MN HHS Final Budget Bill Summary
Shortly before the Constitutional deadline for enacting legislation, it was announced that the Governor had reached an agreement with the Legislature to balance the 2010-2011 biennial budget. However, there was not enough time to process the compromise prior to the May 17, midnight deadline. So, the House and the Senate adjourned Sine Die at 11:55ish P.M. on May 16, 2010 and went almost immediately into special session after the clock struck midnight. They then recessed until the compromise bill was ready for introduction and passage.
The final agreement resulted from intense negotiations over the weekend. It appeared as if an agreement would be reached early in the weekend until House Republicans raised concerns about the Governor’s willingness to support the Medical Assistance expansion to include low income adults without dependent children. In the end, the final agreement allows the Governor to unilaterally decide prior to January 15, 2011 whether to opt-in to the program, thus allowing the next Governor the opportunity to decide and making it an election issue. The agreement also ratifies most of the unallotments that were made by the Governor last summer. This action effectively makes the recent court decision moot with regard to those unallotments.
The legislature took up the compromise bill this morning and passed it. The Governor is expected to sign the bill.
Other issues of interest included in the final bill are:
Rate Reduction: The compromise includes no general rate reduction for medical assistance continuing care providers!!
Customized Living Rates: It appears that the committee adopted the entire Senate position on Housing with Services which includes a reduction, effective July 1, 2010, of the service component rates and service rate limits for customized living services and 24-Hour customized living services by 5%.
Medicare Payment Limit: The compromise includes a provision that states that physician, professional and basic care services shall not be reimbursed at a rate in excess of the Medicare reimbursement level.
Certification of Transitional Consultation: The provision that prohibited Housing with Services Establishments from entering into a contract with a prospective resident unless the prospective resident has received a certificate that he/she has received “transition to housing with services” consultation was not included in the final compromise. However, language was included about information that such providers need to provide to residents.
PCA Monthly Cap: The bill ratifies the Governor’s unallotment action effective July 1, 2009 and makes permanent the cap of 275 hours per month that a PCA may work.
Private Duty Nursing: Adopted was a requirement that private health plan coverage of Private Duty Nursing services for those people who have both private insurance and are on Medical Assistance.
Waiver Caps: The committee adopted the Governor’s waiver cap proposal. The proposal limits the growth of the Community Alternatives for Disabled Individuals (CADI) at 60 new waivers per month and Developmental Disabilities (DD) Waivers at 6 waivers per month.
Rehab Therapies (PT/OT/ST): Lifetime limits on these therapies were agreed to. The limit can be exceeded with prior authorization. The one-time service thresholds are by recipient, and include care from all providers for all episodes of care and conditions. The thresholds do not apply to rehabilitation services provided in the recipient’s home by home health agencies, and these services are not tied to the current thresholds, either
Specialized Maintenance Therapies: The House position to eliminate Specialized Maintenance Therapies from Home Care Therapies was not included in the final compromise bill.
Elderly Waiver: Elimination of automatic increase in EW case mix caps was not adopted.
Health Teams: Adopted was the Health Team concept that establishes health teams to support the patient-centered health home.and provide the services. Health teams are community-based, interdisciplinary, inter-professional teams of health care providers that support primary care practices. These providers may include medical specialists, nurses, pharmacists, nutritionists, social workers, behavioral and mental health providers, doctors of chiropractic, licensed complementary and alternative medicine practitioners, and physician’s assistants.
Health Care Delivery System: Also adopted was a Health Care Delivery System demonstration project to test alternative and innovative health care delivery systems. For more detail see the bill beginning at line 85.12.
PACE: The House PACE proposal was included.
Here is the link to the bill:
https://www.revisor.mn.gov/bin/bldbill.php?bill=H0001.1.html&session_year=2010&session_number=1
