Bill Text: MN HF1404 | 2013-2014 | 88th Legislature | Introduced
Bill Title: Durable medical equipment, prostethics, orthotics, or medical supplies exempted from the Medicare payment limit and the Medicare enrollment requirement.
Spectrum: Partisan Bill (Republican 2-0)
Status: (Introduced - Dead) 2013-03-14 - Author added Lohmer [HF1404 Detail]
Download: Minnesota-2013-HF1404-Introduced.html
1.2relating to human services; exempting providers of durable medical equipment,
1.3prosthetics, orthotics, or medical supplies from the Medicare payment limit
1.4and the Medicare enrollment requirement;amending Minnesota Statutes 2012,
1.5sections 256B.0625, subdivision 31; 256B.767.
1.6BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.7 Section 1. Minnesota Statutes 2012, section 256B.0625, subdivision 31, is amended to
1.8read:
1.9 Subd. 31. Medical supplies and equipment. (a) Medical assistance covers medical
1.10supplies and equipment. Separate payment outside of the facility's payment rate shall
1.11be made for wheelchairs and wheelchair accessories for recipients who are residents
1.12of intermediate care facilities for the developmentally disabled. Reimbursement for
1.13wheelchairs and wheelchair accessories for ICF/MR recipients shall be subject to the same
1.14conditions and limitations as coverage for recipients who do not reside in institutions. A
1.15wheelchair purchased outside of the facility's payment rate is the property of the recipient.
1.16The commissioner may set reimbursement rates for specified categories of medical
1.17supplies at levels below the Medicare payment rate.
1.18(b) Vendors of durable medical equipment, prosthetics, orthotics, or medical supplies
1.19must enroll as a Medicare provider, except as provided in paragraphs (c) and (e).
1.20(c) When necessary to ensure access to durable medical equipment, prosthetics,
1.21orthotics, or medical supplies, the commissioner may exempt a vendor from the Medicare
1.22enrollment requirement if:
1.23(1) the vendor supplies only one type of durable medical equipment, prosthetic,
1.24orthotic, or medical supply;
1.25(2) the vendor serves ten or fewer medical assistance recipients per year;
2.1(3) the commissioner finds that other vendors are not available to provide same or
2.2similar durable medical equipment, prosthetics, orthotics, or medical supplies; and
2.3(4) the vendor complies with all screening requirements in this chapter and Code of
2.4Federal Regulations, title 42, part 455. The commissioner may also exempt a vendor from
2.5the Medicare enrollment requirement if the vendor is accredited by a Centers for Medicare
2.6and Medicaid Services approved national accreditation organization as complying with
2.7the Medicare program's supplier and quality standards and the vendor serves primarily
2.8pediatric patients.
2.9(d) Durable medical equipment means a device or equipment that:
2.10(1) can withstand repeated use;
2.11(2) is generally not useful in the absence of an illness, injury, or disability; and
2.12(3) is provided to correct or accommodate a physiological disorder or physical
2.13condition or is generally used primarily for a medical purpose.
2.14(e) The commissioner may exempt a vendor of durable medical equipment,
2.15prosthetics, orthotics, or medical supplies from the Medicare enrollment requirement, if
2.16the vendor is providing a service or item that is covered for the recipient under medical
2.17assistance, but is not covered under Medicare.
2.18EFFECTIVE DATE.This section is effective July 1, 2013.
2.19 Sec. 2. Minnesota Statutes 2012, section 256B.767, is amended to read:
2.20256B.767 MEDICARE PAYMENT LIMIT.
2.21(a) Effective for services rendered on or after July 1, 2010, fee-for-service payment
2.22rates for physician and professional services under section256B.76, subdivision 1 , and
2.23basic care services subject to the rate reduction specified in section256B.766 , shall not
2.24exceed the Medicare payment rate for the applicable service, as adjusted for any changes
2.25in Medicare payment rates after July 1, 2010. The commissioner shall implement this
2.26section after any other rate adjustment that is effective July 1, 2010, and shall reduce rates
2.27under this section by first reducing or eliminating provider rate add-ons.
2.28(b) This section does not apply to services provided by advanced practice certified
2.29nurse midwives licensed under chapter 148 or traditional midwives licensed under chapter
2.30147D. Notwithstanding this exemption, medical assistance fee-for-service payment rates
2.31for advanced practice certified nurse midwives and licensed traditional midwives shall
2.32equal and shall not exceed the medical assistance payment rate to physicians for the
2.33applicable service.
3.1(c) This section does not apply to mental health services or physician services billed
3.2by a psychiatrist or an advanced practice registered nurse with a specialty in mental health.
3.3(d) This section does not apply to payments for durable medical equipment,
3.4prosthetics, orthotics, or supplies.
3.5EFFECTIVE DATE.This section is effective July 1, 2013.
1.3prosthetics, orthotics, or medical supplies from the Medicare payment limit
1.4and the Medicare enrollment requirement;amending Minnesota Statutes 2012,
1.5sections 256B.0625, subdivision 31; 256B.767.
1.6BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.7 Section 1. Minnesota Statutes 2012, section 256B.0625, subdivision 31, is amended to
1.8read:
1.9 Subd. 31. Medical supplies and equipment. (a) Medical assistance covers medical
1.10supplies and equipment. Separate payment outside of the facility's payment rate shall
1.11be made for wheelchairs and wheelchair accessories for recipients who are residents
1.12of intermediate care facilities for the developmentally disabled. Reimbursement for
1.13wheelchairs and wheelchair accessories for ICF/MR recipients shall be subject to the same
1.14conditions and limitations as coverage for recipients who do not reside in institutions. A
1.15wheelchair purchased outside of the facility's payment rate is the property of the recipient.
1.16The commissioner may set reimbursement rates for specified categories of medical
1.17supplies at levels below the Medicare payment rate.
1.18(b) Vendors of durable medical equipment, prosthetics, orthotics, or medical supplies
1.19must enroll as a Medicare provider, except as provided in paragraphs (c) and (e).
1.20(c) When necessary to ensure access to durable medical equipment, prosthetics,
1.21orthotics, or medical supplies, the commissioner may exempt a vendor from the Medicare
1.22enrollment requirement if:
1.23(1) the vendor supplies only one type of durable medical equipment, prosthetic,
1.24orthotic, or medical supply;
1.25(2) the vendor serves ten or fewer medical assistance recipients per year;
2.1(3) the commissioner finds that other vendors are not available to provide same or
2.2similar durable medical equipment, prosthetics, orthotics, or medical supplies; and
2.3(4) the vendor complies with all screening requirements in this chapter and Code of
2.4Federal Regulations, title 42, part 455. The commissioner may also exempt a vendor from
2.5the Medicare enrollment requirement if the vendor is accredited by a Centers for Medicare
2.6and Medicaid Services approved national accreditation organization as complying with
2.7the Medicare program's supplier and quality standards and the vendor serves primarily
2.8pediatric patients.
2.9(d) Durable medical equipment means a device or equipment that:
2.10(1) can withstand repeated use;
2.11(2) is generally not useful in the absence of an illness, injury, or disability; and
2.12(3) is provided to correct or accommodate a physiological disorder or physical
2.13condition or is generally used primarily for a medical purpose.
2.14(e) The commissioner may exempt a vendor of durable medical equipment,
2.15prosthetics, orthotics, or medical supplies from the Medicare enrollment requirement, if
2.16the vendor is providing a service or item that is covered for the recipient under medical
2.17assistance, but is not covered under Medicare.
2.18EFFECTIVE DATE.This section is effective July 1, 2013.
2.19 Sec. 2. Minnesota Statutes 2012, section 256B.767, is amended to read:
2.20256B.767 MEDICARE PAYMENT LIMIT.
2.21(a) Effective for services rendered on or after July 1, 2010, fee-for-service payment
2.22rates for physician and professional services under section
2.23basic care services subject to the rate reduction specified in section
2.24exceed the Medicare payment rate for the applicable service, as adjusted for any changes
2.25in Medicare payment rates after July 1, 2010. The commissioner shall implement this
2.26section after any other rate adjustment that is effective July 1, 2010, and shall reduce rates
2.27under this section by first reducing or eliminating provider rate add-ons.
2.28(b) This section does not apply to services provided by advanced practice certified
2.29nurse midwives licensed under chapter 148 or traditional midwives licensed under chapter
2.30147D. Notwithstanding this exemption, medical assistance fee-for-service payment rates
2.31for advanced practice certified nurse midwives and licensed traditional midwives shall
2.32equal and shall not exceed the medical assistance payment rate to physicians for the
2.33applicable service.
3.1(c) This section does not apply to mental health services or physician services billed
3.2by a psychiatrist or an advanced practice registered nurse with a specialty in mental health.
3.3(d) This section does not apply to payments for durable medical equipment,
3.4prosthetics, orthotics, or supplies.
3.5EFFECTIVE DATE.This section is effective July 1, 2013.
