Title Minnesota Statutes, Minnesota Statutes

256B.4907 ADVISORY TASK FORCE ON WAIVER REIMAGINE. § Subdivision 1.Membership; co-chairs. (a) The Advisory Task Force on Waiver Reimagine consists of the following members: (1) one member of the house of representatives, appointed by the speaker of the house; (2) one member of th…

256B.4911 CONSUMER-DIRECTED COMMUNITY SUPPORTS. § Subdivision 1.Federal authority. Consumer-directed community supports, as referenced in sections 256B.0913, subdivision 5, paragraph (a), clause (17); 256B.092, subdivision 1b, clause (4); 256B.49, subdivision 16, paragraph (c); a…

256B.4912 HOME AND COMMUNITY-BASED WAIVERS; PROVIDERS AND PAYMENT. § Subdivision 1.Provider qualifications. (a) For the home and community-based waivers providing services to seniors and individuals with disabilities under chapter 256S and sections 256B.0913, 256B.092, and 256B.4…

256B.4914 HOME AND COMMUNITY-BASED SERVICES WAIVERS; RATE SETTING. § Subdivision 1.Application. The payment methodologies in this section apply to home and community-based services waivers under sections 256B.092 and 256B.49. This section does not change existing waiver policies …

256B.492 HOME AND COMMUNITY-BASED SETTINGS FOR PEOPLE WITH DISABILITIES. § Subdivision 1.Definitions. (a) For the purposes of this section, the following terms have the meanings given. (b) "Community-living setting" means a single-family home or multifamily dwelling unit where a …

256B.493 ADULT FOSTER CARE PLANNED CLOSURE. § Subdivision 1.Commissioner's duties; report. The commissioner of human services has the authority to manage statewide licensed corporate foster care or community residential settings capacity, including the reduction and realignment o…

256B.50 APPEALS. § Subdivision 1.Scope. A provider may appeal from a determination of a payment rate established pursuant to this chapter or allowed costs under chapter 256R if the appeal, if successful, would result in a change to the provider's payment rate or to the calculatio…

256B.501 RATES FOR COMMUNITY-BASED SERVICES FOR PERSONS WITH DISABILITIES. § Subdivision 1.Definitions. For the purposes of this section, the following terms have the meanings given them. (a) "Commissioner" means the commissioner of human services. (b) "Facility" means a facility…

256B.5011 ICF/DD REIMBURSEMENT SYSTEM EFFECTIVE OCTOBER 1, 2000. § Subdivision 1.In general. Effective October 1, 2000, the commissioner shall implement a contracting system to replace the current method of setting total cost payment rates under section 256B.501 and Minnesota Rul…

256B.5012 ICF/DD PAYMENT SYSTEM IMPLEMENTATION. § Subdivision 1.Total payment rate. The total payment rate effective October 1, 2000, for existing ICF/DD facilities is the total of the operating payment rate and the property payment rate plus inflation factors as defined in this …

256B.5013 PAYMENT RATE ADJUSTMENTS. § Subdivision 1.Variable rate adjustments. (a) When there is a documented increase in the needs of a current ICF/DD recipient, the county of financial responsibility may recommend a variable rate to enable the facility to meet the individual's …

256B.5014 REPORTING REQUIREMENTS. § Subdivision 1.Financial reporting. All facilities shall maintain financial records and shall provide annual income and expense reports to the commissioner of human services on a form prescribed by the commissioner no later than April 30 of each…

256B.5015 PASS-THROUGH OF OTHER SERVICES COSTS. § Subdivision 1.Day training and habilitation services. Day training and habilitation services costs shall be paid as a pass-through payment at the lowest rate paid for the comparable services at that site under sections 252.41 to 2…

256B.502 RULES. The commissioners of health and human services shall promulgate rules necessary to implement Laws 1983, chapter 199. History: 1983 c 199 s 16; 1984 c 640 s 32; 1984 c 654 art 5 s 58; 1996 c 305 art 2 s 51; 1997 c 187 art 5 s 29

256B.51 NURSING HOMES; COST OF HOME CARE. § Subdivision 1.In-home care for elderly; experimental program. To determine the effectiveness of home care in providing or arranging for the care and services which would normally be provided in a nursing home, the commissioner of human …

256B.69 PREPAID HEALTH PLANS. § Subdivision 1.Purpose. The commissioner of human services shall establish a medical assistance demonstration project to determine whether prepayment combined with better management of health care services is an effective mechanism to ensure that al…

256B.6903 OMBUDSPERSON FOR MANAGED CARE. § Subdivision 1.Definitions. (a) For purposes of this section, the following terms have the meanings given them. (b) "Adverse benefit determination" has the meaning provided in Code of Federal Regulations, title 42, section 438.400, subpar…

256B.691 RISK-BASED TRANSPORTATION PAYMENTS. Any contract with a prepaid health plan under the medical assistance or MinnesotaCare program that requires the health plan to cover transportation services for obtaining medical care for eligible individuals who are ambulatory must pr…

256B.692 COUNTY-BASED PURCHASING. § Subdivision 1.In general. County boards or groups of county boards may elect to purchase or provide health care services on behalf of persons eligible for medical assistance who would otherwise be required to or may elect to participate in the …

256B.6925 ENROLLEE INFORMATION. § Subdivision 1.Information provided by commissioner. The commissioner shall provide to each potential enrollee the following information: (1) basic features of receiving services through managed care; (2) which individuals are excluded from manage…

256B.6926 STATE MONITORING. § Subdivision 1.Generally. (a) The commissioner shall establish a monitoring system that addresses all aspects of the managed care program, including the performance of each managed care organization in the areas identified under Code of Federal Regula…

256B.6927 QUALITY ASSESSMENT AND PERFORMANCE. § Subdivision 1.Definitions. (a) For the purposes of this section, the following terms have the meanings given them. (b) "Access" means the availability and timely use of services to achieve optimal outcomes as required under Code of …

256B.6928 MANAGED CARE RATES AND PAYMENTS. § Subdivision 1.Definitions. (a) For the purposes of this section, the following terms have the meanings given them. (b) "Base amount" has the meaning given in Code of Federal Regulations, part 42, section 438.6, paragraph (a). (c) "Budg…

256B.693 STATE-OPERATED SERVICES; MANAGED CARE. § Subdivision 1.Proposals for managed care; role of state-operated services. Any proposal integrating state-operated services with managed care systems for persons with disabilities must identify the specific role to be assumed by s…

256B.694 SOLE-SOURCE OR SINGLE-PLAN MANAGED CARE CONTRACT. The commissioner shall consider, and may approve, contracting on a single-health plan basis with county-based purchasing plans, or with other qualified health plans that have coordination arrangements with counties, to se…

256B.695 COUNTY-ADMINISTERED RURAL MEDICAL ASSISTANCE PROGRAM. § Subdivision 1.Definitions. (a) For the purposes of this section, the following terms have the meanings given. (b) "CARMA" means the county-administered rural medical assistance program established under this section…

256B.696 PRESCRIPTION DRUGS; STATE PHARMACY BENEFIT MANAGER. § Subdivision 1.Definitions. (a) For purposes of this section, the following terms have the meanings given. (b) "Managed care enrollees" means medical assistance and MinnesotaCare enrollees receiving coverage from manag…

256B.70 DEMONSTRATION PROJECT WAIVER. Each hospital that participates as a provider in a demonstration project, established by the commissioner of human services to deliver medical assistance, or substance use disorder services on a prepaid, capitation basis, is exempt from the p…

256B.71 SOCIAL HEALTH MAINTENANCE ORGANIZATION DEMONSTRATION. § Subdivision 1.Purpose. The commissioner of human services may participate in social health maintenance organization demonstration projects to determine if prepayment combined with the delivery of alternative services…

256B.72 COMMISSIONER'S RECOVERY OF OVERPAYMENTS. The commissioner shall not recover overpayments from medical assistance vendors if an administrative appeal or judicial action challenging the proposed recovery is pending. History: 1Sp1985 c 9 art 2 s 54

256B.73 DEMONSTRATION PROJECT FOR UNINSURED LOW-INCOME PERSONS. § Subdivision 1.Purpose. The purpose of the demonstration project is to determine the need for and the feasibility of establishing a statewide program of medical insurance for uninsured low-income persons. § Subd. 2.…

256B.74 SPECIAL PAYMENTS. § Subdivision 1.Hospital reimbursement. Effective for services rendered on or after July 1, 1991, the commissioner shall reimburse outpatient hospital facility fees at 80 percent of calendar year 1990 submitted charges, not to exceed the Medicare upper p…

256B.75 HOSPITAL OUTPATIENT REIMBURSEMENT. (a) For outpatient hospital facility fee payments for services rendered on or after October 1, 1992, the commissioner of human services shall pay the lower of (1) submitted charge, or (2) 32 percent above the rate in effect on June 30, 1…

256B.756 REIMBURSEMENT RATES FOR BIRTHS. § Subdivision 1.Provider rate. (a) Notwithstanding section 256B.76, effective for services provided on or after October 1, 2009, the payment rate for professional services related to labor, delivery, and antepartum and postpartum care when…

256B.758 REIMBURSEMENT FOR DOULA SERVICES. (a) Effective for services provided on or after July 1, 2019, through December 31, 2023, payments for doula services provided by a certified doula shall be $47 per prenatal or postpartum visit and $488 for attending and providing doula s…

256B.76 PHYSICIAN, PROFESSIONAL SERVICES, AND DENTAL REIMBURSEMENT. § Subdivision 1.Physician and professional services reimbursement adjustments. (a) Effective for services rendered on or after October 1, 1992, the commissioner shall make payments for physician services as follo…

256B.761 REIMBURSEMENT FOR MENTAL HEALTH SERVICES. § Subdivision 1.Rates effective 2026. (a) Effective for services rendered on or after January 1, 2026, or on or after the date of federal approval, whichever is later, the commissioner must establish and pay market-based payment …

256B.762 REIMBURSEMENT FOR HEALTH CARE SERVICES. (a) Effective for services provided on or after October 1, 2005, payment rates for the following services shall be increased by five percent over the rates in effect on September 30, 2005, when these services are provided as home h…

256B.763 CRITICAL ACCESS MENTAL HEALTH RATE INCREASE. § Subdivision 1.Rate add-on. (a) For services defined in paragraph (b) and rendered on or after July 1, 2007, payment rates shall be increased by 23.7 percent over the rates in effect on January 1, 2006, for: (1) psychiatrists…

256B.7635 REIMBURSEMENT FOR EVIDENCE-BASED PUBLIC HEALTH NURSE HOME VISITS. Effective for services provided on or after January 1, 2018, prenatal and postpartum follow-up home visits provided by public health nurses or registered nurses supervised by a public health nurse using e…

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 c…

256B.765 PROVIDER RATE INCREASES. (a) Effective July 1, 2001, within the limits of appropriations specifically for this purpose, the commissioner shall provide an annual inflation adjustment for the providers listed in paragraph (c). The index for the inflation adjustment must be…

256B.766 REIMBURSEMENT FOR BASIC CARE SERVICES. § Subdivision 1.Payment reductions for base care services effective July 1, 2009. Effective for services provided on or after July 1, 2009, total payments for basic care services, shall be reduced by three percent, except that for t…

256B.767 MEDICARE PAYMENT LIMIT. (a) Effective for services rendered on or after July 1, 2010, fee-for-service payment rates for physician and professional services under section 256B.76, subdivision 1, and basic care services subject to the rate reduction specified in section 25…

256B.77 COORDINATED SERVICE DELIVERY SYSTEM FOR PERSONS WITH DISABILITIES. § Subdivision 1.Demonstration project for persons with disabilities. (a) The commissioner of human services, in cooperation with county authorities, shall develop and implement a demonstration project to c…

256B.771 COMPLEMENTARY AND ALTERNATIVE MEDICINE DEMONSTRATION PROJECT. § Subdivision 1.Establishment and implementation. The commissioner of human services shall contract with a Minnesota-based academic or clinical research institution or institutions specializing in providing co…