Bill Text: MN SF716 | 2011-2012 | 87th Legislature | Introduced
Bill Title: Prepaid health plans medical assistance (MA) program segregated accounting maintenance requirement
Spectrum: Partisan Bill (Republican 1-0)
Status: (Introduced - Dead) 2011-03-10 - Referred to Health and Human Services [SF716 Detail]
Download: Minnesota-2011-SF716-Introduced.html
1.2relating to human services; requiring segregated accounting under prepaid
1.3medical assistance under certain circumstances;amending Minnesota Statutes
1.42010, section 256B.69, subdivision 9.
1.5BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.6 Section 1. Minnesota Statutes 2010, section 256B.69, subdivision 9, is amended to read:
1.7 Subd. 9. Reporting. (a) Each demonstration provider shall submit information as
1.8required by the commissioner, including data required for assessing client satisfaction,
1.9quality of care, cost, and utilization of services for purposes of project evaluation. The
1.10commissioner shall also develop methods of data reporting and collection in order to
1.11provide aggregate enrollee information on encounters and outcomes to determine access
1.12and quality assurance. Required information shall be specified before the commissioner
1.13contracts with a demonstration provider.
1.14(b) Aggregate nonpersonally identifiable health plan encounter data, aggregate
1.15spending data for major categories of service as reported to the commissioners of
1.16health and commerce under section62D.08 , subdivision 3, clause (a), and criteria for
1.17service authorization and service use are public data that the commissioner shall make
1.18available and use in public reports. The commissioner shall require each health plan and
1.19county-based purchasing plan to provide:
1.20(1) encounter data for each service provided, using standard codes and unit of
1.21service definitions set by the commissioner, in a form that the commissioner can report by
1.22age, eligibility groups, and health plan; and
2.1(2) criteria, written policies, and procedures required to be disclosed under section
2.262M.10
, subdivision 7, and Code of Federal Regulations, title 42, part
438.210 (b)(1), used
2.3for each type of service for which authorization is required.
2.4(c) If a demonstration provider asserts that its formulas, protocols, or methodologies
2.5of paying health care providers are trade secrets, the demonstration provider shall maintain
2.6segregated accounts for the prepaid medical assistance and other public programs.
1.3medical assistance under certain circumstances;amending Minnesota Statutes
1.42010, section 256B.69, subdivision 9.
1.5BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.6 Section 1. Minnesota Statutes 2010, section 256B.69, subdivision 9, is amended to read:
1.7 Subd. 9. Reporting. (a) Each demonstration provider shall submit information as
1.8required by the commissioner, including data required for assessing client satisfaction,
1.9quality of care, cost, and utilization of services for purposes of project evaluation. The
1.10commissioner shall also develop methods of data reporting and collection in order to
1.11provide aggregate enrollee information on encounters and outcomes to determine access
1.12and quality assurance. Required information shall be specified before the commissioner
1.13contracts with a demonstration provider.
1.14(b) Aggregate nonpersonally identifiable health plan encounter data, aggregate
1.15spending data for major categories of service as reported to the commissioners of
1.16health and commerce under section
1.17service authorization and service use are public data that the commissioner shall make
1.18available and use in public reports. The commissioner shall require each health plan and
1.19county-based purchasing plan to provide:
1.20(1) encounter data for each service provided, using standard codes and unit of
1.21service definitions set by the commissioner, in a form that the commissioner can report by
1.22age, eligibility groups, and health plan; and
2.1(2) criteria, written policies, and procedures required to be disclosed under section
2.3for each type of service for which authorization is required.
2.4(c) If a demonstration provider asserts that its formulas, protocols, or methodologies
2.5of paying health care providers are trade secrets, the demonstration provider shall maintain
2.6segregated accounts for the prepaid medical assistance and other public programs.
