1.1.................... moves to amend H.F. No. 927, the first engrossment, as follows:
1.2Page 205, after line 20, insert:

1.4(a) The commissioner of human services shall present recommendations to the
1.5legislature by December 15, 2011, for a reformed health care delivery system under
1.6which enrolled provider networks provide basic health care services to qualified medical
1.7assistance and MinnesotaCare enrollees, supplemented by a major medical or stop-loss
1.8policy. For purposes of this section, "enrolled provider network" means a health care
1.9provider or group of health care providers that contracts with the commissioner to meet
1.10standards related to quality, affordability, and patient satisfaction for the provision of
1.11basic care services.
1.12(b) The recommendations must address:
1.13(1) eligibility, quality, reporting, fiscal solvency, and other criteria for enrolled
1.14provider networks;
1.15(2) the geographic area of the state in which the reformed delivery system is to be
1.16implemented, including a schedule for any phase-in of the new delivery system;
1.17(3) methods to coordinate care delivery through enrolled provider networks with
1.18care delivery through managed care and county-based purchasing plans, and the extent
1.19to which care delivery through enrolled provider networks should replace care delivery
1.20through managed care and county-based purchasing plans;
1.21(4) the extent to which managed care and county-based purchasing plans should
1.22provide claims processing, administrative, quality assurance, and other services for
1.23enrolled provider networks and the commissioner;
1.24(5) the definition of basic care services, criteria for stop-loss coverage or
1.25major-medical coverage, and the extent to which risk-sharing should be applied to
1.26enrolled provider networks;
2.1(6) the extent to which certain health care services should continue to be delivered
2.2through fee-for-service;
2.3(7) eligibility criteria for medical assistance and MinnesotaCare enrollees to be
2.4served by enrolled provider networks, and whether enrollee participation should be
2.5mandatory or voluntary;
2.6(8) enrollee cost-sharing and premiums;
2.7(9) methods to coordinate the delivery of care through enrolled provider networks
2.8with state and federal initiatives related to health care homes and care coordination, quality
2.9improvement, and payment reform; and
2.10(10) the extent to which federal waivers and approval will be necessary for
2.12(c) The report must include an estimate of the costs and savings to the state of
2.13delivering care through enrolled provider networks, and an implementation plan and
2.14timeline for establishing the reformed health care delivery system."
2.15Renumber the sections in sequence and correct the internal references
2.16Amend the title accordingly