o);

 

(3) furnished in accordance with acceptable medical standards of medical practice for the diagnosis or treatment of the patient's condition or to improve the function of a malformed body member;

 

(4) furnished in a setting appropriate to the patient's medical need and condition;

 

(5) ordered and furnished by qualified personnel;

 

(6) meets, but does not exceed, the patient's medical need; and

 

(7) is at least as beneficial as an existing and available medically appropriate alternative.

 

Subd. 8.  Payment.  "Payment" includes co-payments and coinsurance and deductible payments made by a patient.

 

Sec. 2.  [62J.806] POLICY FOR COLLECTION OF MEDICAL DEBT.

 

Subdivision 1.  Requirement.  Each health care provider must make available to the public the health care provider's policy for the collection of medical debt from patients.  This policy must be made available by:

 

(1) clearly posting it on the health care provider's website or, for health professionals, on the website of the health clinic, group practice, or hospital at which the health professional is employed or under contract; and

 

(2) providing a copy of the policy to any individual who requests it.


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15818

Subd. 2.  Content.  A policy made available under this section must at least specify the procedures followed by the health care provider for:

 

(1) communicating with patients about the medical debt owed and collecting medical debt;

 

(2) referring medical debt to a collection agency or law firm for collection; and

 

(3) identifying medical debt as uncollectible or satisfied, and ending collection activities.

 

Sec. 3.  [62J.807] DENIAL OF HEALTH TREATMENT OR SERVICES DUE TO OUTSTANDING MEDICAL DEBT.

 

(a) A health care provider must not deny medically necessary health treatment or services to a patient or any member of the patient's family or household because of current or previous outstanding medical debt owed by the patient or any member of the patient's family or household to the health care provider, regardless of whether the health treatment or service may be available from another health care provider.

 

(b) As a condition of providing medically necessary health treatment or services in the circumstances described in paragraph (a), a health care provider may require the patient to enroll in a payment plan for the outstanding medical debt owed to the health care provider.  The payment plan must be reasonable and must take into account any information disclosed by the patient regarding the patient's ability to pay.  Before entering into the payment plan, a health care provider must notify the patient that if the patient is unable to make all or part of the agreed-upon installment payments, the patient must communicate the patient's situation to the health care provider and must pay an amount the patient can afford.

 

Sec. 4.  [62J.808] BILLING ERRORS; HEALTH TREATMENT OR SERVICES.

 

Subdivision 1.  Billing and acceptance of payment.  (a) If a health care provider or health plan company determines or receives notice from a patient or other person that a bill from the health care provider to a patient for health treatment or services may contain one or more billing errors, the health care provider or health plan company must review the bill and correct any billing errors found.  While the review is being conducted, the health care provider must not bill the patient for any health treatment or service subject to review for potential billing errors.  A health care provider may bill the patient for the health treatment and services that were reviewed for potential billing errors under this subdivision only after the review is complete, any billing errors are corrected, and a notice of completed review required under subdivision 3 is transmitted to the patient.

 

(b) If, after completing the review under paragraph (a) and correcting any billing errors, a health care provider or health plan company determines the patient overpaid the health care provider under that bill, the health care provider must refund to the patient, within 30 days after completing the review, the amount the patient overpaid under that bill.

 

Subd. 2.  Notice to patient of potential billing error.  (a) If a health care provider or health plan company determines or receives notice from a patient or other person that a bill from the health care provider to a patient for health treatment or services may contain one or more billing errors, the health care provider or health plan company must notify the patient:

 

(1) of the potential billing error;

 

(2) that the health care provider or health plan company will review the bill and correct any billing errors found; and


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15819

(3) that while the review is being conducted, the health care provider will not bill the patient for any health treatment or service subject to review for potential billing errors.

 

(b) The notice required under this subdivision must be transmitted to the patient within 30 days after the health care provider or health plan company determines or receives notice that the patient's bill may contain one or more billing errors.

 

Subd. 3.  Notice to patient of completed review.  When a health care provider or health plan company completes a review of a bill for potential billing errors, the health care provider or health plan company must notify the patient that the review is complete, explain in detail how any identified billing errors were corrected or explain in detail why the health care provider or health plan company did not modify the bill as requested by the patient or other person, and include applicable coding guidelines, references to health records, and other relevant information.  This notice must be transmitted to the patient within 30 days after the health care provider or health plan company completes the review.

 

Sec. 5.  Minnesota Statutes 2023 Supplement, section 144.587, subdivision 1, is amended to read:

 

Subdivision 1.  Definitions.  (a) The terms defined in this subdivision apply to this section and sections 144.588 to 144.589.

 

(b) "Charity care" means the provision of free or discounted care to a patient according to a hospital's financial assistance policies.

 

(c) "Hospital" means a private, nonprofit, or municipal hospital licensed under sections 144.50 to 144.56.

 

(d) "Insurance affordability program" has the meaning given in section 256B.02, subdivision 19.

 

(e) "Navigator" has the meaning given in section 62V.02, subdivision 9.

 

(f) "Presumptive eligibility" has the meaning given in section 256B.057, subdivision 12.

 

(g) "Revenue recapture" means the use of the procedures in chapter 270A to collect debt.

 

(h) (g) "Uninsured service or treatment" means any service or treatment that is not covered by:

 

(1) a health plan, contract, or policy that provides health coverage to a patient; or

 

(2) any other type of insurance coverage, including but not limited to no-fault automobile coverage, workers' compensation coverage, or liability coverage.

 

(i) (h) "Unreasonable burden" includes requiring a patient to apply for enrollment in a state or federal program for which the patient is obviously or categorically ineligible or has been found to be ineligible in the previous 12 months.

 

Sec. 6.  Minnesota Statutes 2023 Supplement, section 144.587, subdivision 4, is amended to read:

 

Subd. 4.  Prohibited actions.  (a) A hospital must not initiate one or more of the following actions until the hospital determines that the patient is ineligible for charity care or denies an application for charity care:

 

(1) offering to enroll or enrolling the patient in a payment plan;


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15820

(2) changing the terms of a patient's payment plan;

 

(3) offering the patient a loan or line of credit, application materials for a loan or line of credit, or assistance with applying for a loan or line of credit, for the payment of medical debt;

 

(4) referring a patient's debt for collections, including in-house collections, third-party collections, revenue recapture, or any other process for the collection of debt; or

 

(5) denying health care services to the patient or any member of the patient's household because of outstanding medical debt, regardless of whether the services are deemed necessary or may be available from another provider; or

 

(6) (5) accepting a credit card payment of over $500 for the medical debt owed to the hospital.

 

(b) A violation of section 62J.807 is a violation of this subdivision.

 

Sec. 7.  Minnesota Statutes 2023 Supplement, section 151.555, subdivision 1, is amended to read:

 

Subdivision 1.  Definitions.  (a) For the purposes of this section, the terms defined in this subdivision have the meanings given.

 

(b) "Central repository" means a wholesale distributor that meets the requirements under subdivision 3 and enters into a contract with the Board of Pharmacy in accordance with this section.

 

(c) "Distribute" means to deliver, other than by administering or dispensing.

 

(d) "Donor" means:

 

(1) a health care facility as defined in this subdivision an individual at least 18 years of age, provided that the drug or medical supply that is donated was obtained legally and meets the requirements of this section for donation; or

 

(2) a skilled nursing facility licensed under chapter 144A; any entity legally authorized to possess medicine with a license or permit in good standing in the state in which it is located, without further restrictions, including but not limited to a health care facility, skilled nursing facility, assisted living facility, pharmacy, wholesaler, and drug manufacturer.

 

(3) an assisted living facility licensed under chapter 144G;

 

(4) a pharmacy licensed under section 151.19, and located either in the state or outside the state;

 

(5) a drug wholesaler licensed under section 151.47;

 

(6) a drug manufacturer licensed under section 151.252; or

 

(7) an individual at least 18 years of age, provided that the drug or medical supply that is donated was obtained legally and meets the requirements of this section for donation.

 

(e) "Drug" means any prescription drug that has been approved for medical use in the United States, is listed in the United States Pharmacopoeia or National Formulary, and meets the criteria established under this section for donation; or any over-the-counter medication that meets the criteria established under this section for donation.  This


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15821

definition includes cancer drugs and antirejection drugs, but does not include controlled substances, as defined in section 152.01, subdivision 4, or a prescription drug that can only be dispensed to a patient registered with the drug's manufacturer in accordance with federal Food and Drug Administration requirements.

 

(f) "Health care facility" means:

 

(1) a physician's office or health care clinic where licensed practitioners provide health care to patients;

 

(2) a hospital licensed under section 144.50;

 

(3) a pharmacy licensed under section 151.19 and located in Minnesota; or

 

(4) a nonprofit community clinic, including a federally qualified health center; a rural health clinic; public health clinic; or other community clinic that provides health care utilizing a sliding fee scale to patients who are low‑income, uninsured, or underinsured.

 

(g) "Local repository" means a health care facility that elects to accept donated drugs and medical supplies and meets the requirements of subdivision 4.

 

(h) "Medical supplies" or "supplies" means any prescription or nonprescription medical supplies needed to administer a drug.

 

(i) "Original, sealed, unopened, tamper-evident packaging" means packaging that is sealed, unopened, and tamper-evident, including a manufacturer's original unit dose or unit-of-use container, a repackager's original unit dose or unit-of-use container, or unit-dose packaging prepared by a licensed pharmacy according to the standards of Minnesota Rules, part 6800.3750.

 

(j) "Practitioner" has the meaning given in section 151.01, subdivision 23, except that it does not include a veterinarian.

 

Sec. 8.  Minnesota Statutes 2023 Supplement, section 151.555, subdivision 4, is amended to read:

 

Subd. 4.  Local repository requirements.  (a) To be eligible for participation in the medication repository program, a health care facility must agree to comply with all applicable federal and state laws, rules, and regulations pertaining to the medication repository program, drug storage, and dispensing.  The facility must also agree to maintain in good standing any required state license or registration that may apply to the facility.

 

(b) A local repository may elect to participate in the program by submitting the following information to the central repository on a form developed by the board and made available on the board's website:

 

(1) the name, street address, and telephone number of the health care facility and any state-issued license or registration number issued to the facility, including the issuing state agency;

 

(2) the name and telephone number of a responsible pharmacist or practitioner who is employed by or under contract with the health care facility; and

 

(3) a statement signed and dated by the responsible pharmacist or practitioner indicating that the health care facility meets the eligibility requirements under this section and agrees to comply with this section.

 

(c) Participation in the medication repository program is voluntary.  A local repository may withdraw from participation in the medication repository program at any time by providing written notice to the central repository on a form developed by the board and made available on the board's website.  The central repository shall provide the board with a copy of the withdrawal notice within ten business days from the date of receipt of the withdrawal notice.


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15822

Sec. 9.  Minnesota Statutes 2023 Supplement, section 151.555, subdivision 5, is amended to read:

 

Subd. 5.  Individual eligibility and application requirements.  (a) To be eligible for the medication repository program At the time of or before receiving donated drugs or supplies as a new eligible patient, an individual must submit to a local repository an electronic or physical intake application form that is signed by the individual and attests that the individual:

 

(1) is a resident of Minnesota;

 

(2) is uninsured and is not enrolled in the medical assistance program under chapter 256B or the MinnesotaCare program under chapter 256L, has no prescription drug coverage, or is underinsured;

 

(3) acknowledges that the drugs or medical supplies to be received through the program may have been donated; and

 

(4) consents to a waiver of the child-resistant packaging requirements of the federal Poison Prevention Packaging Act.

 

(b) Upon determining that an individual is eligible for the program, the local repository shall furnish the individual with an identification card.  The card shall be valid for one year from the date of issuance and may be used at any local repository.  A new identification card may be issued upon expiration once the individual submits a new application form.

 

(c) (b) The local repository shall send a copy of the intake application form to the central repository by regular mail, facsimile, or secured email within ten days from the date the application is approved by the local repository.

 

(d) (c) The board shall develop and make available on the board's website an application form and the format for the identification card.

 

Sec. 10.  Minnesota Statutes 2023 Supplement, section 151.555, subdivision 6, is amended to read:

 

Subd. 6.  Standards and procedures for accepting donations of drugs and supplies.  (a) Notwithstanding any other law or rule, a donor may donate drugs or medical supplies to the central repository or a local repository if the drug or supply meets the requirements of this section as determined by a pharmacist or practitioner who is employed by or under contract with the central repository or a local repository.

 

(b) A drug is eligible for donation under the medication repository program if the following requirements are met:

 

(1) the donation is accompanied by a medication repository donor form described under paragraph (d) that is signed by an individual who is authorized by the donor to attest to the donor's knowledge in accordance with paragraph (d);

 

(2) (1) the drug's expiration date is at least six months after the date the drug was donated.  If a donated drug bears an expiration date that is less than six months from the donation date, the drug may be accepted and distributed if the drug is in high demand and can be dispensed for use by a patient before the drug's expiration date;

 

(3) (2) the drug is in its original, sealed, unopened, tamper-evident packaging that includes the expiration date.  Single-unit-dose drugs may be accepted if the single-unit-dose packaging is unopened;

 

(4) (3) the drug or the packaging does not have any physical signs of tampering, misbranding, deterioration, compromised integrity, or adulteration;


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15823

(5) (4) the drug does not require storage temperatures other than normal room temperature as specified by the manufacturer or United States Pharmacopoeia, unless the drug is being donated directly by its manufacturer, a wholesale drug distributor, or a pharmacy located in Minnesota; and

 

(6) (5) the drug is not a controlled substance.

 

(c) A medical supply is eligible for donation under the medication repository program if the following requirements are met:

 

(1) the supply has no physical signs of tampering, misbranding, or alteration and there is no reason to believe it has been adulterated, tampered with, or misbranded;

 

(2) the supply is in its original, unopened, sealed packaging; and

 

(3) the donation is accompanied by a medication repository donor form described under paragraph (d) that is signed by an individual who is authorized by the donor to attest to the donor's knowledge in accordance with paragraph (d); and

 

(4) (3) if the supply bears an expiration date, the date is at least six months later than the date the supply was donated.  If the donated supply bears an expiration date that is less than six months from the date the supply was donated, the supply may be accepted and distributed if the supply is in high demand and can be dispensed for use by a patient before the supply's expiration date.

 

(d) The board shall develop the medication repository donor form and make it available on the board's website.  The form must state that to the best of the donor's knowledge the donated drug or supply has been properly stored under appropriate temperature and humidity conditions and that the drug or supply has never been opened, used, tampered with, adulterated, or misbranded.  Prior to the first donation from a new donor, a central repository or local repository shall verify and record the following information on the donor form:

 

(1) the donor's name, address, phone number, and license number, if applicable;

 

(2) that the donor will only make donations in accordance with the program;

 

(3) to the best of the donor's knowledge, only drugs or supplies that have been properly stored under appropriate temperature and humidity conditions will be donated; and

 

(4) to the best of the donor's knowledge, only drugs or supplies that have never been opened, used, tampered with, adulterated, or misbranded will be donated.

 

(e) Notwithstanding any other law or rule, a central repository or a local repository may receive donated drugs from donors.  Donated drugs and supplies may be shipped or delivered to the premises of the central repository or a local repository, and shall be inspected by a pharmacist or an authorized practitioner who is employed by or under contract with the repository and who has been designated by the repository to accept donations prior to dispensing.  A drop box must not be used to deliver or accept donations.

 

(f) The central repository and local repository shall maintain a written or electronic inventory of all drugs and supplies donated to the repository upon acceptance of each drug or supply.  For each drug, the inventory must include the drug's name, strength, quantity, manufacturer, expiration date, and the date the drug was donated.  For each medical supply, the inventory must include a description of the supply, its manufacturer, the date the supply was donated, and, if applicable, the supply's brand name and expiration date.  The board may waive the requirement under this paragraph if an entity is under common ownership or control with a central repository or local repository and either the entity or the repository maintains an inventory containing all the information required under this paragraph.


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15824

Sec. 11.  Minnesota Statutes 2023 Supplement, section 151.555, subdivision 7, is amended to read:

 

Subd. 7.  Standards and procedures for inspecting and storing donated drugs and supplies.  (a) A pharmacist or authorized practitioner who is employed by or under contract with the central repository or a local repository shall inspect all donated drugs and supplies before the drug or supply is dispensed to determine, to the extent reasonably possible in the professional judgment of the pharmacist or practitioner, that the drug or supply is not adulterated or misbranded, has not been tampered with, is safe and suitable for dispensing, has not been subject to a recall, and meets the requirements for donation.  The pharmacist or practitioner who inspects the drugs or supplies shall sign an inspection record stating that the requirements for donation have been met.  If a local repository receives drugs and supplies from the central repository, the local repository does not need to reinspect the drugs and supplies.

 

(b) The central repository and local repositories shall store donated drugs and supplies in a secure storage area under environmental conditions appropriate for the drug or supply being stored.  Donated drugs and supplies may not be stored with nondonated inventory.

 

(c) The central repository and local repositories shall dispose of all drugs and medical supplies that are not suitable for donation in compliance with applicable federal and state statutes, regulations, and rules concerning hazardous waste.

 

(d) In the event that controlled substances or drugs that can only be dispensed to a patient registered with the drug's manufacturer are shipped or delivered to a central or local repository for donation, the shipment delivery must be documented by the repository and returned immediately to the donor or the donor's representative that provided the drugs.

 

(e) Each repository must develop drug and medical supply recall policies and procedures.  If a repository receives a recall notification, the repository shall destroy all of the drug or medical supply in its inventory that is the subject of the recall and complete a record of destruction form in accordance with paragraph (f).  If a drug or medical supply that is the subject of a Class I or Class II recall has been dispensed, the repository shall immediately notify the recipient of the recalled drug or medical supply.  A drug that potentially is subject to a recall need not be destroyed if its packaging bears a lot number and that lot of the drug is not subject to the recall.  If no lot number is on the drug's packaging, it must be destroyed.

 

(f) A record of destruction of donated drugs and supplies that are not dispensed under subdivision 8, are subject to a recall under paragraph (e), or are not suitable for donation shall be maintained by the repository for at least two years.  For each drug or supply destroyed, the record shall include the following information:

 

(1) the date of destruction;

 

(2) the name, strength, and quantity of the drug destroyed; and

 

(3) the name of the person or firm that destroyed the drug.

 

No other record of destruction is required. 

 

Sec. 12.  Minnesota Statutes 2023 Supplement, section 151.555, subdivision 8, is amended to read:

 

Subd. 8.  Dispensing requirements.  (a) Donated prescription drugs and supplies may be dispensed if the drugs or supplies are prescribed by a practitioner for use by an eligible individual and are dispensed by a pharmacist or practitioner.  A repository shall dispense drugs and supplies to eligible individuals in the following priority order:  (1) individuals who are uninsured; (2) individuals with no prescription drug coverage; and (3) individuals who are


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15825

underinsured.  A repository shall dispense donated drugs in compliance with applicable federal and state laws and regulations for dispensing drugs, including all requirements relating to packaging, labeling, record keeping, drug utilization review, and patient counseling.

 

(b) Before dispensing or administering a drug or supply, the pharmacist or practitioner shall visually inspect the drug or supply for adulteration, misbranding, tampering, and date of expiration.  Drugs or supplies that have expired or appear upon visual inspection to be adulterated, misbranded, or tampered with in any way must not be dispensed or administered.

 

(c) Before a the first drug or supply is dispensed or administered to an individual, the individual must sign a an electronic or physical drug repository recipient form acknowledging that the individual understands the information stated on the form.  The board shall develop the form and make it available on the board's website.  The form must include the following information:

 

(1) that the drug or supply being dispensed or administered has been donated and may have been previously dispensed;

 

(2) that a visual inspection has been conducted by the pharmacist or practitioner to ensure that the drug or supply has not expired, has not been adulterated or misbranded, and is in its original, unopened packaging; and

 

(3) that the dispensing pharmacist, the dispensing or administering practitioner, the central repository or local repository, the Board of Pharmacy, and any other participant of the medication repository program cannot guarantee the safety of the drug or medical supply being dispensed or administered and that the pharmacist or practitioner has determined that the drug or supply is safe to dispense or administer based on the accuracy of the donor's form submitted with the donated drug or medical supply and the visual inspection required to be performed by the pharmacist or practitioner before dispensing or administering.

 

Sec. 13.  Minnesota Statutes 2023 Supplement, section 151.555, subdivision 9, is amended to read:

 

Subd. 9.  Handling fees.  (a) The central or local repository may charge the individual receiving a drug or supply a handling fee of no more than 250 percent of the medical assistance program dispensing fee for each drug or medical supply dispensed or administered by that repository.

 

(b) A repository that dispenses or administers a drug or medical supply through the medication repository program shall not receive reimbursement under the medical assistance program or the MinnesotaCare program for that dispensed or administered drug or supply.

 

(c) A supply or handling fee must not be charged to an individual enrolled in the medical assistance or MinnesotaCare program.

 

Sec. 14.  Minnesota Statutes 2023 Supplement, section 151.555, subdivision 11, is amended to read:

 

Subd. 11.  Forms and record-keeping requirements.  (a) The following forms developed for the administration of this program shall be utilized by the participants of the program and shall be available on the board's website:

 

(1) intake application form described under subdivision 5;

 

(2) local repository participation form described under subdivision 4;

 

(3) local repository withdrawal form described under subdivision 4;


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15826

(4) medication repository donor form described under subdivision 6;

 

(5) record of destruction form described under subdivision 7; and

 

(6) medication repository recipient form described under subdivision 8.

 

Participants may use substantively similar electronic or physical forms.

 

(b) All records, including drug inventory, inspection, and disposal of donated drugs and medical supplies, must be maintained by a repository for a minimum of two years.  Records required as part of this program must be maintained pursuant to all applicable practice acts.

 

(c) Data collected by the medication repository program from all local repositories shall be submitted quarterly or upon request to the central repository.  Data collected may consist of the information, records, and forms required to be collected under this section.

 

(d) The central repository shall submit reports to the board as required by the contract or upon request of the board.

 

Sec. 15.  Minnesota Statutes 2023 Supplement, section 151.555, subdivision 12, is amended to read:

 

Subd. 12.  Liability.  (a) The manufacturer of a drug or supply is not subject to criminal or civil liability for injury, death, or loss to a person or to property for causes of action described in clauses (1) and (2).  A manufacturer is not liable for:

 

(1) the intentional or unintentional alteration of the drug or supply by a party not under the control of the manufacturer; or

 

(2) the failure of a party not under the control of the manufacturer to transfer or communicate product or consumer information or the expiration date of the donated drug or supply.

 

(b) A health care facility participating in the program, a pharmacist dispensing a drug or supply pursuant to the program, a practitioner dispensing or administering a drug or supply pursuant to the program, or a donor of a drug or medical supply, or a person or entity that facilitates any of the above is immune from civil liability for an act or omission that causes injury to or the death of an individual to whom the drug or supply is dispensed and no disciplinary action by a health-related licensing board shall be taken against a pharmacist or practitioner person or entity so long as the drug or supply is donated, accepted, distributed, and dispensed according to the requirements of this section.  This immunity does not apply if the act or omission involves reckless, wanton, or intentional misconduct, or malpractice unrelated to the quality of the drug or medical supply.

 

Sec. 16.  Minnesota Statutes 2023 Supplement, section 151.74, subdivision 3, is amended to read:

 

Subd. 3.  Access to urgent-need insulin.  (a) MNsure shall develop an application form to be used by an individual who is in urgent need of insulin.  The application must ask the individual to attest to the eligibility requirements described in subdivision 2.  The form shall be accessible through MNsure's website.  MNsure shall also make the form available to pharmacies and health care providers who prescribe or dispense insulin, hospital emergency departments, urgent care clinics, and community health clinics.  By submitting a completed, signed, and dated application to a pharmacy, the individual attests that the information contained in the application is correct.


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15827

(b) If the individual is in urgent need of insulin, the individual may present a completed, signed, and dated application form to a pharmacy.  The individual must also:

 

(1) have a valid insulin prescription; and

 

(2) present the pharmacist with identification indicating Minnesota residency in the form of a valid Minnesota identification card, driver's license or permit, individual taxpayer identification number, or Tribal identification card as defined in section 171.072, paragraph (b).  If the individual in urgent need of insulin is under the age of 18, the individual's parent or legal guardian must provide the pharmacist with proof of residency.

 

(c) Upon receipt of a completed and signed application, the pharmacist shall dispense the prescribed insulin in an amount that will provide the individual with a 30-day supply.  The pharmacy must notify the health care practitioner who issued the prescription order no later than 72 hours after the insulin is dispensed.

 

(d) The pharmacy may submit to the manufacturer of the dispensed insulin product or to the manufacturer's vendor a claim for payment that is in accordance with the National Council for Prescription Drug Program standards for electronic claims processing, unless the manufacturer agrees to send to the pharmacy a replacement supply of the same insulin as dispensed in the amount dispensed.  If the pharmacy submits an electronic claim to the manufacturer or the manufacturer's vendor, the manufacturer or vendor shall reimburse the pharmacy in an amount that covers the pharmacy's acquisition cost.

 

(e) The pharmacy may collect an insulin co-payment from the individual to cover the pharmacy's costs of processing and dispensing in an amount not to exceed $35 for the 30-day supply of insulin dispensed.

 

(f) The pharmacy shall also provide each eligible individual with the information sheet described in subdivision 7 and a list of trained navigators provided by the Board of Pharmacy for the individual to contact if the individual is in need of accessing needs to access ongoing insulin coverage options, including assistance in:

 

(1) applying for medical assistance or MinnesotaCare;

 

(2) applying for a qualified health plan offered through MNsure, subject to open and special enrollment periods;

 

(3) accessing information on providers who participate in prescription drug discount programs, including providers who are authorized to participate in the 340B program under section 340b of the federal Public Health Services Act, United States Code, title 42, section 256b; and

 

(4) accessing insulin manufacturers' patient assistance programs, co-payment assistance programs, and other foundation-based programs.

 

(g) The pharmacist shall retain a copy of the application form submitted by the individual to the pharmacy for reporting and auditing purposes.

 

(h) A manufacturer may submit to the commissioner of administration a request for reimbursement in an amount not to exceed $35 for each 30-day supply of insulin the manufacturer provides under paragraph (d).  The commissioner of administration shall determine the manner and format for submitting and processing requests for reimbursement.  After receiving a reimbursement request, the commissioner of administration shall reimburse the manufacturer in an amount not to exceed $35 for each 30-day supply of insulin the manufacturer provided under paragraph (d).

 

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


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15828

Sec. 17.  Minnesota Statutes 2022, section 151.74, subdivision 6, is amended to read:

 

Subd. 6.  Continuing safety net program; process.  (a) The individual shall submit to a pharmacy the statement of eligibility provided by the manufacturer under subdivision 5, paragraph (b).  Upon receipt of an individual's eligibility status, the pharmacy shall submit an order containing the name of the insulin product and the daily dosage amount as contained in a valid prescription to the product's manufacturer.

 

(b) The pharmacy must include with the order to the manufacturer the following information:

 

(1) the pharmacy's name and shipping address;

 

(2) the pharmacy's office telephone number, fax number, email address, and contact name; and

 

(3) any specific days or times when deliveries are not accepted by the pharmacy.

 

(c) Upon receipt of an order from a pharmacy and the information described in paragraph (b), the manufacturer shall send to the pharmacy a 90-day supply of insulin as ordered, unless a lesser amount is requested in the order, at no charge to the individual or pharmacy.

 

(d) Except as authorized under paragraph (e), the pharmacy shall provide the insulin to the individual at no charge to the individual.  The pharmacy shall not provide insulin received from the manufacturer to any individual other than the individual associated with the specific order.  The pharmacy shall not seek reimbursement for the insulin received from the manufacturer or from any third-party payer.

 

(e) The pharmacy may collect a co-payment from the individual to cover the pharmacy's costs for processing and dispensing in an amount not to exceed $50 for each 90-day supply if the insulin is sent to the pharmacy.

 

(f) The pharmacy may submit to a manufacturer a reorder for an individual if the individual's eligibility statement has not expired.  Upon receipt of a reorder from a pharmacy, the manufacturer must send to the pharmacy an additional 90-day supply of the product, unless a lesser amount is requested, at no charge to the individual or pharmacy if the individual's eligibility statement has not expired.

 

(g) Notwithstanding paragraph (c), a manufacturer may send the insulin as ordered directly to the individual if the manufacturer provides a mail order service option.

 

(h) A manufacturer may submit to the commissioner of administration a request for reimbursement in an amount not to exceed $105 for each 90-day supply of insulin the manufacturer provides under paragraphs (c) and (f).  The commissioner of administration shall determine the manner and format for submitting and processing requests for reimbursement.  After receiving a reimbursement request, the commissioner of administration shall reimburse the manufacturer in an amount not to exceed $105 for each 90-day supply of insulin the manufacturer provided under paragraphs (c) and (f).  If the manufacturer provides less than a 90-day supply of insulin under paragraphs (c) and (f), the manufacturer may submit a request for reimbursement not to exceed $35 for each 30-day supply of insulin provided.

 

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

 

Sec. 18.  [151.741] INSULIN MANUFACTURER REGISTRATION FEE.

 

Subdivision 1.  Definitions.  (a) For purposes of this section, the following terms have the meanings given.

 

(b) "Board" means the Minnesota Board of Pharmacy under section 151.02.


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15829

(c) "Manufacturer" means a manufacturer licensed under section 151.252 and engaged in the manufacturing of prescription insulin.

 

Subd. 2.  Assessment of registration fee.  (a) The board shall assess each manufacturer an annual registration fee of $100,000, except as provided in paragraph (b).  The board shall notify each manufacturer of this requirement beginning November 1, 2024, and each November 1 thereafter.

 

(b) A manufacturer may request an exemption from the annual registration fee.  The board shall exempt a manufacturer from the annual registration fee if the manufacturer can demonstrate to the board, in the form and manner specified by the board, that sales of prescription insulin produced by that manufacturer and sold or delivered within or into the state totaled $2,000,000 or less in the previous calendar year.

 

Subd. 3.  Payment of the registration fee; deposit of fee.  (a) Each manufacturer must pay the registration fee by March 1, 2025, and by each March 1 thereafter.  In the event of a change in ownership of the manufacturer, the new owner must pay the registration fee that the original owner would have been assessed had the original owner retained ownership.  The board may assess a late fee of ten percent per month or any portion of a month that the registration fee is paid after the due date.

 

(b) The registration fee, including any late fees, must be deposited in the insulin safety net program account.

 

Subd. 4.  Insulin safety net program account.  The insulin safety net program account is established in the special revenue fund in the state treasury.  Money in the account is appropriated each fiscal year to:

 

(1) the MNsure board in an amount sufficient to carry out assigned duties under section 151.74, subdivision 7; and

 

(2) the Board of Pharmacy in an amount sufficient to cover costs incurred by the board in assessing and collecting the registration fee under this section and in administering the insulin safety net program under section 151.74.

 

Subd. 5.  Insulin repayment account; annual transfer from health care access fund.  (a) The insulin repayment account is established in the special revenue fund in the state treasury.  Money in the account is appropriated each fiscal year to the commissioner of administration in an amount sufficient for the commissioner to reimburse manufacturers for insulin dispensed under the insulin safety net program in section 151.74, in accordance with section 151.74, subdivisions 3, paragraph (h), and 6, paragraph (h), and to cover costs incurred by the commissioner in providing these reimbursement payments.

 

(b) The commissioner of management and budget shall transfer from the health care access fund to the insulin repayment account, beginning July 1, 2025, and each July 1 thereafter, an amount sufficient for the commissioner of administration to implement paragraph (a).

 

Subd. 6.  Contingent transfer by commissioner.  If subdivisions 2 and 3, or the application of subdivisions 2 and 3 to any person or circumstance, are held invalid for any reason in a court of competent jurisdiction, the validity of subdivisions 2 and 3 does not affect other provisions of this act, and the commissioner of management and budget shall annually transfer from the health care access fund to the insulin safety net program account an amount sufficient to implement subdivision 4.

 

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


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15830

Sec. 19.  Minnesota Statutes 2023 Supplement, section 270A.03, subdivision 2, is amended to read:

 

Subd. 2.  Claimant agency.  "Claimant agency" means any state agency, as defined by section 14.02, subdivision 2, the regents of the University of Minnesota, any district court of the state, any county, any statutory or home rule charter city, including a city that is presenting a claim for a municipal hospital or a public library or a municipal ambulance service, a hospital district, any ambulance service licensed under chapter 144E, any public agency responsible for child support enforcement, any public agency responsible for the collection of court-ordered restitution, and any public agency established by general or special law that is responsible for the administration of a low-income housing program.

 

Sec. 20.  [332C.01] DEFINITIONS.

 

Subdivision 1.  Application.  For purposes of this chapter, the following terms have the meanings given.

 

Subd. 2.  Collecting party.  "Collecting party" means a party engaged in the collection of medical debt.  Collecting party does not include banks, credit unions, public officers, garnishees, and other parties complying with a court order or statutory obligation to garnish or levy a debtor's property.

 

Subd. 3.  Debtor.  "Debtor" means a person obligated or alleged to be obligated to pay any debt.

 

Subd. 4.  Medical debt.  (a) "Medical debt" means debt incurred primarily for medically necessary health treatment or services.  Medical debt includes debt charged to any credit card or other credit instrument under an open-end or closed-end credit plan:

 

(1) offered solely for the payment of health care; or

 

(2) advertised, promoted, or offered for the payment of health care at the facility in which the credit card or other credit instrument is advertised, promoted, or offered.

 

(b) Medical debt does not include:

 

(1) debt charged to a credit card that is not advertised, promoted, or offered expressly for the payment of health care and is intended, advertised, promoted, or offered to make credit purchases for personal, family, or household purposes;

 

(2) debt incurred for veterinary services;

 

(3) debt incurred for dental services; or

 

(4) debt charged to a home equity line of credit.

 

Subd. 5.  Medically necessary.  "Medically necessary" has the meaning given in section 62J.805, subdivision 7.

 

Subd. 6.  Person.  "Person" means any individual, partnership, association, or corporation.

 

Sec. 21.  [332C.02] PROHIBITED PRACTICES.

 

No collecting party shall:

 

(1) in a collection letter, publication, invoice, or any oral or written communication, threaten wage garnishment or legal suit by a particular lawyer, unless the collecting party has actually retained the lawyer to do so;


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15831

(2) use or employ sheriffs or any other officer authorized to serve legal papers in connection with the collection of a claim, except when performing their legally authorized duties;

 

(3) use or threaten to use methods of collection which violate Minnesota law;

 

(4) furnish legal advice to debtors or represent that the collecting party is competent or able to furnish legal advice to debtors;

 

(5) communicate with debtors in a misleading or deceptive manner by falsely using the stationery of a lawyer, forms or instruments which only lawyers are authorized to prepare, or instruments which simulate the form and appearance of judicial process;

 

(6) publish or cause to be published any list of debtors, use shame cards or shame automobiles, advertise or threaten to advertise for sale any claim as a means of forcing payment thereof, or use similar devices or methods of intimidation;

 

(7) operate under a name or in a manner which falsely implies the collecting party is a branch of or associated with any department of federal, state, county, or local government or an agency thereof;

 

(8) transact business or hold itself out as a debt settlement company, debt management company, debt adjuster, or any person who settles, adjusts, prorates, pools, liquidates, or pays the indebtedness of a debtor, unless there is no charge to the debtor, or the pooling or liquidation is done pursuant to court order or under the supervision of a creditor's committee;

 

(9) unless an exemption in the law exists, violate Code of Federal Regulations, title 12, part 1006, while attempting to collect on any account, bill, or other indebtedness.  For purposes of this section, Public Law 95-109 and Code of Federal Regulations, title 12, part 1006, apply to collecting parties other than health care providers collecting medical debt in their own name;

 

(10) communicate with a debtor about medical debt by use of an automatic telephone dialing system or an artificial or prerecorded voice after the debtor expressly informs the collecting party to cease communication utilizing an automatic telephone dialing system or an artificial or prerecorded voice.  For purposes of this clause, an automatic telephone dialing system or an artificial or prerecorded voice includes but is not limited to (i) artificial intelligence chat bots, and (ii) the usage of the term under the Telephone Consumer Protection Act, United States Code, title 47, section 227(b)(1)(A);

 

(11) in collection letters or publications, or in any oral or written communication, imply or suggest that medically necessary health treatment or services will be denied as a result of a medical debt;

 

(12) when a debtor has a listed telephone number, enlist the aid of a neighbor or third party to request that the debtor contact the collecting party, except a person who resides with the debtor or a third party with whom the debtor has authorized with the collecting party to place the request.  This clause does not apply to a call back message left at the debtor's place of employment which is limited solely to the collecting party's telephone number and name;

 

(13) when attempting to collect a medical debt, fail to provide the debtor with the full name of the collecting party, as registered with the secretary of state;

 

(14) fail to return any amount of overpayment from a debtor to the debtor or to the state of Minnesota pursuant to the requirements of chapter 345;


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15832

(15) accept currency or coin as payment for a medical debt without issuing an original receipt to the debtor and maintaining a duplicate receipt in the debtor's payment records;

 

(16) except for court costs for filing a civil action with the court and service of process, attempt to collect any interest, fee, charge, or expense incidental to the charge-off obligation from a debtor unless the amount is expressly authorized by the agreement creating the medical debt or is otherwise permitted by law;

 

(17) falsify any documents with the intent to deceive;

 

(18) when initially contacting a Minnesota debtor by mail to collect a medical debt, fail to include a disclosure on the contact notice, in a type size or font which is equal to or larger than the largest other type of type size or font used in the text of the notice, that includes and identifies the Office of the Minnesota Attorney General's general telephone number, and states:  "You have the right to hire your own attorney to represent you in this matter.";

 

(19) commence legal action to collect a medical debt outside the limitations period set forth in section 541.053;

 

(20) report to a credit reporting agency any medical debt which the collecting party knows or should know is or was originally owed to a health care provider, as defined in section 62J.805, subdivision 4; or

 

(21) challenge a debtor's claim of exemption to garnishment or levy in a manner that is baseless, frivolous, or otherwise in bad faith.

 

Sec. 22.  [332C.03] MEDICAL DEBT REPORTING PROHIBITED.

 

(a) A collecting party is prohibited from reporting medical debt to a consumer reporting agency.

 

(b) A consumer reporting agency is prohibited from making a consumer report containing an item of information that the consumer reporting agency knows or should know concerns medical debt.

 

(c) For purposes of this section, "consumer report" and "consumer reporting agency" have the meanings given in the Fair Credit Reporting Act, United States Code, title 15, section 1681a.

 

(d) This section also applies to collection agencies and debt buyers licensed under chapter 332.

 

Sec. 23.  [332C.04] DEFENDING MEDICAL DEBT CASES.

 

A debtor who successfully defends against a claim for payment of medical debt that is alleged by a collecting party must be awarded the debtor's costs and a reasonable attorney fee, as determined by the court, incurred in defending against the collecting party's claim for debt payment.  For purposes of this section, a resolution mutually agreed upon by the debtor and collecting party is not a successful defense subject to an additional award of an attorney fee.

 

Sec. 24.  [332C.05] ENFORCEMENT.

 

(a) The attorney general may enforce this chapter under section 8.31.

 

(b) A collecting party that violates this chapter is strictly liable to the debtor in question for the sum of:

 

(1) actual damage sustained by the debtor as a result of the violation;

 

(2) additional damages as the court may allow, but not exceeding $1,000 per violation; and


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15833

(3) in the case of any successful action to enforce the foregoing, the costs of the action, together with a reasonable attorney fee as determined by the court.

 

(c) A collecting party that willfully and maliciously violates this chapter is strictly liable to the debtor for three times the sums allowable under paragraph (b), clauses (1) and (2).

 

(d) The dollar amount limit under paragraph (b), clause (2), changes on July 1 of each even-numbered year in an amount equal to changes made in the Consumer Price Index, compiled by the United States Bureau of Labor Statistics.  The Consumer Price Index for December 2024 is the reference base index.  If the Consumer Price Index is revised, the percentage of change made under this section must be calculated on the basis of the revised Consumer Price Index.  If a Consumer Price Index revision changes the reference base index, a revised reference base index must be determined by multiplying the reference base index that is effective at the time by the rebasing factor furnished by the Bureau of Labor Statistics.

 

(e) If the Consumer Price Index is superseded, the Consumer Price Index referred to in this section is the Consumer Price Index represented by the Bureau of Labor Statistics as most accurately reflecting changes in the prices paid by consumers for consumer goods and services.

 

(f) The attorney general must publish the base reference index under paragraph (d) in the State Register no later than September 1, 2024.  The attorney general must calculate and then publish the revised Consumer Price Index under paragraph (d) in the State Register no later than September 1 each even-numbered year.

 

(g) A collecting party must not be held liable in any action brought under this section if the collecting party shows by a preponderance of evidence that the violation:

 

(1) was not intentional and resulted from a bona fide error made notwithstanding the maintenance of procedures reasonably adopted to avoid any such error; or

 

(2) was the result of inaccurate or incorrect information provided to the collecting party by a health care provider as defined in section 62J.805, subdivision 4; a health carrier as defined in section 62A.011, subdivision 2; or another collecting party currently or previously engaged in collection of the medical debt in question.

 

Sec. 25.  Minnesota Statutes 2022, section 519.05, is amended to read:

 

519.05 LIABILITY OF HUSBAND AND WIFE SPOUSES.

 

(a) A spouse is not liable to a creditor for any debts of the other spouse.  Where husband and wife are living together, they Spouses shall be jointly and severally liable for necessary medical services that have been furnished to either spouse, including any claims arising under section 246.53, 256B.15, 256D.16, or 261.04, and necessary household articles and supplies furnished to and used by the family.  Notwithstanding this paragraph, in a proceeding under chapter 518 the court may apportion such debt between the spouses.

 

(b) Either spouse may close a credit card account or other unsecured consumer line of credit on which both spouses are contractually liable, by giving written notice to the creditor.

 

(c) Nothing in this section prevents a creditor's claim against a decedent's estate.


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15834

Sec. 26.  Laws 2020, chapter 73, section 8, is amended to read:

 

Sec. 8.  APPROPRIATIONS.

 

(a) $297,000 is appropriated in fiscal year 2020 from the health care access fund to the Board of Directors of MNsure to train navigators to assist individuals and provide compensation as required for the insulin safety net program under Minnesota Statutes, section 151.74, subdivision 7.  Of this appropriation, $108,000 is for implementing the training requirements for navigators and $189,000 is for application assistance bonus payments.  This is a onetime appropriation and is available until December 31, 2024 June 30, 2027.

 

(b) $250,000 is appropriated in fiscal year 2020 from the health care access fund to the Board of Directors of MNsure for a public awareness campaign for the insulin safety net program established under Minnesota Statutes, section 151.74.  This is a onetime appropriation and is available until December 31, 2024. 

 

(c) $76,000 is appropriated in fiscal year 2021 from the health care access fund to the Board of Pharmacy to implement Minnesota Statutes, section 151.74.  The base for this appropriation is $76,000 in fiscal year 2022; $76,000 in fiscal year 2023; $76,000 in fiscal year 2024; $38,000 in fiscal year 2025; and $0 in fiscal year 2026.

 

(d) $136,000 in fiscal year 2021 is appropriated from the health care access fund to the commissioner of health to implement the survey to assess program satisfaction in Minnesota Statutes, section 151.74, subdivision 12.  The base for this appropriation is $80,000 in fiscal year 2022 and $0 in fiscal year 2023.  This is a onetime appropriation.

 

Sec. 27.  REPEALER; SUNSET FOR THE LONG-TERM SAFETY NET INSULIN PROGRAM.

 

Minnesota Statutes 2022, section 151.74, subdivision 16, is repealed.

 

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

 

ARTICLE 4

HEALTH INSURANCE

 

Section 1.  Minnesota Statutes 2022, section 62A.28, subdivision 2, is amended to read:

 

Subd. 2.  Required coverage.  (a) Every policy, plan, certificate, or contract referred to in subdivision 1 issued or renewed after August 1, 1987, must provide coverage for scalp hair prostheses, including all equipment and accessories necessary for regular use of scalp hair prostheses, worn for hair loss suffered as a result of a health condition, including, but not limited to, alopecia areata or the treatment for cancer, unless there is a clinical basis for limitation.

 

(b) The coverage required by this section is subject to the co-payment, coinsurance, deductible, and other enrollee cost-sharing requirements that apply to similar types of items under the policy, plan, certificate, or contract and may be limited to one prosthesis per benefit year.

 

(c) The coverage required by this section for scalp hair prostheses is limited to $1,000 per benefit year.

 

(d) A scalp hair prostheses must be prescribed by a doctor to be covered under this section.

 

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


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15835

Sec. 2.  [62A.3098] RAPID WHOLE GENOME SEQUENCING; COVERAGE.

 

Subdivision 1.  Definition.  For purposes of this section, "rapid whole genome sequencing" or "rWGS" means an investigation of the entire human genome, including coding and noncoding regions and mitochondrial deoxyribonucleic acid, to identify disease-causing genetic changes that returns the final results in 14 days.  Rapid whole genome sequencing includes patient-only whole genome sequencing and duo and trio whole genome sequencing of the patient and the patient's biological parent or parents.

 

Subd. 2.  Required coverage.  A health plan that provides coverage to Minnesota residents must cover rWGS testing if the enrollee:

 

(1) is 21 years of age or younger;

 

(2) has a complex or acute illness of unknown etiology that is not confirmed to have been caused by an environmental exposure, toxic ingestion, an infection with a normal response to therapy, or trauma; and

 

(3) is receiving inpatient hospital services in an intensive care unit or a neonatal or high acuity pediatric care unit.

 

Subd. 3.  Coverage criteria.  Coverage may be based on the following medical necessity criteria:

 

(1) the enrollee has symptoms that suggest a broad differential diagnosis that would require an evaluation by multiple genetic tests if rWGS testing is not performed;

 

(2) timely identification of a molecular diagnosis is necessary in order to guide clinical decision making, and the rWGS testing may aid in guiding the treatment or management of the enrollee's condition; and

 

(3) the enrollee's complex or acute illness of unknown etiology includes at least one of the following conditions:

 

(i) congenital anomalies involving at least two organ systems, or complex or multiple congenital anomalies in one organ system;

 

(ii) specific organ malformations that are highly suggestive of a genetic etiology;

 

(iii) abnormal laboratory tests or abnormal chemistry profiles suggesting the presence of a genetic disease, complex metabolic disorder, or inborn error of metabolism;

 

(iv) refractory or severe hypoglycemia or hyperglycemia;

 

(v) abnormal response to therapy related to an underlying medical condition affecting vital organs or bodily systems;

 

(vi) severe muscle weakness, rigidity, or spasticity;

 

(vii) refractory seizures;

 

(viii) a high-risk stratification on evaluation for a brief resolved unexplained event with any of the following features:

 

(A) a recurrent event without respiratory infection;

 

(B) a recurrent seizure-like event; or


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15836

(C) a recurrent cardiopulmonary resuscitation;

 

(ix) abnormal cardiac diagnostic testing results that are suggestive of possible channelopathies, arrhythmias, cardiomyopathies, myocarditis, or structural heart disease;

 

(x) abnormal diagnostic imaging studies that are suggestive of underlying genetic condition;

 

(xi) abnormal physiologic function studies that are suggestive of an underlying genetic etiology; or

 

(xii) family genetic history related to the patient's condition.

 

Subd. 4.  Cost sharing.  Coverage provided in this section is subject to the enrollee's health plan cost-sharing requirements, including any deductibles, co-payments, or coinsurance requirements that apply to diagnostic testing services.

 

Subd. 5.  Payment for services provided.  If the enrollee's health plan uses a capitated or bundled payment arrangement to reimburse a provider for services provided in an inpatient setting, reimbursement for services covered under this section must be paid separately and in addition to any reimbursement otherwise payable to the provider under the capitated or bundled payment arrangement, unless the health carrier and the provider have negotiated an increased capitated or bundled payment rate that includes the services covered under this section.

 

Subd. 6.  Genetic data.  Genetic data generated as a result of performing rWGS and covered under this section:  (1) must be used for the primary purpose of assisting the ordering provider and treating care team to diagnose and treat the patient; (2) is protected health information as set forth under the Health Insurance Portability and Accountability Act (HIPAA), the Health Information Technology for Economic and Clinical Health Act, and any promulgated regulations, including but not limited to Code of Federal Regulations, title 45, parts 160 and 164, subparts A and E; and (3) is a protected health record under sections 144.291 to 144.298.

 

Subd. 7.  Reimbursement.  The commissioner of commerce must reimburse health carriers for coverage under this section.  Reimbursement is available only for coverage that would not have been provided by the health carrier without the requirements of this section.  Each fiscal year, an amount necessary to make payments to health carriers to defray the cost of providing coverage under this section is appropriated to the commissioner of commerce.  Health carriers must report to the commissioner quantified costs attributable to the additional benefit under this section in a format developed by the commissioner.  The commissioner must evaluate submissions and make payments to health carriers as provided in Code of Federal Regulations, title 45, section 155.170.

 

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

 

Sec. 3.  [62A.59] COVERAGE OF SERVICE; PRIOR AUTHORIZATION.

 

Subdivision 1.  Service for which prior authorization not required.  A health carrier must not retrospectively deny or limit coverage of a health care service for which prior authorization was not required by the health carrier, unless there is evidence that the health care service was provided based on fraud or misinformation.

 

Subd. 2.  Service for which prior authorization required but not obtained.  A health carrier must not deny or limit coverage of a health care service which the enrollee has already received solely on the basis of lack of prior authorization if the service would otherwise have been covered had the prior authorization been obtained.

 

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


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15837

Sec. 4.  [62C.045] APPLICATION OF OTHER LAW.

 

Sections 145D.30 to 145D.37 apply to service plan corporations operating under this chapter.

 

Sec. 5.  Minnesota Statutes 2022, section 62D.02, subdivision 4, is amended to read:

 

Subd. 4.  Health maintenance organization.  "Health maintenance organization" means a foreign or domestic nonprofit corporation organized under chapter 317A, or a local governmental unit as defined in subdivision 11, controlled and operated as provided in sections 62D.01 to 62D.30, which provides, either directly or through arrangements with providers or other persons, comprehensive health maintenance services, or arranges for the provision of these services, to enrollees on the basis of a fixed prepaid sum without regard to the frequency or extent of services furnished to any particular enrollee.

 

Sec. 6.  Minnesota Statutes 2022, section 62D.02, subdivision 7, is amended to read:

 

Subd. 7.  Comprehensive health maintenance services.  "Comprehensive health maintenance services" means a set of comprehensive health services which the enrollees might reasonably require to be maintained in good health including as a minimum, but not limited to, emergency care, emergency ground ambulance transportation services, inpatient hospital and physician care, outpatient health services and preventive health services.  Elective, induced abortion, except as medically necessary to prevent the death of the mother, whether performed in a hospital, other abortion facility or the office of a physician, shall not be mandatory for any health maintenance organization.

 

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

 

Sec. 7.  Minnesota Statutes 2022, section 62D.03, subdivision 1, is amended to read:

 

Subdivision 1.  Certificate of authority required.  Notwithstanding any law of this state to the contrary, any foreign or domestic nonprofit corporation organized to do so or a local governmental unit may apply to the commissioner of health for a certificate of authority to establish and operate a health maintenance organization in compliance with sections 62D.01 to 62D.30.  No person shall establish or operate a health maintenance organization in this state, nor sell or offer to sell, or solicit offers to purchase or receive advance or periodic consideration in conjunction with a health maintenance organization or health maintenance contract unless the organization has a certificate of authority under sections 62D.01 to 62D.30.

 

Sec. 8.  Minnesota Statutes 2022, section 62D.05, subdivision 1, is amended to read:

 

Subdivision 1.  Authority granted.  Any nonprofit corporation or local governmental unit may, upon obtaining a certificate of authority as required in sections 62D.01 to 62D.30, operate as a health maintenance organization.

 

Sec. 9.  Minnesota Statutes 2022, section 62D.06, subdivision 1, is amended to read:

 

Subdivision 1.  Governing body composition; enrollee advisory body.  The governing body of any health maintenance organization which is a nonprofit corporation may include enrollees, providers, or other individuals; provided, however, that after a health maintenance organization which is a nonprofit corporation has been authorized under sections 62D.01 to 62D.30 for one year, at least 40 percent of the governing body shall be composed of enrollees and members elected by the enrollees and members from among the enrollees and members.  For purposes of this section, "member" means a consumer who receives health care services through a self-insured contract that is administered by the health maintenance organization or its related third-party administrator.  The number of members elected to the governing body shall not exceed the number of enrollees elected to the governing body.  An enrollee or member elected to the governing board may not be a person:


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15838

(1) whose occupation involves, or before retirement involved, the administration of health activities or the provision of health services;

 

(2) who is or was employed by a health care facility as a licensed health professional; or

 

(3) who has or had a direct substantial financial or managerial interest in the rendering of a health service, other than the payment of a reasonable expense reimbursement or compensation as a member of the board of a health maintenance organization.

 

After a health maintenance organization which is a local governmental unit has been authorized under sections 62D.01 to 62D.30 for one year, an enrollee advisory body shall be established.  The enrollees who make up this advisory body shall be elected by the enrollees from among the enrollees.

 

Sec. 10.  Minnesota Statutes 2022, section 62D.12, subdivision 19, is amended to read:

 

Subd. 19.  Coverage of service.  A health maintenance organization may not deny or limit coverage of a service which the enrollee has already received solely on the basis of lack of prior authorization or second opinion, to the extent that the service would otherwise have been covered under the member's contract by the health maintenance organization had prior authorization or second opinion been obtained.  This subdivision expires December 31, 2025, for health plans offered, sold, issued, or renewed on or after that date.

 

Sec. 11.  Minnesota Statutes 2022, section 62D.19, is amended to read:

 

62D.19 UNREASONABLE EXPENSES.

 

No health maintenance organization shall incur or pay for any expense of any nature which is unreasonably high in relation to the value of the service or goods provided.  The commissioner of health shall implement and enforce this section by rules adopted under this section.

 

In an effort to achieve the stated purposes of sections 62D.01 to 62D.30, in order to safeguard the underlying nonprofit status of health maintenance organizations, and in order to ensure that the payment of health maintenance organization money to major participating entities results in a corresponding benefit to the health maintenance organization and its enrollees, when determining whether an organization has incurred an unreasonable expense in relation to a major participating entity, due consideration shall be given to, in addition to any other appropriate factors, whether the officers and trustees of the health maintenance organization have acted with good faith and in the best interests of the health maintenance organization in entering into, and performing under, a contract under which the health maintenance organization has incurred an expense.  The commissioner has standing to sue, on behalf of a health maintenance organization, officers or trustees of the health maintenance organization who have breached their fiduciary duty in entering into and performing such contracts.

 

Sec. 12.  Minnesota Statutes 2022, section 62D.20, subdivision 1, is amended to read:

 

Subdivision 1.  Rulemaking.  The commissioner of health may, pursuant to chapter 14, promulgate such reasonable rules as are necessary or proper to carry out the provisions of sections 62D.01 to 62D.30.  Included among such rules shall be those which provide minimum requirements for the provision of comprehensive health maintenance services, as defined in section 62D.02, subdivision 7, and reasonable exclusions therefrom.  Nothing in such rules shall force or require a health maintenance organization to provide elective, induced abortions, except as medically necessary to prevent the death of the mother, whether performed in a hospital, other abortion facility, or the office of a physician; the rules shall provide every health maintenance organization the option of excluding or including elective, induced abortions, except as medically necessary to prevent the death of the mother, as part of its comprehensive health maintenance services.

 

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


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15839

Sec. 13.  Minnesota Statutes 2022, section 62D.22, subdivision 5, is amended to read:

 

Subd. 5.  Other state law.  Except as otherwise provided in sections 62A.01 to 62A.42 and 62D.01 to 62D.30, and except as they eliminate elective, induced abortions, wherever performed, from health or maternity benefits, provisions of the insurance laws and provisions of nonprofit health service plan corporation laws shall not be applicable to any health maintenance organization granted a certificate of authority under sections 62D.01 to 62D.30.

 

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

 

Sec. 14.  Minnesota Statutes 2022, section 62D.22, is amended by adding a subdivision to read:

 

Subd. 5a.  Application of other law.  Sections 145D.30 to 145D.37 apply to nonprofit health maintenance organizations operating under this chapter.

 

Sec. 15.  [62D.221] OVERSIGHT OF TRANSACTIONS.

 

Subdivision 1.  Insurance provisions applicable to health maintenance organizations.  (a) Health maintenance organizations are subject to sections 60A.135, 60A.136, 60A.137, 60A.16, 60A.161, 60D.17, 60D.18, and 60D.20 and must comply with the provisions of these sections applicable to insurers.  In applying these sections to health maintenance organizations, "the commissioner" means the commissioner of health.  Health maintenance organizations are subject to Minnesota Rules, chapter 2720, as applicable to sections 60D.17, 60D.18, and 60D.20, and must comply with those provisions of the chapter applicable to insurers unless the commissioner of health adopts rules to implement this subdivision.

 

(b) In addition to the conditions in section 60D.17, subdivision 1, subjecting a health maintenance organization to filing requirements, no person other than the issuer shall acquire all or substantially all of the assets of a domestic nonprofit health maintenance organization through any means unless at the time the offer, request, or invitation is made or the agreement is entered into the person has filed with the commissioner and has sent to the health maintenance organization a statement containing the information required in section 60D.17 and the offer, request, invitation, agreement, or acquisition has been approved by the commissioner of health in the manner prescribed in section 60D.17.

 

Subd. 2.  Conversion transactions.  If a health maintenance organization must notify or report a transaction to the commissioner under subdivision 1, the health maintenance organization must include information regarding the plan for a conversion benefit entity, in the form and manner determined by the commissioner, if the reportable transaction qualifies as a conversion transaction as defined in section 145D.30, subdivision 5.  The commissioner may consider information regarding the conversion transaction and the conversion benefit entity plan in any actions taken under subdivision 1, including in decisions to approve or disapprove transactions, and may extend time frames to a total of 90 days, with notice to the parties to the transaction.

 

Sec. 16.  Minnesota Statutes 2022, section 62E.02, subdivision 3, is amended to read:

 

Subd. 3.  Health maintenance organization.  "Health maintenance organization" means a nonprofit corporation licensed and operated as provided in chapter 62D.


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15840

Sec. 17.  Minnesota Statutes 2022, section 62M.01, subdivision 3, is amended to read:

 

Subd. 3.  Scope.  (a) Nothing in this chapter applies to review of claims after submission to determine eligibility for benefits under a health benefit plan.  The appeal procedure described in section 62M.06 applies to any complaint as defined under section 62Q.68, subdivision 2, that requires a medical determination in its resolution.

 

(b) Effective January 1, 2026, this chapter does not apply applies to managed care plans or county-based purchasing plans when the plan is providing coverage to state public health care program enrollees under chapter 256B or 256L.

 

(c) Effective January 1, 2026, the following sections of this chapter apply to services delivered through fee‑for‑service under chapters 256B and 256L:  62M.02, subdivisions 1 to 5, 7 to 12, 13, 14 to 18, and 21; 62M.04; 62M.05, subdivisions 1 to 4; 62M.06, subdivisions 1 to 3; 62M.07; 62M.072; 62M.09; 62M.10; 62M.12; and 62M.17, subdivision 2.

 

Sec. 18.  Minnesota Statutes 2022, section 62M.02, subdivision 1a, is amended to read:

 

Subd. 1a.  Adverse determination.  "Adverse determination" means a decision by a utilization review organization relating to an admission, extension of stay, or health care service that is partially or wholly adverse to the enrollee, including:

 

(1) a decision to deny an admission, extension of stay, or health care service on the basis that it is not medically necessary; or

 

(2) an authorization for a health care service that is less intensive than the health care service specified in the original request for authorization.

 

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

 

Sec. 19.  Minnesota Statutes 2022, section 62M.02, subdivision 5, is amended to read:

 

Subd. 5.  Authorization.  "Authorization" means a determination by a utilization review organization that an admission, extension of stay, or other health care service has been reviewed and that, based on the information provided, it satisfies the utilization review requirements of the applicable health benefit plan and the health plan company or commissioner will then pay for the covered benefit, provided the preexisting limitation provisions, the general exclusion provisions, and any deductible, co-payment, coinsurance, or other policy requirements have been met.

 

Sec. 20.  Minnesota Statutes 2022, section 62M.02, is amended by adding a subdivision to read:

 

Subd. 8a.  Commissioner.  "Commissioner" means, effective January 1, 2026, for the sections specified in section 62M.01, subdivision 3, paragraph (c), the commissioner of human services, unless otherwise specified.

 

Sec. 21.  Minnesota Statutes 2022, section 62M.02, subdivision 11, is amended to read:

 

Subd. 11.  Enrollee.  "Enrollee" means:

 

(1) an individual covered by a health benefit plan and includes an insured policyholder, subscriber, contract holder, member, covered person, or certificate holder; or

 

(2) effective January 1, 2026, for the sections specified in section 62M.01, subdivision 3, paragraph (c), a recipient receiving coverage through fee-for-service under chapters 256B and 256L.


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15841

Sec. 22.  Minnesota Statutes 2022, section 62M.02, subdivision 12, is amended to read:

 

Subd. 12.  Health benefit plan.  (a) "Health benefit plan" means:

 

(1) a policy, contract, or certificate issued by a health plan company for the coverage of medical, dental, or hospital benefits; or

 

(2) effective January 1, 2026, for the sections specified in section 62M.01, subdivision 3, paragraph (c), coverage of medical, dental, or hospital benefits through fee-for-service under chapters 256B and 256L, as specified by the commissioner on the agency's public website or through other forms of recipient and provider guidance.

 

(b) A health benefit plan does not include coverage that is:

 

(1) limited to disability or income protection coverage;

 

(2) automobile medical payment coverage;

 

(3) supplemental to liability insurance;

 

(4) designed solely to provide payments on a per diem, fixed indemnity, or nonexpense incurred basis;

 

(5) credit accident and health insurance issued under chapter 62B;

 

(6) blanket accident and sickness insurance as defined in section 62A.11;

 

(7) accident only coverage issued by a licensed and tested insurance agent; or

 

(8) workers' compensation.

 

Sec. 23.  Minnesota Statutes 2022, section 62M.02, subdivision 21, is amended to read:

 

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


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15842

Sec. 24.  Minnesota Statutes 2022, section 62M.04, subdivision 1, is amended to read:

 

Subdivision 1.  Responsibility for obtaining authorization.  A health benefit plan that includes utilization review requirements must specify the process for notifying the utilization review organization in a timely manner and obtaining authorization for health care services.  Each health plan company must provide a clear and concise description of this process to an enrollee as part of the policy, subscriber contract, or certificate of coverage.  Effective January 1, 2026, the commissioner must provide a clear and concise description of this process to fee‑for‑service recipients receiving services under chapters 256B and 256L, through the agency's public website or through other forms of recipient guidance.  In addition to the enrollee, the utilization review organization must allow any provider or provider's designee, or responsible patient representative, including a family member, to fulfill the obligations under the health benefit plan.

 

A claims administrator that contracts directly with providers for the provision of health care services to enrollees may, through contract, require the provider to notify the review organization in a timely manner and obtain authorization for health care services.

 

Sec. 25.  Minnesota Statutes 2022, section 62M.05, subdivision 3a, is amended to read:

 

Subd. 3a.  Standard review determination.  (a) Notwithstanding subdivision 3b, a standard review determination on all requests for utilization review must be communicated to the provider and enrollee in accordance with this subdivision within five business days after receiving the request if the request is received electronically, or within six business days if received through nonelectronic means, provided that all information reasonably necessary to make a determination on the request has been made available to the utilization review organization.  Effective January 1, 2022, A standard review determination on all requests for utilization review must be communicated to the provider and enrollee in accordance with this subdivision within five business days after receiving the request, regardless of how the request was received, provided that all information reasonably necessary to make a determination on the request has been made available to the utilization review organization.

 

(b) When a determination is made to authorize, notification must be provided promptly by telephone to the provider.  The utilization review organization shall send written notification to the provider or shall maintain an audit trail of the determination and telephone notification.  For purposes of this subdivision, "audit trail" includes documentation of the telephone notification, including the date; the name of the person spoken to; the enrollee; the service, procedure, or admission authorized; and the date of the service, procedure, or admission.  If the utilization review organization indicates authorization by use of a number, the number must be called the "authorization number."  For purposes of this subdivision, notification may also be made by facsimile to a verified number or by electronic mail to a secure electronic mailbox.  These electronic forms of notification satisfy the "audit trail" requirement of this paragraph.

 

(c) When an adverse determination is made, notification must be provided within the time periods specified in paragraph (a) by telephone, by facsimile to a verified number, or by electronic mail to a secure electronic mailbox to the attending health care professional and hospital or physician office as applicable.  Written notification must also be sent to the hospital or physician office as applicable and attending health care professional if notification occurred by telephone.  For purposes of this subdivision, notification may be made by facsimile to a verified number or by electronic mail to a secure electronic mailbox.  Written notification must be sent to the enrollee and may be sent by United States mail, facsimile to a verified number, or by electronic mail to a secure mailbox.  The written notification must include all reasons relied on by the utilization review organization for the determination and the process for initiating an appeal of the determination.  Upon request, the utilization review organization shall provide the provider or enrollee with the criteria used to determine the necessity, appropriateness, and efficacy of the health care service and identify the database, professional treatment parameter, or other basis for the criteria.  Reasons for an adverse determination may include, among other things, the lack of adequate information to authorize after a reasonable attempt has been made to contact the provider or enrollee.


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15843

(d) When an adverse determination is made, the written notification must inform the enrollee and the attending health care professional of the right to submit an appeal to the internal appeal process described in section 62M.06 and the procedure for initiating the internal appeal.  The written notice shall be provided in a culturally and linguistically appropriate manner consistent with the provisions of the Affordable Care Act as defined under section 62A.011, subdivision 1a.

 

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

 

Sec. 26.  Minnesota Statutes 2022, section 62M.07, subdivision 2, is amended to read:

 

Subd. 2.  Prior authorization of emergency certain services prohibited.  No utilization review organization, health plan company, or claims administrator may conduct or require prior authorization of:

 

(1) emergency confinement or an emergency service.  The enrollee or the enrollee's authorized representative may be required to notify the health plan company, claims administrator, or utilization review organization as soon as reasonably possible after the beginning of the emergency confinement or emergency service.;

 

(2) oral buprenorphine to treat a substance use disorder;

 

(3) outpatient mental health treatment or outpatient substance use disorder treatment, except for treatment which is:  (i) a medication; and (ii) not otherwise listed in this subdivision.  Prior authorizations required for medications used for outpatient mental health treatment or outpatient substance use disorder treatment, and not otherwise listed in this subdivision, must be processed according to section 62M.05, subdivision 3b, for initial determinations, and according to section 62M.06, subdivision 2, for appeals;

 

(4) antineoplastic cancer treatment that is consistent with guidelines of the National Comprehensive Cancer Network, except for treatment which is:  (i) a medication; and (ii) not otherwise listed in this subdivision.  Prior authorizations required for medications used for antineoplastic cancer treatment, and not otherwise listed in this subdivision, must be processed according to section 62M.05, subdivision 3b, for initial determinations, and according to section 62M.06, subdivision 2, for appeals;

 

(5) services that currently have a rating of A or B from the United States Preventive Services Task Force, immunizations recommended by the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention, or preventive services and screenings provided to women as described in Code of Federal Regulations, title 45, section 147.130;

 

(6) pediatric hospice services provided by a hospice provider licensed under sections 144A.75 to 144A.755; and

 

(7) treatment delivered through a neonatal abstinence program operated by pediatric pain or palliative care subspecialists.

 

Clauses (2) to (7) are effective January 1, 2026, and apply to health benefit plans offered, sold, issued, or renewed on or after that date.

 

Sec. 27.  Minnesota Statutes 2022, section 62M.07, subdivision 4, is amended to read:

 

Subd. 4.  Submission of prior authorization requests.  (a) If prior authorization for a health care service is required, the utilization review organization, health plan company, or claim administrator must allow providers to submit requests for prior authorization of the health care services without unreasonable delay by telephone, facsimile, or voice mail or through an electronic mechanism 24 hours a day, seven days a week.  This subdivision does not apply to dental service covered under MinnesotaCare or medical assistance.


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15844

(b) Effective January 1, 2027, for health benefit plans offered, sold, issued, or renewed on or after that date, utilization review organizations, health plan companies, and claims administrators must have and maintain a prior authorization application programming interface (API) that automates the prior authorization process for health care services, excluding prescription drugs and medications.  The API must allow providers to determine whether a prior authorization is required for health care services, identify prior authorization information and documentation requirements, and facilitate the exchange of prior authorization requests and determinations from provider electronic health records or practice management systems.  The API must use the Health Level Seven (HL7) Fast Healthcare Interoperability Resources (FHIR) standard in accordance with Code of Federal Regulations, title 45, section 170.215(a)(1), and the most recent standards and guidance adopted by the United States Department of Health and Human Services to implement that section.  Prior authorization submission requests for prescription drugs and medications must comply with the requirements of section 62J.497.

 

Sec. 28.  Minnesota Statutes 2022, section 62M.07, is amended by adding a subdivision to read:

 

Subd. 5.  Treatment of a chronic condition.  This subdivision is effective January 1, 2026, and applies to health benefit plans offered, sold, issued, or renewed on or after that date.  An authorization for treatment of a chronic health condition does not expire unless the standard of treatment for that health condition changes.  A chronic health condition is a condition that is expected to last one year or more and:

 

(1) requires ongoing medical attention to effectively manage the condition or prevent an adverse health event; or

 

(2) limits one or more activities of daily living.

 

Sec. 29.  Minnesota Statutes 2022, section 62M.10, subdivision 7, is amended to read:

 

Subd. 7.  Availability of criteria.  (a) For utilization review determinations other than prior authorization, a utilization review organization shall, upon request, provide to an enrollee, a provider, and the commissioner of commerce the criteria used to determine the medical necessity, appropriateness, and efficacy of a procedure or service and identify the database, professional treatment guideline, or other basis for the criteria.

 

(b) For prior authorization determinations, a utilization review organization must submit the organization's current prior authorization requirements and restrictions, including written, evidence-based, clinical criteria used to make an authorization or adverse determination, to all health plan companies for which the organization performs utilization review.  A health plan company must post on its public website the prior authorization requirements and restrictions of any utilization review organization that performs utilization review for the health plan company.  These prior authorization requirements and restrictions must be detailed and written in language that is easily understandable to providers.  This paragraph does not apply to the commissioner of human services when delivering services through fee-for-service under chapters 256B and 256L.

 

(c) Effective January 1, 2026, the commissioner of human services must post on the department's public website the prior authorization requirements and restrictions, including written, evidence-based, clinical criteria used to make an authorization or adverse determination, that apply to prior authorization determinations for fee-for-service under chapters 256B and 256L.  These prior authorization requirements and restrictions must be detailed and written in language that is easily understandable to providers.

 

Sec. 30.  Minnesota Statutes 2022, section 62M.10, subdivision 8, is amended to read:

 

Subd. 8.  Notice; new prior authorization requirements or restrictions; change to existing requirement or restriction.  (a) Before a utilization review organization may implement a new prior authorization requirement or restriction or amend an existing prior authorization requirement or restriction, the utilization review organization must submit the new or amended requirement or restriction to all health plan companies for which the organization


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15845

performs utilization review.  A health plan company must post on its website the new or amended requirement or restriction.  This paragraph does not apply to the commissioner of human services when delivering services through fee-for-service under chapters 256B and 256L.

 

(b) At least 45 days before a new prior authorization requirement or restriction or an amended existing prior authorization requirement or restriction is implemented, the utilization review organization, health plan company, or claims administrator must provide written or electronic notice of the new or amended requirement or restriction to all Minnesota-based, in-network attending health care professionals who are subject to the prior authorization requirements and restrictions.  This paragraph does not apply to the commissioner of human services when delivering services through fee-for-service under chapters 256B and 256L.

 

(c) Effective January 1, 2026, before the commissioner of human services may implement a new prior authorization requirement or restriction or amend an existing prior authorization requirement or restriction, the commissioner, at least 45 days before the new or amended requirement or restriction takes effect, must provide written or electronic notice of the new or amended requirement or restriction, to all health care professionals participating as fee-for-service providers under chapters 256B and 256L who are subject to the prior authorization requirements and restrictions.

 

Sec. 31.  Minnesota Statutes 2022, section 62M.17, subdivision 2, is amended to read:

 

Subd. 2.  Effect of change in prior authorization clinical criteria.  (a) If, during a plan year, a utilization review organization changes coverage terms for a health care service or the clinical criteria used to conduct prior authorizations for a health care service, the change in coverage terms or change in clinical criteria shall not apply until the next plan year for any enrollee who received prior authorization for a health care service using the coverage terms or clinical criteria in effect before the effective date of the change.

 

(b) Paragraph (a) does not apply if a utilization review organization changes coverage terms for a drug or device that has been deemed unsafe by the United States Food and Drug Administration (FDA); that has been withdrawn by either the FDA or the product manufacturer; or when an independent source of research, clinical guidelines, or evidence-based standards has issued drug- or device-specific warnings or recommended changes in drug or device usage.

 

(c) Paragraph (a) does not apply if a utilization review organization changes coverage terms for a service or the clinical criteria used to conduct prior authorizations for a service when an independent source of research, clinical guidelines, or evidence-based standards has recommended changes in usage of the service for reasons related to patient harm.  This paragraph expires December 31, 2025, for health benefit plans offered, sold, issued, or renewed on or after that date.

 

(d) Effective January 1, 2026, and applicable to health benefit plans offered, sold, issued, or renewed on or after that date, paragraph (a) does not apply if a utilization review organization changes coverage terms for a service or the clinical criteria used to conduct prior authorizations for a service when an independent source of research, clinical guidelines, or evidence-based standards has recommended changes in usage of the service for reasons related to previously unknown and imminent patient harm.

 

(d) (e) Paragraph (a) does not apply if a utilization review organization removes a brand name drug from its formulary or places a brand name drug in a benefit category that increases the enrollee's cost, provided the utilization review organization (1) adds to its formulary a generic or multisource brand name drug rated as therapeutically equivalent according to the FDA Orange Book, or a biologic drug rated as interchangeable according to the FDA Purple Book, at a lower cost to the enrollee, and (2) provides at least a 60-day notice to prescribers, pharmacists, and affected enrollees.


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15846

Sec. 32.  [62M.19] ANNUAL REPORT TO COMMISSIONER OF HEALTH; PRIOR AUTHORIZATIONS.

 

On or before September 1 each year, each utilization review organization must report to the commissioner of health, in a form and manner specified by the commissioner, information on prior authorization requests for the previous calendar year.  The report submitted under this subdivision must include the following data:

 

(1) the total number of prior authorization requests received;

 

(2) the number of prior authorization requests for which an authorization was issued;

 

(3) the number of prior authorization requests for which an adverse determination was issued;

 

(4) the number of adverse determinations reversed on appeal;

 

(5) the 25 codes with the highest number of prior authorization requests and the percentage of authorizations for each of these codes;

 

(6) the 25 codes with the highest percentage of prior authorization requests for which an authorization was issued and the total number of the requests;

 

(7) the 25 codes with the highest percentage of prior authorization requests for which an adverse determination was issued but which was reversed on appeal and the total number of the requests;

 

(8) the 25 codes with the highest percentage of prior authorization requests for which an adverse determination was issued and the total number of the requests; and

 

(9) the reasons an adverse determination to a prior authorization request was issued, expressed as a percentage of all adverse determinations.  The reasons listed may include but are not limited to:

 

(i) the patient did not meet prior authorization criteria;

 

(ii) incomplete information was submitted by the provider to the utilization review organization;

 

(iii) the treatment program changed; and

 

(iv) the patient is no longer covered by the health benefit plan.

 

Sec. 33.  Minnesota Statutes 2022, section 62Q.14, is amended to read:

 

62Q.14 RESTRICTIONS ON ENROLLEE SERVICES.

 

No health plan company may restrict the choice of an enrollee as to where the enrollee receives services related to:

 

(1) the voluntary planning of the conception and bearing of children, provided that this clause does not refer to abortion services;

 

(2) the diagnosis of infertility;

 

(3) the testing and treatment of a sexually transmitted disease; and

 

(4) the testing for AIDS or other HIV-related conditions.

 

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


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15847

Sec. 34.  Minnesota Statutes 2022, section 62Q.19, subdivision 3, is amended to read:

 

Subd. 3.  Health plan company affiliation.  A health plan company must offer a provider contract to any all designated essential community provider providers located within the area served by the health plan company.  A health plan company must include all essential community providers that have accepted a contract in each of the company's provider networks.  A health plan company shall not restrict enrollee access to services designated to be provided by the essential community provider for the population that the essential community provider is certified to serve.  A health plan company may also make other providers available for these services.  A health plan company may require an essential community provider to meet all data requirements, utilization review, and quality assurance requirements on the same basis as other health plan providers.

 

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

 

Sec. 35.  Minnesota Statutes 2022, section 62Q.19, is amended by adding a subdivision to read:

 

Subd. 4a.  Contract payment rates; private.  An essential community provider and a health plan company may negotiate the payment rate for covered services provided by the essential community provider.  This rate must be at least the same rate per unit of service as is paid by the health plan company to the essential community provider under the provider contract between the two with the highest number of enrollees receiving health care services from the provider or, if there is no provider contract between the health plan company and the essential community provider, the rate must be at least the same rate per unit of service as is paid to other plan providers for the same or similar services.  The provider contract used to set the rate under this subdivision must be in relation to an individual, small group, or large group health plan.  This subdivision applies only to provider contracts in relation to individual, small employer, and large group health plans.

 

Sec. 36.  Minnesota Statutes 2022, section 62Q.19, subdivision 5, is amended to read:

 

Subd. 5.  Contract payment rates; public.  An essential community provider and a health plan company may negotiate the payment rate for covered services provided by the essential community provider.  This rate must be at least the same rate per unit of service as is paid to other health plan providers for the same or similar services.  This subdivision applies only to provider contracts in relation to health plans offered through the State Employee Group Insurance Program, medical assistance, and MinnesotaCare.

 

Sec. 37.  Minnesota Statutes 2023 Supplement, section 62Q.473, is amended by adding a subdivision to read:

 

Subd. 3.  Reimbursement.  The commissioner of commerce must reimburse health plan companies for coverage under this section.  Reimbursement is available only for coverage that would not have been provided by the health plan company without the requirements of this section.  Each fiscal year, an amount necessary to make payments to health plan companies to defray the cost of providing coverage under this section is appropriated to the commissioner of commerce.  Health plan companies must report to the commissioner quantified costs attributable to the additional benefit under this section in a format developed by the commissioner.  The commissioner must evaluate submissions and make payments to health plan companies as provided in Code of Federal Regulations, title 45, section 155.170.

 

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


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15848

Sec. 38.  Minnesota Statutes 2023 Supplement, section 62Q.522, subdivision 1, is amended to read:

 

Subdivision 1.  Definitions.  (a) The definitions in this subdivision apply to this section.

 

(b) "Closely held for-profit entity" means an entity that:

 

(1) is not a nonprofit entity;

 

(2) has more than 50 percent of the value of its ownership interest owned directly or indirectly by five or fewer owners; and

 

(3) has no publicly traded ownership interest.

 

For purposes of this paragraph:

 

(i) ownership interests owned by a corporation, partnership, limited liability company, estate, trust, or similar entity are considered owned by that entity's shareholders, partners, members, or beneficiaries in proportion to their interest held in the corporation, partnership, limited liability company, estate, trust, or similar entity;

 

(ii) ownership interests owned by a nonprofit entity are considered owned by a single owner;

 

(iii) ownership interests owned by all individuals in a family are considered held by a single owner.  For purposes of this item, "family" means brothers and sisters, including half-brothers and half-sisters, a spouse, ancestors, and lineal descendants; and

 

(iv) if an individual or entity holds an option, warrant, or similar right to purchase an ownership interest, the individual or entity is considered to be the owner of those ownership interests.

 

(c) (b) "Contraceptive method" means a drug, device, or other product approved by the Food and Drug Administration to prevent unintended pregnancy.

 

(d) (c) "Contraceptive service" means consultation, examination, procedures, and medical services related to the prevention of unintended pregnancy, excluding vasectomies.  This includes but is not limited to voluntary sterilization procedures, patient education, counseling on contraceptives, and follow-up services related to contraceptive methods or services, management of side effects, counseling for continued adherence, and device insertion or removal.

 

(e) "Eligible organization" means an organization that opposes providing coverage for some or all contraceptive methods or services on account of religious objections and that is:

 

(1) organized as a nonprofit entity and holds itself out to be religious; or

 

(2) organized and operates as a closely held for-profit entity, and the organization's owners or highest governing body has adopted, under the organization's applicable rules of governance and consistent with state law, a resolution or similar action establishing that the organization objects to covering some or all contraceptive methods or services on account of the owners' sincerely held religious beliefs.

 

(f) "Exempt organization" means an organization that is organized and operates as a nonprofit entity and meets the requirements of section 6033(a)(3)(A)(i) or (iii) of the Internal Revenue Code of 1986, as amended.


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15849

(g) (d) "Medical necessity" includes but is not limited to considerations such as severity of side effects, difference in permanence and reversibility of a contraceptive method or service, and ability to adhere to the appropriate use of the contraceptive method or service, as determined by the attending provider.

 

(h) (e) "Therapeutic equivalent version" means a drug, device, or product that can be expected to have the same clinical effect and safety profile when administered to a patient under the conditions specified in the labeling, and that:

 

(1) is approved as safe and effective;

 

(2) is a pharmaceutical equivalent:  (i) containing identical amounts of the same active drug ingredient in the same dosage form and route of administration; and (ii) meeting compendial or other applicable standards of strength, quality, purity, and identity;

 

(3) is bioequivalent in that:

 

(i) the drug, device, or product does not present a known or potential bioequivalence problem and meets an acceptable in vitro standard; or

 

(ii) if the drug, device, or product does present a known or potential bioequivalence problem, it is shown to meet an appropriate bioequivalence standard;

 

(4) is adequately labeled; and

 

(5) is manufactured in compliance with current manufacturing practice regulations.

 

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

 

Sec. 39.  Minnesota Statutes 2023 Supplement, section 62Q.523, subdivision 1, is amended to read:

 

Subdivision 1.  Scope of coverage.  Except as otherwise provided in section 62Q.522 62Q.679, subdivisions 2 and 3 and 4, all health plans that provide prescription coverage must comply with the requirements of this section.

 

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

 

Sec. 40.  [62Q.524] COVERAGE OF ABORTIONS AND ABORTION-RELATED SERVICES.

 

Subdivision 1.  Definition.  For purposes of this section, "abortion" means any medical treatment intended to induce the termination of a pregnancy with a purpose other than producing a live birth.

 

Subd. 2.  Required coverage; cost-sharing.  (a) A health plan must provide coverage for abortions and abortion-related services, including preabortion services and follow-up services.

 

(b) A health plan must not impose on the coverage under this section any co-payment, coinsurance, deductible, or other enrollee cost-sharing that is greater than the cost-sharing that applies to similar services covered under the health plan.

 

(c) A health plan must not impose any limitation on the coverage under this section, including but not limited to any utilization review, prior authorization, referral requirements, restrictions, or delays, that is not generally applicable to other coverages under the plan.


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15850

Subd. 3.  Exclusion.  This section does not apply to managed care organizations or county-based purchasing plans when the plan provides coverage to public health care program enrollees under chapter 256B or 256L.

 

Subd. 4.  Reimbursement.  The commissioner of commerce must reimburse health plan companies for coverage under this section.  Reimbursement is available only for coverage that would not have been provided by the health plan company without the requirements of this section.  Each fiscal year, an amount necessary to make payments to health plan companies to defray the cost of providing coverage under this section is appropriated to the commissioner of commerce.  Health plan companies must report to the commissioner quantified costs attributable to the additional benefit under this section in a format developed by the commissioner.  The commissioner must evaluate submissions and make payments to health plan companies as provided in Code of Federal Regulations, title 45, section 155.170.

 

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

 

Sec. 41.  [62Q.531] AMINO ACID-BASED FORMULA COVERAGE.

 

Subdivision 1.  Definition.  (a) For purposes of this section, the following term has the meaning given.

 

(b) "Formula" means an amino acid-based elemental formula.

 

Subd. 2.  Required coverage.  A health plan company must provide coverage for formula when formula is medically necessary.

 

Subd. 3.  Covered conditions.  Conditions for which formula is medically necessary include but are not limited to:

 

(1) cystic fibrosis;

 

(2) amino acid, organic acid, and fatty acid metabolic and malabsorption disorders;

 

(3) IgE mediated allergies to food proteins;

 

(4) food protein-induced enterocolitis syndrome;

 

(5) eosinophilic esophagitis;

 

(6) eosinophilic gastroenteritis;

 

(7) eosinophilic colitis; and

 

(8) mast cell activation syndrome.

 

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

 

Sec. 42.  [62Q.585] GENDER-AFFIRMING CARE COVERAGE; MEDICALLY NECESSARY CARE.

 

Subdivision 1.  Requirement.  No health plan that covers physical or mental health services may be offered, sold, issued, or renewed in this state that:

 

(1) excludes coverage for medically necessary gender-affirming care; or


Journal of the House - 113th Day - Tuesday, May 7, 2024 - Top of Page 15851

(2) requires gender-affirming treatments to satisfy a definition of "medically necessary care," "medical necessity," or any similar term that is more restrictive than the definition provided in subdivision 2.

 

Subd. 2.  Minimum definition.  "Medically necessary care" means health care services appropriate in terms of type, frequency, level, setting, and duration to the enrollee's diagnosis or condition and diagnostic testing and preventive services.  Medically necessary care must be consistent with generally accepted practice parameters as determined by health care providers in the same or similar general specialty as typically manages the condition, procedure, or treatment at issue and must: