Bill Text: MN SF474 | 2011-2012 | 87th Legislature | Introduced
Bill Title: Managed care and county-based purchasing plans provider payment rates increase and generally accepted accounting principles requirements
Spectrum: Partisan Bill (Republican 1-0)
Status: (Introduced - Dead) 2011-02-28 - Referred to Health and Human Services [SF474 Detail]
Download: Minnesota-2011-SF474-Introduced.html
1.2relating to human services; requiring increases in managed care and county-based
1.3purchasing plan provider payment rates; requiring plans to use generally accepted
1.4accounting principles; amending Minnesota Statutes 2010, section 256B.69,
1.5subdivision 9, by adding a subdivision.
1.6BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.7 Section 1. Minnesota Statutes 2010, section 256B.69, is amended by adding a
1.8subdivision to read:
1.9 Subd. 5l. Provider payment rates. (a) Effective January 1, 2012, managed care and
1.10county-based purchasing plans shall increase payment rates to providers under contract or
1.11employed by the plan by 15 percent from the rates in effect on December 31, 2011.
1.12(b) The commissioner shall not adjust managed care and county-based purchasing
1.13plan capitation rates to reflect the rate changes required by this subdivision.
1.14(c) The commissioner shall require managed care and county-based purchasing plans
1.15to submit to the commissioner, in the form and manner specified by the commissioner, all
1.16data needed to verify compliance with this subdivision. Data provided to the commissioner
1.17under this subdivision are public data as defined under section 13.02.
1.18 Sec. 2. Minnesota Statutes 2010, section 256B.69, subdivision 9, is amended to read:
1.19 Subd. 9. Reporting. (a) Each demonstration provider shall submit information as
1.20required by the commissioner, including data required for assessing client satisfaction,
1.21quality of care, cost, and utilization of services for purposes of project evaluation. The
1.22commissioner shall also develop methods of data reporting and collection in order to
1.23provide aggregate enrollee information on encounters and outcomes to determine access
2.1and quality assurance. Required information shall be specified before the commissioner
2.2contracts with a demonstration provider.
2.3(b) Aggregate nonpersonally identifiable health plan encounter data, aggregate
2.4spending data for major categories of service as reported to the commissioners of
2.5health and commerce under section62D.08 , subdivision 3, clause (a), and criteria for
2.6service authorization and service use are public data that the commissioner shall make
2.7available and use in public reports. The commissioner shall require each health plan and
2.8county-based purchasing plan to provide:
2.9(1) encounter data for each service provided, using standard codes and unit of
2.10service definitions set by the commissioner, in a form that the commissioner can report by
2.11age, eligibility groups, and health plan; and
2.12(2) criteria, written policies, and procedures required to be disclosed under section
2.1362M.10
, subdivision 7, and Code of Federal Regulations, title 42, part
438.210 (b)(1), used
2.14for each type of service for which authorization is required.
2.15(c) All financial reporting, including administrative expenses, under this section or
2.16section 256B.692, must be reported in compliance with generally accepted accounting
2.17principles.
2.18EFFECTIVE DATE.This section is effective January 1, 2012.
1.3purchasing plan provider payment rates; requiring plans to use generally accepted
1.4accounting principles; amending Minnesota Statutes 2010, section 256B.69,
1.5subdivision 9, by adding a subdivision.
1.6BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.7 Section 1. Minnesota Statutes 2010, section 256B.69, is amended by adding a
1.8subdivision to read:
1.9 Subd. 5l. Provider payment rates. (a) Effective January 1, 2012, managed care and
1.10county-based purchasing plans shall increase payment rates to providers under contract or
1.11employed by the plan by 15 percent from the rates in effect on December 31, 2011.
1.12(b) The commissioner shall not adjust managed care and county-based purchasing
1.13plan capitation rates to reflect the rate changes required by this subdivision.
1.14(c) The commissioner shall require managed care and county-based purchasing plans
1.15to submit to the commissioner, in the form and manner specified by the commissioner, all
1.16data needed to verify compliance with this subdivision. Data provided to the commissioner
1.17under this subdivision are public data as defined under section 13.02.
1.18 Sec. 2. Minnesota Statutes 2010, section 256B.69, subdivision 9, is amended to read:
1.19 Subd. 9. Reporting. (a) Each demonstration provider shall submit information as
1.20required by the commissioner, including data required for assessing client satisfaction,
1.21quality of care, cost, and utilization of services for purposes of project evaluation. The
1.22commissioner shall also develop methods of data reporting and collection in order to
1.23provide aggregate enrollee information on encounters and outcomes to determine access
2.1and quality assurance. Required information shall be specified before the commissioner
2.2contracts with a demonstration provider.
2.3(b) Aggregate nonpersonally identifiable health plan encounter data, aggregate
2.4spending data for major categories of service as reported to the commissioners of
2.5health and commerce under section
2.6service authorization and service use are public data that the commissioner shall make
2.7available and use in public reports. The commissioner shall require each health plan and
2.8county-based purchasing plan to provide:
2.9(1) encounter data for each service provided, using standard codes and unit of
2.10service definitions set by the commissioner, in a form that the commissioner can report by
2.11age, eligibility groups, and health plan; and
2.12(2) criteria, written policies, and procedures required to be disclosed under section
2.14for each type of service for which authorization is required.
2.15(c) All financial reporting, including administrative expenses, under this section or
2.16section 256B.692, must be reported in compliance with generally accepted accounting
2.17principles.
2.18EFFECTIVE DATE.This section is effective January 1, 2012.
