1.1 A bill for an act
1.2 relating to health; guaranteeing that health care is available and affordable for
1.3 every Minnesotan; establishing the Minnesota Health Plan, Minnesota Health
1.4 Board, Minnesota Health Fund, Office of Health Quality and Planning, ombudsman
1.5 for patient advocacy, and auditor general for the Minnesota Health Plan; requesting
1.6 an Affordable Care Act 1332 waiver; authorizing rulemaking; making conforming
1.7 changes; requiring a report; appropriating money; amending Minnesota Statutes
1.8 2024, sections 13.3806, by adding a subdivision; 14.03, subdivisions 2, 3;
1.9 15A.0815, subdivision 2; proposing coding for new law as Minnesota Statutes,
1.10 chapter 62X.
1.11BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.12 ARTICLE 1
1.13 MINNESOTA HEALTH PLAN
1.14 Section 1. [62X.01] HEALTH PLAN REQUIREMENTS.
1.15 In order to keep Minnesota residents healthy and provide the best quality of health care,
1.16the Minnesota Health Plan must:
1.17 (1) ensure all Minnesota residents are covered;
1.18 (2) cover all necessary care, including medical, dental, vision and hearing, mental health,
1.19chemical dependency treatment, prescription drugs, medical equipment and supplies,
1.20long-term care, and home care;
1.21 (3) allow patients to choose their providers;
1.22 (4) reduce costs by negotiating fair prices and by cutting administrative bureaucracy,
1.23not by restricting or denying care;
1Article 1 Section 1.
25-02772 as introduced01/24/25 REVISOR SGS/LJ
SENATE
STATE OF MINNESOTA
S.F. No. 932NINETY-FOURTH SESSION
(SENATE AUTHORS: JOHNSON STEWART, Pappas, Mohamed, Fateh and Mitchell)
OFFICIAL STATUSD-PGDATE
Introduction and first reading02/03/2025
Referred to Commerce and Consumer Protection 2.1 (5) be affordable to all through premiums based on ability to pay and elimination of
2.2co-pays;
2.3 (6) focus on preventive care and early intervention to improve health;
2.4 (7) ensure that there are enough health care providers to guarantee timely access to care;
2.5 (8) continue Minnesota's leadership in medical education, research, and technology;
2.6 (9) provide adequate and timely payments to providers; and
2.7 (10) use a simple funding and payment system.
2.8 Sec. 2. [62X.02] MINNESOTA HEALTH PLAN GENERAL PROVISIONS.
2.9 Subdivision 1.Short title.This chapter may be cited as the "Minnesota Health Plan."
2.10 Subd. 2.Purpose.The Minnesota Health Plan shall provide all medically necessary
2.11health care services for all Minnesota residents in a manner that meets the requirements in
2.12section 62X.01.
2.13 Subd. 3.Definitions.As used in this chapter, the following terms have the meanings
2.14provided:
2.15 (a) "Board" means the Minnesota Health Board.
2.16 (b) "Plan" means the Minnesota Health Plan.
2.17 (c) "Fund" means the Minnesota Health Fund.
2.18 (d) "Medically necessary" means services or supplies needed to promote health and to
2.19prevent, diagnose, or treat a particular patient's medical condition that meet accepted
2.20standards of medical practice within a provider's professional peer group and geographic
2.21region.
2.22 (e) "Institutional provider" means an inpatient hospital, nursing facility, rehabilitation
2.23facility, and other health care facilities that provide overnight care.
2.24 (f) "Noninstitutional provider" means individual providers, group practices, clinics,
2.25outpatient surgical centers, imaging centers, and other health facilities that do not provide
2.26overnight care.
2Article 1 Sec. 2.
25-02772 as introduced01/24/25 REVISOR SGS/LJ 3.1 ARTICLE 2
3.2 ELIGIBILITY
3.3 Section 1. [62X.03] ELIGIBILITY.
3.4 Subdivision 1.Residency.All Minnesota residents are eligible for the Minnesota Health
3.5Plan.
3.6 Subd. 2.Enrollment; identification.The Minnesota Health Board shall establish a
3.7procedure to enroll residents and provide each with identification that may be used by health
3.8care providers to confirm eligibility for services. The application for enrollment shall be no
3.9more than two pages.
3.10 Subd. 3.Premium remittance.All Minnesota residents must pay the plan premiums
3.11beginning on the date when the resident becomes eligible under the plan. Minnesota residents
3.12are eligible for the plan even if they have not filled out the enrollment form.
3.13 Subd. 4.Residents temporarily out of state.(a) The Minnesota Health Plan shall
3.14provide health care coverage to Minnesota residents who are temporarily out of the state
3.15who intend to return and reside in Minnesota.
3.16 (b) Coverage for emergency care obtained out of state shall be at prevailing local rates.
3.17Coverage for nonemergency care obtained out of state, or routine care obtained out of state
3.18by people living in border communities, shall be according to rates and conditions established
3.19by the board.
3.20 Subd. 5.Visitors.Nonresidents visiting Minnesota shall be billed by the board for all
3.21services received under the Minnesota Health Plan. The board may enter into
3.22intergovernmental arrangements or contracts with other states and countries to provide
3.23reciprocal coverage for temporary visitors.
3.24 Subd. 6.Nonresident employed in Minnesota.The board shall extend eligibility to
3.25nonresidents employed in Minnesota under a premium schedule set by the board.
3.26 Subd. 7.Business outside of Minnesota employing Minnesota residents.The board
3.27shall apply for a federal waiver to collect the employer contribution mandated by federal
3.28law.
3.29 Subd. 8.Retiree benefits.All persons who are eligible for retiree medical benefits under
3.30an employer-employee contract shall remain eligible for those benefits.
3.31 Subd. 9.Presumptive eligibility.(a) An individual is presumed eligible for coverage
3.32under the Minnesota Health Plan if the individual arrives at a health facility unconscious,
3Article 2 Section 1.
25-02772 as introduced01/24/25 REVISOR SGS/LJ 4.1comatose, or otherwise unable, because of the individual's physical or mental condition, to
4.2document eligibility or to act on the individual's own behalf. If the patient is a minor, the
4.3patient is presumed eligible, and the health facility shall provide care as if the patient were
4.4eligible.
4.5 (b) Any individual is presumed eligible when brought to a health facility.
4.6 (c) Any individual involuntarily committed to an acute psychiatric facility or to a hospital
4.7with psychiatric beds is presumed eligible.
4.8 (d) All health facilities subject to state and federal provisions governing emergency
4.9medical treatment must comply with those provisions.
4.10 Subd. 10.Data.Data collected because an individual applies for or is enrolled in the
4.11Minnesota Health Plan are private data on individuals as defined in section 13.02, subdivision
4.1212, but may be released to:
4.13 (1) providers for purposes of confirming enrollment and processing payments for benefits;
4.14 (2) the ombudsman for patient advocacy for purposes of performing duties under section
4.1562X.12 or 62X.13; or
4.16 (3) the auditor general for purposes of performing duties under section 62X.14.
4.17 Sec. 2. Minnesota Statutes 2024, section 13.3806, is amended by adding a subdivision to
4.18read:
4.19 Subd. 1d.Minnesota Health Plan.Data on enrollees under the Minnesota Health Plan
4.20are classified under sections 62X.03, subdivision 10, and 62X.13, subdivision 6.
4.21 ARTICLE 3
4.22 BENEFITS
4.23 Section 1. [62X.04] BENEFITS.
4.24 Subdivision 1.General provisions.Any eligible individual may choose to receive
4.25services under the Minnesota Health Plan from any participating provider.
4.26 Subd. 2.Covered benefits.Covered health care benefits in this chapter include all
4.27medically necessary care subject to the limitations specified in subdivision 4. Covered health
4.28care benefits for Minnesota Health Plan enrollees include:
4.29 (1) inpatient and outpatient health facility services;
4.30 (2) inpatient and outpatient professional health care provider services;
4Article 3 Section 1.
25-02772 as introduced01/24/25 REVISOR SGS/LJ 5.1 (3) diagnostic imaging, laboratory services, and other diagnostic and evaluative services;
5.2 (4) medical equipment, supplies, including prescribed dietary and nutritional therapies,
5.3appliances, and assistive technology, including prosthetics, eyeglasses, and hearing aids,
5.4their repair, technical support, and customization needed for individual use;
5.5 (5) inpatient and outpatient rehabilitative care;
5.6 (6) emergency care services;
5.7 (7) emergency transportation;
5.8 (8) necessary transportation for health care services for persons with disabilities or who
5.9may qualify as low income;
5.10 (9) child and adult immunizations and preventive care;
5.11 (10) reproductive and sexual health care;
5.12 (11) health and wellness education;
5.13 (12) hospice care;
5.14 (13) care in a skilled nursing facility;
5.15 (14) home health care including health care provided in an assisted living facility;
5.16 (15) mental health services;
5.17 (16) substance abuse treatment;
5.18 (17) dental care;
5.19 (18) vision care;
5.20 (19) hearing care;
5.21 (20) prescription drugs and devices;
5.22 (21) podiatric care;
5.23 (22) chiropractic care;
5.24 (23) acupuncture;
5.25 (24) therapies which are shown by the National Institutes of Health National Center for
5.26Complementary and Integrative Health to be safe and effective;
5.27 (25) blood and blood products;
5.28 (26) dialysis;
5Article 3 Section 1.
25-02772 as introduced01/24/25 REVISOR SGS/LJ 6.1 (27) adult day care;
6.2 (28) rehabilitative and habilitative services;
6.3 (29) ancillary health care or social services previously covered by Minnesota's public
6.4health programs;
6.5 (30) case management and care coordination;
6.6 (31) language interpretation and translation for health care services, including sign
6.7language and Braille or other services needed for individuals with communication barriers;
6.8and
6.9 (32) those health care and long-term supportive services currently covered under
6.10Minnesota Statutes 2016, chapter 256B, for persons on medical assistance, including home
6.11and community-based waivered services under chapter 256B.
6.12 Subd. 3.Benefit expansion.The Minnesota Health Board may expand health care
6.13benefits beyond the minimum benefits described in this section when expansion meets the
6.14intent of this chapter and when there are sufficient funds to cover the expansion.
6.15 Subd. 4.Cost-sharing for the room and board portion of long-term care.The
6.16Minnesota Health Board shall develop income and asset qualifications based on medical
6.17assistance standards for covered benefits under subdivision 2, clauses (12) and (13). All
6.18health care services for long-term care in a skilled nursing facility or assisted living facility
6.19are fully covered but, notwithstanding section 62X.20, subdivision 6, room and board costs
6.20may be charged to patients who do not meet income and asset qualifications.
6.21 Subd. 5.Exclusions.The following health care services shall be excluded from coverage
6.22by the Minnesota Health Plan:
6.23 (1) health care services determined to have no medical benefit by the board;
6.24 (2) treatments and procedures primarily for cosmetic purposes, unless required to correct
6.25a functional or congenital impairment, restore or correct a part of the body that has been
6.26altered as a result of injury, disease, or surgery, or determined to be medically necessary
6.27by a qualified, licensed health care provider in the Minnesota Health Plan; and
6.28 (3) services of a health care provider or facility that is not licensed or accredited by the
6.29state, except for approved services provided to a Minnesota resident who is temporarily out
6.30of the state.
6Article 3 Section 1.
25-02772 as introduced01/24/25 REVISOR SGS/LJ 7.1 Subd. 6.Prohibition.The Minnesota Health Plan shall not pay for drugs requiring a
7.2prescription if the pharmaceutical companies directly market those drugs to consumers in
7.3Minnesota.
7.4 Sec. 2. [62X.041] PATIENT CARE.
7.5 (a) All patients shall have a primary care provider and have access to care coordination.
7.6 (b) Referrals are not required for a patient to see a health care specialist. If a patient sees
7.7a specialist and does not have a primary care provider, the Minnesota Health Plan may assist
7.8with choosing a primary care provider.
7.9 (c) The board may establish an online registry to assist patients in identifying appropriate
7.10providers.
7.11 ARTICLE 4
7.12 FUNDING
7.13 Section 1. [62X.19] MINNESOTA HEALTH FUND.
7.14 Subdivision 1.General provisions.(a) The Minnesota Health Fund, a revolving fund,
7.15is established under the jurisdiction and control of the Minnesota Health Board to implement
7.16the Minnesota Health Plan and to receive premiums and other sources of revenue. The fund
7.17shall be administered by a director appointed by the Minnesota Health Board.
7.18 (b) All money collected, received, and transferred according to this chapter shall be
7.19deposited in the Minnesota Health Fund.
7.20 (c) Money deposited in the Minnesota Health Fund shall be used exclusively to finance
7.21the Minnesota Health Plan.
7.22 (d) All claims for health care services rendered shall be made to the Minnesota Health
7.23Fund.
7.24 (e) All payments made for health care services shall be disbursed from the Minnesota
7.25Health Fund.
7.26 (f) Premiums and other revenues collected each year must be sufficient to cover that
7.27year's projected costs.
7.28 Subd. 2.Accounts.The Minnesota Health Fund shall have operating, capital, and reserve
7.29accounts.
7Article 4 Section 1.
25-02772 as introduced01/24/25 REVISOR SGS/LJ 8.1 Subd. 3.Operating account.The operating account in the Minnesota Health Fund shall
8.2be comprised of the accounts specified in paragraphs (a) to (e).
8.3 (a) Medical services account. The medical services account must be used to provide
8.4for all medical services and benefits covered under the Minnesota Health Plan.
8.5 (b) Prevention account. The prevention account must be used to establish and maintain
8.6primary community prevention programs, including preventive screening tests.
8.7 (c) Program administration, evaluation, planning, and assessment account. The
8.8program administration, evaluation, planning, and assessment account must be used to
8.9monitor and improve the plan's effectiveness and operations. The board may establish grant
8.10programs including demonstration projects for this purpose.
8.11 (d) Training and development account. The training and development account must
8.12be used to incentivize the training and development of health care providers and the health
8.13care workforce needed to meet the health care needs of the population.
8.14 (e) Health service research account. The health service research account must be used
8.15to support research and innovation as determined by the Minnesota Health Board, and
8.16recommended by the Office of Health Quality and Planning and the Ombudsman for Patient
8.17Advocacy.
8.18 Subd. 4.Capital account.The capital account must be used to pay for capital
8.19expenditures for institutional providers.
8.20 Subd. 5.Reserve account.(a) The Minnesota Health Plan must at all times hold in
8.21reserve an amount estimated in the aggregate to provide for the payment of all losses and
8.22claims for which the Minnesota Health Plan may be liable and to provide for the expense
8.23of adjustment or settlement of losses and claims.
8.24 (b) Money currently held in reserve by state, city, and county health programs must be
8.25transferred to the Minnesota Health Fund when the Minnesota Health Plan replaces those
8.26programs.
8.27 (c) The board shall have provisions in place to insure the Minnesota Health Plan against
8.28unforeseen expenditures or revenue shortfalls not covered by the reserve account. The board
8.29may borrow money to cover temporary shortfalls.
8.30 Subd. 6.Assets of the Minnesota Health Plan; functions of the commissioner of
8.31Minnesota Management and Budget.All money received by the Minnesota Health Fund
8.32shall be paid to the commissioner of Minnesota Management and Budget as agent of the
8.33board who shall not commingle these funds with any other money. The money in these
8Article 4 Section 1.
25-02772 as introduced01/24/25 REVISOR SGS/LJ 9.1accounts shall be paid out on warrants drawn by the commissioner on requisition by the
9.2board.
9.3 Subd. 7.Management.The Minnesota Health Fund shall be separate from the state
9.4treasury. Management of the fund shall be conducted by the Minnesota Health Board, which
9.5has exclusive authority over the fund.
9.6 Sec. 2. [62X.20] REVENUE SOURCES.
9.7 Subdivision 1.Minnesota Health Plan premium.(a) The Minnesota Health Board
9.8shall:
9.9 (1) determine the aggregate cost of providing health care according to this chapter;
9.10 (2) develop an equitable and affordable premium structure based on income, including
9.11unearned income, and a business health tax;
9.12 (3) in consultation with the Department of Revenue, develop an efficient means of
9.13collecting premiums and the business health tax; and
9.14 (4) coordinate with existing, ongoing funding sources from federal and state programs.
9.15 (b) The premium structure must be based on ability to pay.
9.16 (c) Within one year after the effective date of this act, the board shall submit to the
9.17governor and the legislature a report on the premium and business health tax structure
9.18established to finance the Minnesota Health Plan.
9.19 Subd. 2.Federal receipts.All federal funding received by Minnesota including the
9.20premium subsidies under the Affordable Care Act, Public Law 111-148, as amended by
9.21Public Law 111-152, is appropriated to the Minnesota Health Plan Board to be used to
9.22administer the Minnesota Health Plan under chapter 62X. Federal funding that is received
9.23for implementing and administering the Minnesota Health Plan must be used to provide
9.24health care for Minnesota residents.
9.25 Subd. 3.Funds from outside sources.Institutional providers operating under Minnesota
9.26Health Plan operating budgets may raise and expend funds from sources other than the
9.27Minnesota Health Plan including private or foundation donors. Contributions to providers
9.28in excess of $500,000 must be reported to the board.
9.29 Subd. 4.Governmental payments.The chief executive officer and, if required under
9.30federal law, the commissioners of health, human services, and commerce shall seek all
9.31necessary waivers, exemptions, agreements, or legislation so that all current federal payments
9.32to the state, including the premium tax credits under the Affordable Care Act, are paid
9Article 4 Sec. 2.
25-02772 as introduced01/24/25 REVISOR SGS/LJ 10.1directly to the Minnesota Health Plan. When any required waivers, exemptions, agreements,
10.2or legislation are obtained, the Minnesota Health Plan shall assume responsibility for all
10.3health care benefits and health care services previously paid for with federal funds. In
10.4obtaining the waivers, exemptions, agreements, or legislation, the chief executive officer
10.5and, if required, commissioners shall seek from the federal government a contribution for
10.6health care services in Minnesota that reflects: medical inflation, the state gross domestic
10.7product, the size and age of the population, the number of residents living below the poverty
10.8level, and the number of Medicare and VA eligible individuals, and that does not decrease
10.9in relation to the federal contribution to other states as a result of the waivers, exemptions,
10.10agreements, or savings from implementation of the Minnesota Health Plan.
10.11 Subd. 5.Federal preemption.(a) The board shall secure a repeal or a waiver of any
10.12provision of federal law that preempts any provision of this chapter. The commissioners of
10.13health, human services, and commerce shall provide all necessary assistance.
10.14 (b) In the section 1332 waiver application, the board shall request to waive any of the
10.15following provisions of the Patient Protection and Affordable Care Act, to the extent
10.16necessary to implement this act:
10.17 (1) United States Code, title 42, sections 18021 to 18024;
10.18 (2) United States Code, title 42, sections 18031 to 18033;
10.19 (3) United States Code, title 42, section 18071; and
10.20 (4) sections 36B and 5000A of the Internal Revenue Code of 1986, as amended.
10.21 (c) In the event that a repeal or a waiver of law or regulations cannot be secured, the
10.22board shall adopt rules, or seek conforming state legislation, consistent with federal law, in
10.23an effort to best fulfill the purposes of this chapter.
10.24 (d) The Minnesota Health Plan's responsibility for providing care shall be secondary to
10.25existing federal government programs for health care services to the extent that funding for
10.26these programs is not transferred to the Minnesota Health Fund or that the transfer is delayed
10.27beyond the date on which initial benefits are provided under the Minnesota Health Plan.
10.28 Subd. 6.No cost-sharing.No deductible, co-payment, coinsurance, or other cost-sharing
10.29shall be imposed with respect to covered benefits.
10.30Sec. 3. [62X.21] SUBROGATION.
10.31 Subdivision 1.Collateral source.(a) Health care costs shall be collected from collateral
10.32sources whenever medical services provided to an individual by the MHP are, or may be,
10Article 4 Sec. 3.
25-02772 as introduced01/24/25 REVISOR SGS/LJ 11.1covered services under a policy of insurance, or other collateral source available to that
11.2individual, or when the individual has a right of action for compensation permitted under
11.3law.
11.4 (b) As used in this section, collateral source includes but is not limited to:
11.5 (1) health insurance policies and the medical components of automobile, homeowners,
11.6and other forms of insurance;
11.7 (2) medical components of workers' compensation;
11.8 (3) a judgment for damages for personal injury;
11.9 (4) the state of last domicile for individuals moving to Minnesota for medical care who
11.10have extraordinary medical needs; and
11.11 (5) any third party who is or may be liable to an individual for health care services or
11.12costs.
11.13 (c) An entity described in paragraph (b) is not excluded from the obligations imposed
11.14by this section by virtue of a contract or relationship with a government unit, agency, or
11.15service.
11.16 (d) The board shall negotiate waivers or make other arrangements to incorporate collateral
11.17sources into the Minnesota Health Plan if necessary.
11.18 Subd. 2.Notification.When an individual who receives health care services under the
11.19Minnesota Health Plan is entitled to coverage, reimbursement, indemnity, or other
11.20compensation from a collateral source, the individual shall notify the health care provider
11.21and provide information identifying the collateral source, the nature and extent of coverage
11.22or entitlement, and other relevant information. The health care provider shall forward this
11.23information to the board. The individual entitled to coverage, reimbursement, indemnity,
11.24or other compensation from a collateral source shall provide additional information as
11.25requested by the board.
11.26 Subd. 3.Reimbursement.(a) The Minnesota Health Plan shall seek reimbursement
11.27from the collateral source for services provided to the individual and may institute appropriate
11.28action, including legal proceedings, to recover the reimbursement. Upon demand, the
11.29collateral source shall pay to the Minnesota Health Fund the sums it would have paid or
11.30expended on behalf of the individual for the health care services provided by the Minnesota
11.31Health Plan.
11Article 4 Sec. 3.
25-02772 as introduced01/24/25 REVISOR SGS/LJ 12.1 (b) In addition to any other right to recovery provided in this section, the board shall
12.2have the same right to recover the reasonable value of health care benefits from a collateral
12.3source as provided to the commissioner of human services under section 256B.37.
12.4 Subd. 4.Defaults, underpayments, and late payments.(a) Default, underpayment, or
12.5late payment of any tax or other obligation imposed by this chapter shall result in the remedies
12.6and penalties provided by law, except as provided in this section.
12.7 (b) Eligibility for health care benefits under section 62X.04 shall not be impaired by any
12.8default, underpayment, or late payment of any premium or other obligation imposed by this
12.9chapter.
12.10 ARTICLE 5
12.11 PAYMENTS
12.12Section 1. [62X.05] PROVIDER PAYMENTS.
12.13 Subdivision 1.General provisions.(a) All health care providers licensed to practice in
12.14Minnesota may participate in the Minnesota Health Plan as well as other providers as
12.15determined by the board.
12.16 (b) A participating health care provider shall comply with all federal laws and regulations
12.17governing referral fees and fee splitting including, but not limited to, United States Code,
12.18title 42, sections 1320a-7b and 1395nn, whether reimbursed by federal funds or not.
12.19 (c) A fee schedule or financial incentive may not adversely affect the care a patient
12.20receives or the care a health provider recommends.
12.21 Subd. 2.Payments to noninstitutional providers.(a) The Minnesota Health Board
12.22shall establish and oversee a fair and efficient payment system for noninstitutional providers.
12.23 (b) The board shall pay noninstitutional providers based on rates negotiated with
12.24providers. Rates shall take into account the need to address provider shortages.
12.25 (c) The board shall establish payment criteria and methods of payment for care
12.26coordination for patients especially those with chronic illness and complex medical needs.
12.27 (d) Providers who accept any payment from the Minnesota Health Plan for a covered
12.28health care service shall not bill the patient for the covered health care service.
12.29 (e) Providers shall be paid within 30 business days for claims filed following procedures
12.30established by the board.
12Article 5 Section 1.
25-02772 as introduced01/24/25 REVISOR SGS/LJ 13.1 Subd. 3.Payments to institutional providers.(a) The board shall set annual budgets
13.2for institutional providers. These budgets shall consist of an operating and a capital budget.
13.3An institution's annual budget shall be set to cover its anticipated health care services for
13.4the next year based on past performance and projected changes in prices and health care
13.5service levels. The annual budget for each individual institutional provider must be set
13.6separately. The board shall not set a joint budget for a group of more than one institutional
13.7provider nor for a parent corporation that owns or operates one or more institutional provider.
13.8 (b) Providers who accept any payment from the Minnesota Health Plan for a covered
13.9health care service shall not bill the patient for the covered health care service.
13.10 Subd. 4.Capital management plan.(a) The board shall periodically develop a capital
13.11investment plan that will serve as a guide in determining the annual budgets of institutional
13.12providers and in deciding whether to approve applications for approval of capital expenditures
13.13by noninstitutional providers.
13.14 (b) Providers who propose to make capital purchases in excess of $500,000 must obtain
13.15board approval. The board may alter the threshold expenditure level that triggers the
13.16requirement to submit information on capital expenditures. Institutional providers shall
13.17propose these expenditures and submit the required information as part of the annual budget
13.18they submit to the board. Noninstitutional providers shall submit applications for approval
13.19of these expenditures to the board. The board must respond to capital expenditure applications
13.20in a timely manner.
13.21 ARTICLE 6
13.22 GOVERNANCE
13.23Section 1. Minnesota Statutes 2024, section 14.03, subdivision 2, is amended to read:
13.24 Subd. 2.Contested case procedures.The contested case procedures of the
13.25Administrative Procedure Act provided in sections 14.57 to 14.69 do not apply to (a)
13.26proceedings under chapter 414, except as specified in that chapter, (b) the commissioner of
13.27corrections, (c) the unemployment insurance program and the Social Security disability
13.28determination program in the Department of Employment and Economic Development, (d)
13.29the commissioner of mediation services, (e) the Workers' Compensation Division in the
13.30Department of Labor and Industry, (f) the Workers' Compensation Court of Appeals, or (g)
13.31the Board of Pardons, or (h) the Minnesota Health Plan.
13Article 6 Section 1.
25-02772 as introduced01/24/25 REVISOR SGS/LJ 14.1 Sec. 2. Minnesota Statutes 2024, section 15A.0815, subdivision 2, is amended to read:
14.2 Subd. 2.Agency head salaries.The salary for a position listed in this subdivision shall
14.3be determined by the Compensation Council under section 15A.082. The commissioner of
14.4management and budget must publish the salaries on the department's website. This
14.5subdivision applies to the following positions:
14.6 Commissioner of administration;
14.7 Commissioner of agriculture;
14.8 Commissioner of education;
14.9 Commissioner of children, youth, and families;
14.10 Commissioner of commerce;
14.11 Commissioner of corrections;
14.12 Commissioner of health;
14.13 Chief executive officer of the Minnesota Health Plan;
14.14 Commissioner, Minnesota Office of Higher Education;
14.15 Commissioner, Minnesota IT Services;
14.16 Commissioner, Housing Finance Agency;
14.17 Commissioner of human rights;
14.18 Commissioner of human services;
14.19 Commissioner of labor and industry;
14.20 Commissioner of management and budget;
14.21 Commissioner of natural resources;
14.22 Commissioner, Pollution Control Agency;
14.23 Commissioner of public safety;
14.24 Commissioner of revenue;
14.25 Commissioner of employment and economic development;
14.26 Commissioner of transportation;
14.27 Commissioner of veterans affairs;
14.28 Executive director of the Gambling Control Board;
14Article 6 Sec. 2.
25-02772 as introduced01/24/25 REVISOR SGS/LJ 15.1 Executive director of the Minnesota State Lottery;
15.2 Executive director of the Office of Cannabis Management;
15.3 Commissioner of Iron Range resources and rehabilitation;
15.4 Commissioner, Bureau of Mediation Services;
15.5 Ombudsman for mental health and developmental disabilities;
15.6 Ombudsperson for corrections;
15.7 Chair, Metropolitan Council;
15.8 Chair, Metropolitan Airports Commission;
15.9 School trust lands director;
15.10 Executive director of pari-mutuel racing;
15.11 Commissioner, Public Utilities Commission;
15.12 Chief Executive Officer, Direct Care and Treatment; and
15.13 Director of the Office of Emergency Medical Services.
15.14Sec. 3. [62X.06] MINNESOTA HEALTH BOARD.
15.15 Subdivision 1.Establishment.The Minnesota Health Board is established to promote
15.16the delivery of high quality, coordinated health care services that enhance health; prevent
15.17illness, disease, and disability; slow the progression of chronic diseases; and improve personal
15.18health management. The board shall administer the Minnesota Health Plan. The board shall
15.19oversee:
15.20 (1) the Office of Health Quality and Planning under section 62X.09; and
15.21 (2) the Minnesota Health Fund under section 62X.19.
15.22 Subd. 2.Board composition.(a) The board shall consist of 15 members, including a
15.23representative selected by each of the five rural regional health planning boards under section
15.2462X.08 and three representatives selected by the metropolitan regional health planning
15.25board under section 62X.08. These members shall appoint the following additional members
15.26to serve on the board:
15.27 (1) one patient member and one employer member; and
15.28 (2) five providers that include one physician, one registered nurse, one mental health
15.29provider, one dentist, and one facility director.
15Article 6 Sec. 3.
25-02772 as introduced01/24/25 REVISOR SGS/LJ 16.1 (b) Each member shall qualify by taking the oath of office to uphold the Minnesota and
16.2United States Constitution and to operate the Minnesota Health Plan in the public interest
16.3by upholding the underlying principles of this chapter.
16.4 Subd. 3.Term and compensation; selection of chair.Board members shall serve four
16.5years. Board members shall set the board's compensation not to exceed the compensation
16.6of Public Utilities Commission members. The board shall select the chair from its
16.7membership.
16.8 Subd. 4.Removal of board member.A board member may be removed by a two-thirds
16.9vote of the members voting on removal. After receiving notice and hearing, a member may
16.10be removed for malfeasance or nonfeasance in performance of the member's duties.
16.11Conviction of any criminal behavior regardless of how much time has lapsed is grounds for
16.12immediate removal.
16.13 Subd. 5.General duties.The board shall:
16.14 (1) ensure that all of the requirements of section 62X.01 are met;
16.15 (2) hire a chief executive officer for the Minnesota Health Plan who shall be qualified
16.16after taking the oath of office specified in subdivision 2 and who shall administer all aspects
16.17of the plan as directed by the board;
16.18 (3) hire a director for the Office of Health Quality and Planning who shall be qualified
16.19after taking the oath of office specified in subdivision 2;
16.20 (4) hire a director of the Minnesota Health Fund who shall be qualified after taking the
16.21oath of office specified in subdivision 2;
16.22 (5) provide technical assistance to the regional boards established under section 62X.08;
16.23 (6) conduct necessary investigations and inquiries and require the submission of
16.24information, documents, and records the board considers necessary to carry out the purposes
16.25of this chapter;
16.26 (7) establish a process for the board to receive the concerns, opinions, ideas, and
16.27recommendations of the public regarding all aspects of the Minnesota Health Plan and the
16.28means of addressing those concerns;
16.29 (8) conduct other activities the board considers necessary to carry out the purposes of
16.30this chapter;
16Article 6 Sec. 3.
25-02772 as introduced01/24/25 REVISOR SGS/LJ 17.1 (9) collaborate with the agencies that license health facilities to ensure that facility
17.2performance is monitored and that deficient practices are recognized and corrected in a
17.3timely manner;
17.4 (10) adopt rules, policies, and procedures as necessary to carry out the duties assigned
17.5under this chapter;
17.6 (11) establish conflict of interest standards that prohibit providers from receiving any
17.7financial benefit from their medical decisions outside of board reimbursement, including
17.8any financial benefit for referring a patient for any service, product, or provider, or for
17.9prescribing, ordering, or recommending any drug, product, or service;
17.10 (12) establish conflict of interest standards related to pharmaceuticals, medical supplies
17.11and devices and their marketing to providers so that no provider receives any incentive to
17.12prescribe, administer, or use any product or service;
17.13 (13) require all electronic health records used by providers be fully interoperable with
17.14the open source electronic health records system used by the United States Veterans
17.15Administration;
17.16 (14) provide financial help and assistance in retraining and job placement to Minnesota
17.17workers who may be displaced because of the administrative efficiencies of the Minnesota
17.18Health Plan;
17.19 (15) ensure that assistance is provided to all workers and communities who may be
17.20affected by provisions in this chapter; and
17.21 (16) work with the Department of Employment and Economic Development (DEED)
17.22to ensure that funding and program services are promptly and efficiently distributed to all
17.23affected workers. DEED shall monitor and report on a regular basis on the status of displaced
17.24workers.
17.25 There is currently a serious shortage of providers in many health care professions, from
17.26medical technologists to registered nurses, and many potentially displaced health
17.27administrative workers already have training in some medical field. To alleviate these
17.28shortages, the dislocated worker support program should emphasize retraining and placement
17.29into health care related positions if appropriate. As Minnesota residents, all displaced workers
17.30shall be covered under the Minnesota Health Plan.
17.31 Subd. 6.Waiver request duties.Before submitting a waiver application under section
17.321332 of the Patient Protection and Affordable Care Act, Public Law Number 111-148, as
17.33amended, the board shall do the following, as required by federal law:
17Article 6 Sec. 3.
25-02772 as introduced01/24/25 REVISOR SGS/LJ 18.1 (1) conduct or contract for any necessary actuarial analyses and actuarial certifications
18.2needed to support the board's estimates that the waiver will comply with the comprehensive
18.3coverage, affordability, and scope of coverage requirements in federal law;
18.4 (2) conduct or contract for any necessary economic analyses needed to support the
18.5board's estimates that the waiver will comply with the comprehensive coverage, affordability,
18.6scope of coverage, and federal deficit requirements in federal law. These analyses must
18.7include:
18.8 (i) a detailed ten-year budget plan; and
18.9 (ii) a detailed analysis regarding the estimated impact of the waiver on health insurance
18.10coverage in the state;
18.11 (3) establish a detailed draft implementation timeline for the waiver plan; and
18.12 (4) establish quarterly, annual, and cumulative targets for the comprehensive coverage,
18.13affordability, scope of coverage, and federal deficit requirements in federal law.
18.14 Subd. 7.Financial duties.The board shall:
18.15 (1) establish and after enactment into law, collect premiums and the business health tax
18.16according to section 62X.20, subdivision 1;
18.17 (2) approve statewide and regional budgets that include budgets for the accounts in
18.18section 62X.19;
18.19 (3) negotiate and establish payment rates for providers;
18.20 (4) monitor compliance with all budgets and payment rates and take action to achieve
18.21compliance to the extent authorized by law;
18.22 (5) pay claims for medical products or services as negotiated, and may issue requests
18.23for proposals from Minnesota nonprofit business corporations for a contract to process
18.24claims;
18.25 (6) seek federal approval to bill other states for health care coverage provided to residents
18.26from out-of-state who come to Minnesota for long-term care or other costly treatment when
18.27the resident's home state fails to provide such coverage, unless a reciprocal agreement with
18.28those states to provide similar coverage to Minnesota residents relocating to those states
18.29can be negotiated;
18.30 (7) administer the Minnesota Health Fund created under section 62X.19;
18Article 6 Sec. 3.
25-02772 as introduced01/24/25 REVISOR SGS/LJ 19.1 (8) annually determine the appropriate level for the Minnesota Health Plan reserve
19.2account and implement policies needed to establish the appropriate reserve;
19.3 (9) implement fraud prevention measures necessary to protect the operation of the
19.4Minnesota Health Plan; and
19.5 (10) work to ensure appropriate cost control by:
19.6 (i) instituting aggressive public health measures, early intervention and preventive care,
19.7health and wellness education, and promotion of personal health improvement;
19.8 (ii) making changes in the delivery of health care services and administration that improve
19.9efficiency and care quality;
19.10 (iii) minimizing administrative costs;
19.11 (iv) ensuring that the delivery system does not contain excess capacity; and
19.12 (v) negotiating the lowest reasonable prices for prescription drugs, medical equipment,
19.13and medical services.
19.14 Subd. 8.Minnesota Health Board management duties.The board shall:
19.15 (1) develop and implement enrollment procedures for the Minnesota Health Plan;
19.16 (2) implement eligibility standards for the Minnesota Health Plan;
19.17 (3) arrange for health care to be provided at convenient locations, including ensuring
19.18the availability of school nurses so that all students have access to health care, immunizations,
19.19and preventive care at public schools and encouraging providers to open small health clinics
19.20at larger workplaces and retail centers;
19.21 (4) make recommendations, when needed, to the legislature about changes in the
19.22geographic boundaries of the health planning regions;
19.23 (5) establish an electronic claims and payments system for the Minnesota Health Plan;
19.24 (6) monitor the operation of the Minnesota Health Plan through consumer surveys and
19.25regular data collection and evaluation activities, including evaluations of the adequacy and
19.26quality of services furnished under the program, the need for changes in the benefit package,
19.27the cost of each type of service, and the effectiveness of cost control measures under the
19.28program;
19.29 (7) disseminate information and establish a health care website to provide information
19.30to the public about the Minnesota Health Plan including providers and facilities, and state
19.31and regional health planning board meetings and activities;
19Article 6 Sec. 3.
25-02772 as introduced01/24/25 REVISOR SGS/LJ 20.1 (8) collaborate with public health agencies, schools, and community clinics;
20.2 (9) ensure that Minnesota Health Plan policies and providers, including public health
20.3providers, support all Minnesota residents in achieving and maintaining maximum physical
20.4and mental health; and
20.5 (10) annually report to the chairs and ranking minority members of the senate and house
20.6of representatives committees with jurisdiction over health care issues on the performance
20.7of the Minnesota Health Plan, fiscal condition and need for payment adjustments, any needed
20.8changes in geographic boundaries of the health planning regions, recommendations for
20.9statutory changes, receipt of revenue from all sources, whether current year goals and
20.10priorities are met, future goals and priorities, major new technology or prescription drugs,
20.11and other circumstances that may affect the cost or quality of health care.
20.12 Subd. 9.Policy duties.The board shall:
20.13 (1) develop and implement cost control and quality assurance procedures;
20.14 (2) ensure strong public health services including education and community prevention
20.15and clinical services;
20.16 (3) ensure a continuum of coordinated high-quality primary to tertiary care to all
20.17Minnesota residents; and
20.18 (4) implement policies to ensure that all Minnesota residents receive culturally and
20.19linguistically competent care.
20.20 Subd. 10.Self-insurance.The board shall determine the feasibility of self-insuring
20.21providers for malpractice and shall establish a self-insurance system and create a special
20.22fund for payment of losses incurred if the board determines self-insuring providers would
20.23reduce costs.
20.24Sec. 4. [62X.07] HEALTH PLANNING REGIONS.
20.25 A metropolitan health planning region consisting of the seven-county metropolitan area
20.26is established. The commissioner of health shall designate five rural health planning regions
20.27from the greater Minnesota area composed of geographically contiguous counties grouped
20.28on the basis of the following considerations:
20.29 (1) patterns of utilization of health care services;
20.30 (2) health care resources, including workforce resources;
20.31 (3) health needs of the population, including public health needs;
20Article 6 Sec. 4.
25-02772 as introduced01/24/25 REVISOR SGS/LJ 21.1 (4) geography;
21.2 (5) population and demographic characteristics; and
21.3 (6) other considerations as appropriate.
21.4 The commissioner of health shall designate the health planning regions.
21.5 Sec. 5. [62X.08] REGIONAL HEALTH PLANNING BOARD.
21.6 Subdivision 1.Regional planning board composition.(a) Each regional board shall
21.7consist of one county commissioner per county selected by the county board and two county
21.8commissioners per county selected by the county board in the seven-county metropolitan
21.9area. A county commissioner may designate a representative to act as a member of the board
21.10in the member's absence. Each board shall select the chair from among its membership.
21.11 (b) Board members shall serve for four-year terms and may receive per diems for meetings
21.12as provided in section 15.059, subdivision 3.
21.13 Subd. 2.Regional health board duties.Regional health planning boards shall:
21.14 (1) recommend health standards, goals, priorities, and guidelines for the region;
21.15 (2) prepare an operating and capital budget for the region to recommend to the Minnesota
21.16Health Board;
21.17 (3) hire a regional planning director;
21.18 (4) address the needs of high risk populations by:
21.19 (i) collaborating with community health clinics and social service providers through
21.20planning and financing to provide outreach, medical care, and case management services
21.21in the community for patients who, because of mental illness, homelessness, or other
21.22circumstances, are unlikely to obtain needed care; and
21.23 (ii) collaborating with hospitals, medical and social service providers through planning
21.24and financing to keep people healthy and reduce hospital readmissions by providing discharge
21.25planning and services including medical respite and transitional care for patients leaving
21.26medical facilities and mental health and chemical dependency treatment programs;
21.27 (5) collaborate with local public health care agencies to educate consumers and providers
21.28on public health programs;
21.29 (6) collaborate with public health care agencies to implement public health and wellness
21.30initiatives; and
21Article 6 Sec. 5.
25-02772 as introduced01/24/25 REVISOR SGS/LJ 22.1 (7) ensure that all parts of the region have access to a 24-hour nurse hotline and 24-hour
22.2urgent care clinics.
22.3 Sec. 6. [62X.09] OFFICE OF HEALTH QUALITY AND PLANNING.
22.4 Subdivision 1.Establishment.The Minnesota Health Board shall establish an Office
22.5of Health Quality and Planning to assess the quality, access, and funding adequacy of the
22.6Minnesota Health Plan.
22.7 Subd. 2.General duties.(a) The Office of Health Quality and Planning shall make
22.8annual recommendations to the board on the overall direction on subjects including:
22.9 (1) the overall effectiveness of the Minnesota Health Plan in addressing public health
22.10and wellness;
22.11 (2) access to health care;
22.12 (3) quality improvement;
22.13 (4) efficiency of administration;
22.14 (5) adequacy of budget and funding;
22.15 (6) appropriateness of payments for providers;
22.16 (7) capital expenditure needs;
22.17 (8) long-term health care;
22.18 (9) mental health and substance abuse services;
22.19 (10) staffing levels and working conditions in health care facilities;
22.20 (11) identification of number and mix of health care facilities and providers required to
22.21best meet the needs of the Minnesota Health Plan;
22.22 (12) care for chronically ill patients;
22.23 (13) educating providers on promoting the use of advance directives with patients to
22.24enable patients to obtain the health care of their choice;
22.25 (14) research needs; and
22.26 (15) integration of disease management programs into health care delivery.
22.27 (b) Analyze shortages in health care workforce required to meet the needs of the
22.28population and develop plans to meet those needs in collaboration with regional planners
22.29and educational institutions.
22Article 6 Sec. 6.
25-02772 as introduced01/24/25 REVISOR SGS/LJ 23.1 (c) Analyze methods of paying providers and make recommendations to improve quality
23.2and control costs.
23.3 (d) Assist in coordination of the Minnesota Health Plan and public health programs.
23.4 Subd. 3.Assessment and evaluation of benefits.(a) The Office of Health Quality and
23.5Planning shall:
23.6 (1) consider health care benefit additions to the Minnesota Health Plan and evaluate
23.7them based on evidence of clinical efficacy;
23.8 (2) establish a process and criteria by which providers may request authorization to
23.9provide health care services and treatments that are not included in the Minnesota Health
23.10Plan benefit set, including experimental health care treatments;
23.11 (3) evaluate proposals to increase the efficiency and effectiveness of the health care
23.12delivery system, and make recommendations to the board based on the cost-effectiveness
23.13of the proposals; and
23.14 (4) identify complementary and alternative health care modalities that have been shown
23.15to be safe and effective.
23.16 (b) The board may convene advisory panels as needed.
23.17Sec. 7. [62X.10] ETHICS AND CONFLICT OF INTEREST.
23.18 (a) All provisions of section 43A.38 apply to employees and the chief executive officer
23.19of the Minnesota Health Plan, the members and directors of the Minnesota Health Board,
23.20the regional health boards, the director of the Office of Health Quality and Planning, the
23.21director of the Minnesota Health Fund, and the ombudsman for patient advocacy. Failure
23.22to comply with section 43A.38 shall be grounds for disciplinary action which may include
23.23termination of employment or removal from the board.
23.24 (b) In order to avoid the appearance of political bias or impropriety, the Minnesota Health
23.25Plan chief executive officer shall not:
23.26 (1) engage in leadership of, or employment by, a political party or a political organization;
23.27 (2) publicly endorse a political candidate;
23.28 (3) contribute to any political candidates or political parties and political organizations;
23.29or
23.30 (4) attempt to avoid compliance with this subdivision by making contributions through
23.31a spouse or other family member.
23Article 6 Sec. 7.
25-02772 as introduced01/24/25 REVISOR SGS/LJ 24.1 (c) In order to avoid a conflict of interest, individuals specified in paragraph (a) shall
24.2not be currently employed by a medical provider or a pharmaceutical, medical insurance,
24.3or medical supply company. This paragraph does not apply to the five provider members
24.4of the board.
24.5 Sec. 8. [62X.11] CONFLICT OF INTEREST COMMITTEE.
24.6 (a) The board shall establish a conflict of interest committee to develop standards of
24.7practice for individuals or entities doing business with the Minnesota Health Plan, including
24.8but not limited to, board members, providers, and medical suppliers. The committee shall
24.9establish guidelines on the duty to disclose the existence of a financial interest and all
24.10material facts related to that financial interest to the committee.
24.11 (b) In considering the transaction or arrangement, if the committee determines a conflict
24.12of interest exists, the committee shall investigate alternatives to the proposed transaction
24.13or arrangement. After exercising due diligence, the committee shall determine whether the
24.14Minnesota Health Plan can obtain with reasonable efforts a more advantageous transaction
24.15or arrangement with a person or entity that would not give rise to a conflict of interest. If
24.16this is not reasonably possible under the circumstances, the committee shall make a
24.17recommendation to the board on whether the transaction or arrangement is in the best interest
24.18of the Minnesota Health Plan, and whether the transaction is fair and reasonable. The
24.19committee shall provide the board with all material information used to make the
24.20recommendation. After reviewing all relevant information, the board shall decide whether
24.21to approve the transaction or arrangement.
24.22Sec. 9. [62X.12] OMBUDSMAN OFFICE FOR PATIENT ADVOCACY.
24.23 Subdivision 1.Creation of office.(a) The Ombudsman Office for Patient Advocacy is
24.24created to represent the interests of the consumers of health care. The ombudsman shall
24.25help residents of the state secure the health care services and health care benefits they are
24.26entitled to under the laws administered by the Minnesota Health Board and advocate on
24.27behalf of and represent the interests of enrollees in entities created by this chapter and in
24.28other forums.
24.29 (b) The ombudsman shall be a patient advocate appointed by the governor, who serves
24.30in the unclassified service and may be removed only for just cause. The ombudsman must
24.31be selected without regard to political affiliation and must be knowledgeable about and have
24.32experience in health care services and administration.
24Article 6 Sec. 9.
25-02772 as introduced01/24/25 REVISOR SGS/LJ 25.1 (c) The ombudsman may gather information about decisions, acts, and other matters of
25.2the Minnesota Health Board, health care organization, or a health care program. A person
25.3may not serve as ombudsman while holding another public office.
25.4 (d) The budget for the ombudsman's office shall be determined by the legislature and is
25.5independent from the Minnesota Health Board. The ombudsman shall establish offices to
25.6provide convenient access to residents.
25.7 (e) The Minnesota Health Board has no oversight or authority over the ombudsman for
25.8patient advocacy.
25.9 Subd. 2.Ombudsman's duties.The ombudsman shall:
25.10 (1) ensure that patient advocacy services are available to all Minnesota residents;
25.11 (2) establish and maintain the grievance process according to section 62X.13;
25.12 (3) receive, evaluate, and respond to consumer complaints about the Minnesota Health
25.13Plan;
25.14 (4) establish a process to receive recommendations from the public about ways to improve
25.15the Minnesota Health Plan;
25.16 (5) develop educational and informational guides according to communication services
25.17under section 15.441, describing consumer rights and responsibilities;
25.18 (6) ensure the guides in clause (5) are widely available to consumers and specifically
25.19available in provider offices and health care facilities; and
25.20 (7) prepare an annual report about the consumer perspective on the performance of the
25.21Minnesota Health Plan, including recommendations for needed improvements.
25.22Sec. 10. [62X.13] GRIEVANCE SYSTEM.
25.23 Subdivision 1.Grievance system established.The ombudsman shall establish a
25.24grievance system for complaints. The system shall provide a process that ensures adequate
25.25consideration of Minnesota Health Plan enrollee grievances and appropriate remedies.
25.26 Subd. 2.Referral of grievances.The ombudsman may refer any grievance that does
25.27not pertain to compliance with this chapter to the federal Centers for Medicare and Medicaid
25.28Services or any other appropriate local, state, and federal government entity for investigation
25.29and resolution.
25.30 Subd. 3.Submittal by designated agents and providers.A provider may join with,
25.31or otherwise assist, a complainant to submit the grievance to the ombudsman. A provider
25Article 6 Sec. 10.
25-02772 as introduced01/24/25 REVISOR SGS/LJ 26.1or an employee of a provider who, in good faith, joins with or assists a complainant in
26.2submitting a grievance is subject to the protections and remedies under sections 181.931 to
26.3181.935.
26.4 Subd. 4.Review of documents.The ombudsman may require additional information
26.5from health care providers or the board.
26.6 Subd. 5.Written notice of disposition.The ombudsman shall send a written notice of
26.7the final disposition of the grievance, and the reasons for the decision, to the complainant,
26.8to any provider who is assisting the complainant, and to the board, within 30 calendar days
26.9of receipt of the request for review unless the ombudsman determines that additional time
26.10is reasonably necessary to fully and fairly evaluate the relevant grievance. The ombudsman's
26.11order of corrective action shall be binding on the Minnesota Health Plan. A decision of the
26.12ombudsman is subject to de novo review by the district court.
26.13 Subd. 6.Data.Data on enrollees collected because an enrollee submits a complaint to
26.14the ombudsman are private data on individuals as defined in section 13.02, subdivision 12,
26.15but may be released to a provider who is the subject of the complaint or to the board for
26.16purposes of this section.
26.17Sec. 11. [62X.14] AUDITOR GENERAL FOR THE MINNESOTA HEALTH PLAN.
26.18 Subdivision 1.Establishment.There is within the Office of the Legislative Auditor an
26.19auditor general for health care fraud and abuse for the Minnesota Health Plan who is
26.20appointed by the legislative auditor.
26.21 Subd. 2.Duties.The auditor general shall:
26.22 (1) investigate, audit, and review the financial and business records of the Minnesota
26.23Health Plan and the Minnesota Health Fund;
26.24 (2) investigate, audit, and review the financial and business records of individuals, public
26.25and private agencies and institutions, and private corporations that provide services or
26.26products to the Minnesota Health Plan, the costs of which are reimbursed by the Minnesota
26.27Health Plan;
26.28 (3) investigate allegations of misconduct on the part of an employee or appointee of the
26.29Minnesota Health Board and on the part of any provider of health care services that is
26.30reimbursed by the Minnesota Health Plan, and report any findings of misconduct to the
26.31attorney general;
26.32 (4) investigate fraud and abuse;
26Article 6 Sec. 11.
25-02772 as introduced01/24/25 REVISOR SGS/LJ 27.1 (5) arrange for the collection and analysis of data needed to investigate the inappropriate
27.2utilization of these products and services; and
27.3 (6) annually report recommendations for improvements to the Minnesota Health Plan
27.4to the board.
27.5 Sec. 12. [62X.15] MINNESOTA HEALTH PLAN POLICIES AND PROCEDURES;
27.6RULEMAKING.
27.7 Subdivision 1.Exempt rules.The Minnesota Health Plan policies and procedures are
27.8exempt from the Administrative Procedure Act but, to the extent authorized by law to adopt
27.9rules, the board may use the provisions of section 14.386, paragraph (a), clauses (1) and
27.10(3). Section 14.386, paragraph (b), does not apply to these rules.
27.11 Subd. 2.Rulemaking procedures.(a) Whenever the board determines that a rule should
27.12be adopted under this section establishing, modifying, or revoking a policy or procedure,
27.13the board shall publish in the State Register the proposed policy or procedure and shall
27.14afford interested persons a period of 30 days after publication to submit written data or
27.15comments.
27.16 (b) On or before the last day of the period provided for the submission of written data
27.17or comments, any interested person may file with the board written objections to the proposed
27.18rule, stating the grounds for objection and requesting a public hearing on those objections.
27.19Within 30 days after the last day for filing objections, the board shall publish in the State
27.20Register a notice specifying the policy or procedure to which objections have been filed
27.21and a hearing requested and specifying a time and place for the hearing.
27.22 Subd. 3.Rule adoption.Within 60 days after the expiration of the period provided for
27.23the submission of written data or comments, or within 60 days after the completion of any
27.24hearing, the board shall issue a rule adopting, modifying, or revoking a policy or procedure,
27.25or make a determination that a rule should not be adopted. The rule may contain a provision
27.26delaying its effective date for such period as the board determines is necessary.
27.27Sec. 13. [62X.151] EXEMPTION FROM RULEMAKING.
27.28 The board and its operation of the Minnesota Health Plan and the Minnesota Health
27.29Fund is exempt from rulemaking under chapter 14.
27Article 6 Sec. 13.
25-02772 as introduced01/24/25 REVISOR SGS/LJ 28.1 Sec. 14. Minnesota Statutes 2024, section 14.03, subdivision 3, is amended to read:
28.2 Subd. 3.Rulemaking procedures.(a) The definition of a rule in section 14.02,
28.3subdivision 4, does not include:
28.4 (1) rules concerning only the internal management of the agency or other agencies that
28.5do not directly affect the rights of or procedures available to the public;
28.6 (2) an application deadline on a form; and the remainder of a form and instructions for
28.7use of the form to the extent that they do not impose substantive requirements other than
28.8requirements contained in statute or rule;
28.9 (3) the curriculum adopted by an agency to implement a statute or rule permitting or
28.10mandating minimum educational requirements for persons regulated by an agency, provided
28.11the topic areas to be covered by the minimum educational requirements are specified in
28.12statute or rule;
28.13 (4) procedures for sharing data among government agencies, provided these procedures
28.14are consistent with chapter 13 and other law governing data practices.
28.15 (b) The definition of a rule in section 14.02, subdivision 4, does not include:
28.16 (1) rules of the commissioner of corrections relating to the release, placement, term, and
28.17supervision of inmates serving a supervised release or conditional release term, the internal
28.18management of institutions under the commissioner's control, and rules adopted under
28.19section 609.105 governing the inmates of those institutions;
28.20 (2) rules relating to weight limitations on the use of highways when the substance of the
28.21rules is indicated to the public by means of signs;
28.22 (3) opinions of the attorney general;
28.23 (4) the data element dictionary and the annual data acquisition calendar of the Department
28.24of Education to the extent provided by section 125B.07;
28.25 (5) the occupational safety and health standards provided in section 182.655;
28.26 (6) revenue notices and tax information bulletins of the commissioner of revenue;
28.27 (7) uniform conveyancing forms adopted by the commissioner of commerce under
28.28section 507.09;
28.29 (8) standards adopted by the Electronic Real Estate Recording Commission established
28.30under section 507.0945; or
28Article 6 Sec. 14.
25-02772 as introduced01/24/25 REVISOR SGS/LJ 29.1 (9) the interpretive guidelines developed by the commissioner of human services to the
29.2extent provided in chapter 245A.; or
29.3 (10) rules, policies, and procedures adopted by the Minnesota Health Board under chapter
29.462X.
29.5 ARTICLE 7
29.6 IMPLEMENTATION
29.7 Section 1. [62X.16] IMPLEMENTATION.
29.8 Subdivision 1.Prohibition.On and after the day the Minnesota Health Plan becomes
29.9operational, a health plan, as defined in section 62Q.01, subdivision 3, may not be sold in
29.10Minnesota for health services provided by the Minnesota Health Plan.
29.11 Subd. 2.Analysis; transition.(a) The commissioners of health, human services, and
29.12commerce shall prepare an analysis of the state's capital expenditure needs for the purpose
29.13of assisting the board in adopting the statewide capital budget for the year following
29.14implementation. The commissioners shall submit this analysis to the board.
29.15 (b) The following timelines shall be implemented:
29.16 (1) the commissioner of health shall designate the health planning regions utilizing the
29.17criteria specified in section 62X.07, 30 days after the date of enactment of this act;
29.18 (2) the regional boards shall be established three months after the date of enactment of
29.19this act; and
29.20 (3) the Minnesota Health Board shall be established five months after the date of
29.21enactment of this act; and
29.22 (4) the commissioner of health, or the commissioner's designee, shall convene the first
29.23meeting of each of the regional boards and the Minnesota Health Board within 30 days after
29.24each of the boards has been established.
29.25 Subd. 3.Report.Within one year of the effective date of chapter 62X, DEED shall
29.26provide to the Minnesota Health Board, the governor, and the chairs and ranking members
29.27of the legislative committees with jurisdiction over health, human services, and commerce
29.28a report spelling out the appropriations and legislation necessary to assist all affected
29.29individuals and communities through the transition.
29Article 7 Section 1.
25-02772 as introduced01/24/25 REVISOR SGS/LJ 30.1 Sec. 2. APPROPRIATION.
30.2 $....... in fiscal year 2026 is appropriated from the general fund to the Minnesota Health
30.3Fund under the Minnesota Health Plan to provide start-up funding for the provisions of
30.4Minnesota Statutes, chapter 62X.
30.5 Sec. 3. EFFECTIVE DATE AND TRANSITION.
30.6 Subdivision 1.Effective date.This act is effective the day following final enactment.
30.7The commissioner of management and budget and the chief executive officer of the
30.8Minnesota Health Plan shall regularly update the legislature on the status of planning,
30.9implementation, and financing of this act.
30.10 Subd. 2.Timing to implement.The Minnesota Health Plan must be operational within
30.11two years from the date of final enactment of this act.
30Article 7 Sec. 3.
25-02772 as introduced01/24/25 REVISOR SGS/LJ Page.Ln 1.12MINNESOTA HEALTH PLAN.............................................................ARTICLE 1
Page.Ln 3.1ELIGIBILITY.........................................................................................ARTICLE 2
Page.Ln 4.21BENEFITS..............................................................................................ARTICLE 3
Page.Ln 7.11FUNDING..............................................................................................ARTICLE 4
Page.Ln 12.10PAYMENTS...........................................................................................ARTICLE 5
Page.Ln 13.21GOVERNANCE.....................................................................................ARTICLE 6
Page.Ln 29.5IMPLEMENTATION.............................................................................ARTICLE 7
1
APPENDIX
Article locations for 25-02772