reglab/statecodes huggingface dataset:
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256B — Medical Assistance For Needy Persons › Section 256B.095 — Quality Assurance System Established.

256B.095 QUALITY ASSURANCE SYSTEM ESTABLISHED.
(a) Effective July 1, 1998, a quality assurance system for persons with developmental disabilities, which includes an alternative quality assurance licensing system for programs, is established in Dodge, Fillmore, Freeborn, Goodhue, Houston, Mower, Olmsted, Rice, Steele, Wabasha, and Winona Counties for the purpose of improving the quality of services provided to persons with developmental disabilities. A county, at its option, may choose to have all programs for persons with developmental disabilities located within the county licensed under chapter 245A using standards determined under the alternative quality assurance licensing system or may continue regulation of these programs under the licensing system operated by the commissioner.
(b) Effective July 1, 2003, a county not listed in paragraph (a) may apply to participate in the quality assurance system established under paragraph (a). The commission established under section 256B.0951 may, at its option, allow additional counties to participate in the system.
(c) Effective July 1, 2003, any county or group of counties not listed in paragraph (a) may establish a quality assurance system under this section. A new system established under this section shall have the same rights and duties as the system established under paragraph (a). A new system shall be governed by a commission under section 256B.0951. The commissioner shall appoint the initial commission members based on recommendations from advocates, families, service providers, and counties in the geographic area included in the new system. Counties that choose to participate in a new system shall have the duties assigned under section 256B.0952. The new system shall establish a quality assurance process under section 256B.0953. The provisions of section 256B.0954 shall apply to a new system established under this paragraph. The commissioner shall delegate authority to a new system established under this paragraph according to section 256B.0955.
(d) Effective July 1, 2007, the quality assurance system may be expanded to include programs for persons with disabilities and older adults.
(e) Effective July 1, 2013, a provider of service located in a county listed in paragraph (a) that is a non-opted-in county may opt in to the quality assurance system provided the county where services are provided indicates its agreement with a county with a delegation agreement with the Department of Human Services.
History:
1997 c 203 art 7 s 18; 1Sp2001 c 9 art 3 s 48; 2002 c 379 art 1 s 113; 1Sp2003 c 14 art 3 s 33; 1Sp2005 c 4 art 7 s 24; 2007 c 147 art 7 s 16; 2013 c 108 art 7 s 15
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256B — Medical Assistance For Needy Persons › Section 256B.0953 — Quality Assurance Process.

256B.0953 QUALITY ASSURANCE PROCESS.
Subdivision 1.
Process components.
(a) The quality assurance licensing process consists of an evaluation by a quality assurance team of the facility, program, or service according to outcome-based measurements. The process must include an evaluation of a random sample of program consumers. The sample must be representative of each service provided. The sample size must be at least five percent of consumers but not less than two consumers.
(b) All consumers must be given the opportunity to be included in the quality assurance process in addition to those chosen for the random sample.
Subd. 2.
Licensure periods.
(a) In order to be licensed under the alternative quality assurance licensing system, a facility, program, or service must satisfy the health and safety outcomes approved for the alternative quality assurance licensing system.
(b) Licensure shall be approved for periods of one to three years for a facility, program, or service that satisfies the requirements of paragraph (a) and achieves the outcome measurements in the categories of consumer evaluation, education and training, providers, and systems.
Subd. 3.
Appeals process.
A facility, program, or service may contest a licensing decision of the quality assurance team as permitted under chapter 245A.
History:
1997 c 203 art 7 s 21; 1Sp2003 c 14 art 3 s 41; 1Sp2005 c 4 art 7 s 27
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256B — Medical Assistance For Needy Persons › Section 256B.0954 — Certain Persons Defined As Mandated Reporters.

256B.0954 CERTAIN PERSONS DEFINED AS MANDATED REPORTERS.
Members of the Quality Assurance Commission established under section 256B.0951, members of quality assurance review councils established under section 256B.0952, quality assurance managers appointed under section 256B.0952, and members of quality assurance teams established under section 256B.0952 are mandated reporters as that term is defined in sections 260E.06, subdivision 1, and 626.5572, subdivision 16.
History:
1997 c 203 art 7 s 22; 1Sp2020 c 2 art 8 s 95
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256B — Medical Assistance For Needy Persons › Section 256B.0955 — Duties Of The Commissioner Of Human Services.

256B.0955 DUTIES OF THE COMMISSIONER OF HUMAN SERVICES.
(a) Effective July 1, 1998, the commissioner of human services shall delegate authority to perform licensing functions and activities, in accordance with section 245A.16, to counties participating in the alternative quality assurance licensing system. The commissioner shall not license or reimburse a facility, program, or service for persons with disabilities in a county that participates in the alternative quality assurance licensing system if the commissioner has received from the appropriate county notification that the facility, program, or service has been reviewed by a quality assurance team and has failed to qualify for licensure.
(b) The commissioner may conduct random licensing inspections based on outcomes adopted under section 256B.0951 at facilities, programs, and services governed by the alternative quality assurance licensing system. The role of such random inspections shall be to verify that the alternative quality assurance licensing system protects the safety and well-being of consumers and maintains the availability of high-quality services for persons with developmental disabilities.
History:
1997 c 203 art 7 s 23; 1999 c 245 art 4 s 65; 1Sp2003 c 14 art 3 s 42; 2013 c 108 art 7 s 20
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256B — Medical Assistance For Needy Persons › Section 256B.12 — Legal Representation.

256B.12 LEGAL REPRESENTATION.
The attorney general or the appropriate county attorney appearing at the direction of the attorney general shall be the attorney for the state agency, and the county attorney of the appropriate county shall be the attorney for the local agency in all matters pertaining hereto. To prosecute under this chapter or sections 609.466 and 609.52, subdivision 2, or to recover payments wrongfully made under this chapter, the attorney general or the appropriate county attorney, acting independently or at the direction of the attorney general may institute a criminal or civil action.
History:
Ex1967 c 16 s 12; 1975 c 437 art 2 s 6; 1976 c 188 s 2
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256B — Medical Assistance For Needy Persons › Section 256B.121 — Treble Damages.

256B.121 TREBLE DAMAGES.
Any vendor of medical care who willfully submits a cost report, rate application or claim for reimbursement for medical care which the vendor knows is a false representation and which results in the payment of public funds for which the vendor is ineligible shall, in addition to other provisions of Minnesota law, be subject to an action by the state of Minnesota or any of its subdivisions or agencies for civil damages. The damages awarded shall include three times the payments which result from the false representation, together with costs and disbursements, including reasonable attorney fees or their equivalent.
History:
1976 c 188 s 4
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256B — Medical Assistance For Needy Persons › Section 256B.13 — Subpoenas.

256B.13 SUBPOENAS.
Each county agency and the state agency shall have the power to issue subpoenas for witnesses and compel their attendance and the production of papers and writing; and officers and employees designated by any county agency or the state agency may administer oaths and examine witnesses under oath in connection with any application or proceedings hereunder.
History:
Ex1967 c 16 s 13
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256B — Medical Assistance For Needy Persons › Section 256B.17 — Transfers Of Property.

256B.17 TRANSFERS OF PROPERTY.
Subdivision 1.
[Repealed, 1997 c 107 s 19]
Subd. 2.
[Repealed, 1997 c 107 s 19]
Subd. 3.
[Repealed, 1997 c 107 s 19]
Subd. 4.
[Repealed, 1997 c 107 s 19]
Subd. 5.
[Repealed, 1997 c 107 s 19]
Subd. 6.
[Repealed, 1997 c 107 s 19]
Subd. 7.
Exception for asset transfers.
An institutionalized spouse, institutionalized before October 1, 1989, for a continuous period, who applies for medical assistance on or after July 1, 1983, may transfer liquid assets to a noninstitutionalized spouse if all of the following conditions apply:
(a) The noninstitutionalized spouse is not applying for or receiving assistance;
(b) Either (1) the noninstitutionalized spouse has less than $10,000 in liquid assets, including assets singly owned and 50 percent of assets owned jointly with the institutionalized spouse; or (2) the noninstitutionalized spouse has less than 50 percent of the total value of nonexempt assets owned by both parties, jointly or individually;
(c) The amount transferred, together with the noninstitutionalized spouse's own assets, totals no more than one-half of the total value of the liquid assets of the parties or $10,000 in liquid assets, whichever is greater; and
(d) The transfer may be effected only once, at the time of initial medical assistance application.
Subd. 8.
[Repealed, 1997 c 107 s 19]
History:
Ex1967 c 16 s 17; 1981 c 360 art 2 s 30; 1983 c 312 art 5 s 20-24; 1984 c 534 s 23; 1985 c 252 s 23; 1986 c 444; 1987 c 403 art 2 s 83,84; 1988 c 689 art 2 s 151,268; 1989 c 282 art 3 s 98; 1990 c 568 art 3 s 95,96; 1997 c 107 s 7
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256B — Medical Assistance For Needy Persons › Section 256B.18 — Methods Of Administration.

256B.18 METHODS OF ADMINISTRATION.
The state agency shall prescribe such methods of administration as are necessary for compliance with requirements of the Social Security Act, as amended, and for the proper and efficient operation of the program of assistance hereunder. The state agency shall establish and maintain a system of personnel standards on a merit basis for all such employees of the county agencies and the examination thereof, and the administration thereof shall be directed and controlled exclusively by the state agency except in those counties in which such employees are covered by a merit system that meets the requirements of the state agency and the Social Security Act, as amended.
History:
Ex1967 c 16 s 18
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256B — Medical Assistance For Needy Persons › Section 256B.194 — Federal Payments.

256B.194 FEDERAL PAYMENTS.
The commissioner may require medical assistance and MinnesotaCare providers to provide any information necessary to determine Medicaid-related costs, and require the cooperation of providers in any audit or review necessary to ensure payments are limited to cost. This section does not apply to providers who are exempt from the provisions of the CMS final rule, published May 29, 2007, at Federal Register, Vol. 72, No. 100, governing payments to providers that are units of government. This section becomes effective when the CMS final rule goes into effect at the end of the moratorium imposed by Congress.
History:
2008 c 363 art 17 s 12
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256B — Medical Assistance For Needy Persons › Section 256B.198 — Payments For Non-hospital-based Governmental Health Centers.

256B.198 PAYMENTS FOR NON-HOSPITAL-BASED GOVERNMENTAL HEALTH CENTERS.
(a) The commissioner may make payments to non-hospital-based health centers operated by a governmental entity for the difference between the expenditures incurred by the health center for patients eligible for medical assistance, and the payments to the health center for medical assistance permitted elsewhere under this chapter.
(b) The nonfederal share of payments authorized under paragraph (a) shall be provided through certified public expenditures authorized under section 256B.199, paragraph (b).
(c) Effective July 1, 2013, or no earlier than 12 months after implementation of a total cost of care demonstration project, Hennepin County may receive federal matching funds for certified public expenditures under paragraph (a), if the county participates in a total cost of care demonstration project under sections 256B.0755 and 256B.0756, or another total cost of care demonstration project approved by the commissioner, and the county exceeds the minimum performance threshold established by the commissioner for the demonstration project. The value of the federal matching funds for the certified public expenditures allocated to Hennepin County shall be equal to the value of savings achieved above the minimum performance threshold. The same proportion of federal matching funds for certified public expenditure allocated to Hennepin County based on savings achieved under the demonstration project shall continue after the demonstration project and must continue to be paid to Hennepin County each year thereafter.
(d) Beginning July 1, 2014, or no earlier than 12 months after the initial allocation under paragraph (c) if a portion of the federal matching funds for certified public expenditure remains with the state, the commissioner shall annually determine if the savings from county's total cost of care demonstration project exceeded the savings from the previous year and allocate federal matching funds for certified public expenditures to Hennepin County equal to the amount of savings achieved above the amount achieved in the previous year. The proportion of federal matching funds for certified public expenditure allocated to Hennepin County shall be paid to Hennepin County each year thereafter, until no federal matching funds for certified public expenditures under paragraph (a) remain with the state.
(e) Nothing under this section precludes Hennepin County from receiving an additional gain-sharing payment or relieves the county from paying a downside risk-sharing payment to the state under the demonstration project under section 256B.0755.
History:
1Sp2011 c 9 art 6 s 59
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256B — Medical Assistance For Needy Persons › Section 256B.199 — Payments Reported By Governmental Entities.

256B.199 PAYMENTS REPORTED BY GOVERNMENTAL ENTITIES.
(a) The commissioner shall apply for federal matching funds for the expenditures in paragraphs (b) and (c).
(b) The commissioner shall apply for federal matching funds for certified public expenditures as follows:
(1) Hennepin County, Hennepin County Medical Center, Ramsey County, and Regions Hospital shall report quarterly to the commissioner beginning June 1, 2007, payments made during the second previous quarter that may qualify for reimbursement under federal law;
(2) based on these reports, the commissioner shall apply for federal matching funds; and
(3) by May 1 of each year, beginning May 1, 2007, the commissioner shall inform the nonstate entities listed in paragraph (a) of the amount of federal disproportionate share hospital payment money expected to be available in the current federal fiscal year.
(c) For the period from April 1, 2009, to September 30, 2010, the commissioner shall apply for additional federal matching funds available as disproportionate share hospital payments under the American Recovery and Reinvestment Act of 2009. These funds shall be made available as the state share of payments. The entities required to report certified public expenditures under paragraph (b), clause (1), shall report additional certified public expenditures as necessary under this paragraph.
(d) For services provided on or after September 1, 2011, the commissioner shall apply for additional federal matching funds available as disproportionate share hospital payments under the MinnesotaCare program. A hospital may elect on an annual basis to not be a disproportionate share hospital for purposes of this paragraph, if the hospital does not qualify for a payment under section 256.969, subdivision 9, paragraph (a).
History:
1Sp2005 c 4 art 8 s 50; 2007 c 147 art 5 s 13; 2009 c 79 art 5 s 45; 1Sp2011 c 9 art 6 s 60; 2014 c 312 art 24 s 37; 2015 c 21 art 1 s 57
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256B — Medical Assistance For Needy Persons › Section 256B.21 — Change Of Residence.

256B.21 CHANGE OF RESIDENCE.
On changing residence, a recipient shall notify the county agency through which the recipient's medical assistance hereunder is paid. On removing to another county, the recipient shall declare whether such absence is temporary or for the purpose of residing therein.
History:
Ex1967 c 16 s 21; 1986 c 444
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256B — Medical Assistance For Needy Persons › Section 256B.22 — Compliance With Social Security Act.

256B.22 COMPLIANCE WITH SOCIAL SECURITY ACT.
The various terms and provisions hereof, including the amount of medical assistance paid hereunder, are intended to comply with and give effect to the program set out in title XIX of the federal Social Security Act. During any period when federal funds shall not be available or shall be inadequate to pay in full the federal share of medical assistance as defined in title XIX of the federal Social Security Act, as amended by Public Law 92-603, the state may reduce by an amount equal to such deficiency the payments it would otherwise be obligated to make pursuant to section 256B.041.
History:
Ex1967 c 16 s 22; 1973 c 717 s 20
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256B — Medical Assistance For Needy Persons › Section 256B.23 — Use Of Federal Funds.

256B.23 USE OF FEDERAL FUNDS.
All federal funds made available for the purposes hereof are hereby appropriated to the state agency to be disbursed and paid out in accordance with the provisions hereof.
History:
Ex1967 c 16 s 23
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256B — Medical Assistance For Needy Persons › Section 256B.24 — Prohibitions.

256B.24 PROHIBITIONS.
No enrollment fee, premium, or similar charge shall be required as a condition of eligibility for medical assistance hereunder.
History:
Ex1967 c 16 s 24
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256B — Medical Assistance For Needy Persons › Section 256B.25 — Payments To Certified Facilities.

256B.25 PAYMENTS TO CERTIFIED FACILITIES.
Subdivision 1.
Licensing required.
Payments may not be made hereunder for care in any private or public institution, including but not limited to hospitals and nursing homes, unless licensed by an appropriate licensing authority of this state, any other state, or a Canadian province and if applicable, certified by an appropriate authority under United States Code, title 42, sections 1396-1396p.
Subd. 2.
Payment distribution.
The payment of state or county funds to nursing homes, boarding care homes, and supervised living facilities, except payments to state operated institutions, for the care of persons who are eligible for medical assistance, shall be made only through the medical assistance program, except as provided in subdivision 3.
Subd. 3.
Payment exceptions.
The limitation in subdivision 2 shall not apply to:
(1) payment of Minnesota supplemental assistance funds to recipients who reside in facilities which are involved in litigation contesting their designation as an institution for treatment of mental disease;
(2) payment or grants to a boarding care home or supervised living facility licensed by the Department of Human Services under Minnesota Rules, parts 2960.0130 to 2960.0220, 2960.0580 to 2960.0700, or 9520.0500 to 9520.0670, or under chapter 245G or 245I, or payment to recipients who reside in these facilities;
(3) payments or grants to a boarding care home or supervised living facility which are ineligible for certification under United States Code, title 42, sections 1396-1396p; or
(4) payments or grants otherwise specifically authorized by statute or rule.
Subd. 4.
[Repealed, 2016 c 99 art 1 s 43]
History:
Ex1967 c 16 s 25; 1969 c 395 s 2; 1984 c 641 s 13; 1984 c 654 art 5 s 58; 1985 c 248 s 69; 1989 c 282 art 3 s 64; 2016 c 158 art 1 s 120,214; 2017 c 40 art 1 s 71; 2018 c 182 art 2 s 20; 2021 c 30 art 17 s 107; 2022 c 55 art 1 s 133
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256B — Medical Assistance For Needy Persons › Section 256B.26 — Agreements With Other State Departments.

256B.26 AGREEMENTS WITH OTHER STATE DEPARTMENTS.
The commissioner of the Department of Human Services is authorized to enter into cooperative agreements with other state departments or divisions of this state or of other states responsible for administering or supervising the administration of health services and vocational rehabilitation services in the state for maximum utilization of such service in the provision of medical assistance under sections 256B.01 to 256B.26.
History:
Ex1967 c 16 s 26; 1984 c 654 art 5 s 58
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256B — Medical Assistance For Needy Persons › Section 256B.30 — Health Care Facility Report.

256B.30 HEALTH CARE FACILITY REPORT.
Every facility required to be licensed under the provisions of sections 144.50 to 144.58, or 144A.02, shall provide annually to the commissioner of human services the reports as may be required under law and under rules adopted by the commissioner of human services under the Administrative Procedure Act. The rules shall provide for the submission of a full and complete financial report of a facility's operations including:
(1) An annual statement of income and expenditures;
(2) A complete statement of fees and charges;
(3) The names of all persons other than mortgage companies owning any interest in the facility including stockholders with an ownership interest of ten percent or more of the facility.
The financial reports and supporting data of the facility shall be available for inspection and audit by the commissioner of human services.
History:
1973 c 688 s 8; 1976 c 173 c 57; 1984 c 654 art 5 s 58
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256B — Medical Assistance For Needy Persons › Section 256B.32 — Facility Fee Payment.

256B.32 FACILITY FEE PAYMENT.
Subdivision 1.
Facility fee for hospital emergency room and clinic visit.
(a) The commissioner shall establish a facility fee payment mechanism that will pay a facility fee to all enrolled outpatient hospitals for each emergency room or outpatient clinic visit provided on or after July 1, 1989. This payment mechanism may not result in an overall increase in outpatient payment rates. This section does not apply to federally mandated maximum payment limits, department-approved program packages, or services billed using a nonoutpatient hospital provider number.
(b) For fee-for-service services provided on or after July 1, 2002, the total payment, before third-party liability and spenddown, made to hospitals for outpatient hospital facility services is reduced by .5 percent from the current statutory rates.
(c) In addition to the reduction in paragraph (b), the total payment for fee-for-service services provided on or after July 1, 2003, made to hospitals for outpatient hospital facility services before third-party liability and spenddown, is reduced five percent from the current statutory rates. Facilities defined under section 256.969, subdivision 16, are excluded from this paragraph.
(d) In addition to the reductions in paragraphs (b) and (c), the total payment for fee-for-service services provided on or after July 1, 2008, made to hospitals for outpatient hospital facility services before third-party liability and spenddown, is reduced three percent from the current statutory rates. Mental health services and facilities defined under section 256.969, subdivision 16, are excluded from this paragraph.
Subd. 2.
Prospective payment system.
Effective for services provided on or after July 1, 2003, rates that are based on the Medicare outpatient prospective payment system shall be replaced by a budget-neutral prospective payment system that is derived using medical assistance data.
History:
1989 c 285 s 4; 2002 c 220 art 15 s 14; 2002 c 275 s 4; 1Sp2003 c 14 art 12 s 55; 2008 c 363 art 17 s 13
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256B — Medical Assistance For Needy Persons › Section 256B.36 — Special Personal Allowance For Certain Individuals.

256B.36 SPECIAL PERSONAL ALLOWANCE FOR CERTAIN INDIVIDUALS.
In addition to the personal allowance established in section 256B.35, any disabled recipient of medical assistance who is a resident of a nursing facility or intermediate care facility for the developmentally disabled, shall also be permitted a special personal allowance drawn solely from earnings from any employment under an individual plan of rehabilitation. This special personal allowance shall consist of the sum of the following amounts, deducted from earnings in the following order:
(1) $80 for the costs of meals and miscellaneous work expenses;
(2) Federal Insurance Contributions Act payments withheld from the person's earned income;
(3) actual employment related transportation expenses;
(4) other actual employment related expenses; and
(5) state and federal income taxes withheld from the person's earned income, if the person cannot be claimed as exempt from federal income tax withholding.
The maximum special personal allowance from earnings is the sum of clauses (1) to (5).
History:
1974 c 575 s 16; 1985 c 21 s 56; 1986 c 444; 1992 c 513 art 7 s 83; 2005 c 56 s 1
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256B — Medical Assistance For Needy Persons › Section 256B.39 — Avoidance Of Duplicate Payments.

256B.39 AVOIDANCE OF DUPLICATE PAYMENTS.
Billing statements forwarded to recipients of medical assistance by vendors seeking payment for medical care rendered shall clearly state that reimbursement from the state agency is contemplated.
History:
1975 c 247 s 8
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256B — Medical Assistance For Needy Persons › Section 256B.421 — Definitions.

256B.421 DEFINITIONS.
Subdivision 1.
Scope.
For the purposes of this section and sections 256B.431, 256B.434, 256B.48, 256B.50, and 256B.502, the following term has the meaning given to it.
Subd. 2.
[Repealed, 2016 c 99 art 1 s 43]
Subd. 3.
[Repealed, 2016 c 99 art 1 s 43]
Subd. 4.
[Repealed, 2016 c 99 art 1 s 43]
Subd. 5.
[Repealed, 2016 c 99 art 1 s 43]
Subd. 6.
[Repealed, 2016 c 99 art 1 s 43]
Subd. 7.
[Repealed, 2016 c 99 art 1 s 43]
Subd. 8.
[Repealed, 2016 c 99 art 1 s 43]
Subd. 9.
[Repealed, 2016 c 99 art 1 s 43]
Subd. 10.
[Repealed, 2016 c 99 art 1 s 43]
Subd. 11.
[Repealed, 2016 c 99 art 1 s 43]
Subd. 12.
[Repealed, 2016 c 99 art 1 s 43]
Subd. 13.
[Repealed, 2016 c 99 art 1 s 43]
Subd. 14.
[Repealed, 2016 c 99 art 1 s 43]
Subd. 15.
[Repealed, 2016 c 99 art 1 s 43]
Subd. 16.
Capital assets.
"Capital assets," for purposes of section 256B.431, subdivisions 13 to 21, means a nursing facility's buildings, attached fixtures, land improvements, leasehold improvements, and all additions to or replacements of those assets used directly for resident care.
History:
1983 c 199 s 11; 1984 c 641 s 14-16; 1984 c 654 art 5 s 58; 1985 c 267 s 2; 1Sp1985 c 3 s 26; 1Sp1985 c 9 art 2 s 49; 1987 c 403 art 2 s 88; 1989 c 282 art 3 s 65; 1992 c 513 art 7 s 86,87,136; 1997 c 203 art 3 s 6; 2004 c 206 s 52; 2016 c 99 art 1 s 43; 2017 c 40 art 1 s 73
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256B — Medical Assistance For Needy Persons › Section 256B.4906 — Subminimum Wages In Home And Community-based Services Reporting.

256B.4906 SUBMINIMUM WAGES IN HOME AND COMMUNITY-BASED SERVICES REPORTING.
(a) A provider of home and community-based services for people with developmental disabilities under section 256B.092 or home and community-based services for people with disabilities under section 256B.49 that holds a credential listed in clause (1) or (2) as of August 1, 2023, must submit to the commissioner of human services data on individuals who are currently being paid subminimum wages or were being paid subminimum wages by the provider organization as of August 1, 2023:
(1) a certificate through the United States Department of Labor under United States Code, title 29, section 214(c), of the Fair Labor Standards Act authorizing the payment of subminimum wages to workers with disabilities; or
(2) a permit by the Minnesota Department of Labor and Industry under section 177.28.
(b) The report required under paragraph (a) must include the following data about each individual being paid subminimum wages:
(1) name;
(2) date of birth;
(3) identified race and ethnicity;
(4) disability type;
(5) key employment status measures as determined by the commissioner; and
(6) key community-life engagement measures as determined by the commissioner.
(c) The information in paragraph (b) must be submitted in a format determined by the commissioner.
(d) A provider must submit the data required under this section annually on a date specified by the commissioner. The commissioner must give a provider at least 30 calendar days to submit the data following notice of the due date. If a provider fails to submit the requested data by the date specified by the commissioner, the commissioner may delay medical assistance reimbursement until the requested data is submitted.
(e) Individually identifiable data submitted to the commissioner under this section are considered private data on individuals as defined by section 13.02, subdivision 12.
(f) The commissioner must analyze data annually for tracking employment and community-life engagement outcomes.
History:
2023 c 61 art 1 s 22
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256B — Medical Assistance For Needy Persons › Section 256B.5011 — Icf/dd Reimbursement System Effective October 1, 2000.

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 Rules, parts 9553.0010 to 9553.0080. In determining prospective payment rates of intermediate care facilities for persons with developmental disabilities, the commissioner shall index each facility's operating payment rate by an inflation factor as described in section 256B.5012. The commissioner of management and budget shall include annual inflation adjustments in operating costs for intermediate care facilities for persons with developmental disabilities as a budget change request in each biennial detailed expenditure budget submitted to the legislature under section 16A.11.
Subd. 2.
Contract provisions.
(a) The service contract with each intermediate care facility must include provisions for:
(1) modifying payments when significant changes occur in the needs of the consumers;
(2) appropriate and necessary statistical information required by the commissioner;
(3) annual aggregate facility financial information; and
(4) additional requirements for intermediate care facilities not meeting the standards set forth in the service contract.
(b) The commissioner of human services and the commissioner of health, in consultation with representatives from counties, advocacy organizations, and the provider community, shall review the home and community-based services standards under chapter 245D and the supervised living facility rule under Minnesota Rules, chapter 4665, to determine what provisions in Minnesota Rules, chapter 4665, may be waived by the commissioner of health for intermediate care facilities in order to enable facilities to implement the performance measures in their contract and provide quality services to residents without a duplication of or increase in regulatory requirements.
Subd. 3.
[Repealed, 1999 c 245 art 3 s 51]
History:
1998 c 407 art 3 s 16; 1999 c 245 art 3 s 31,32; 2000 c 474 s 13; 2005 c 56 s 1; 2009 c 79 art 8 s 70; 2009 c 101 art 2 s 109; 2009 c 159 s 100; 2013 c 108 art 9 s 11; 2013 c 125 art 1 s 107
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256B — Medical Assistance For Needy Persons › Section 256B.5014 — Reporting Requirements.

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 year in order to receive medical assistance payments. The reports for the reporting year ending December 31 must include:
(1) salaries and related expenses, including program salaries, administrative salaries, other salaries, payroll taxes, and fringe benefits;
(2) general operating expenses, including supplies, training, repairs, purchased services and consultants, utilities, food, licenses and fees, real estate taxes, insurance, and working capital interest;
(3) property related costs, including depreciation, capital debt interest, rent, and leases; and
(4) total annual resident days.
Subd. 2.
Labor market reporting.
All intermediate care facilities shall comply with the labor market reporting requirements described in section 256B.4912, subdivision 1a.
History:
1999 c 245 art 3 s 35; 1Sp2019 c 9 art 5 s 69
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256B — Medical Assistance For Needy Persons › Section 256B.5015 — Pass-through Of Other Services Costs.

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 252.46. The pass-through payments for training and habilitation services shall be paid separately by the commissioner and shall not be included in the computation of the ICF/DD facility total payment rate.
Subd. 2.
Services during the day.
(a) Services during the day, as defined in section 256B.501, but excluding day training and habilitation services, shall be paid as a pass-through payment. The commissioner shall establish rates for these services, other than day training and habilitation services, at 100 percent of a recipient's day training and habilitation service costs prior to the service change.
(b) An individual qualifies for services during the day under paragraph (a) if, through consultation with the individual and the individual's support team or interdisciplinary team:
(1) it has been determined that the individual's needs can best be met through partial or full retirement from:
(i) participation in a day training and habilitation service; or
(ii) the use of services during the day in the individual's home environment; and
(2) an individualized plan has been developed with designated outcomes that:
(i) address the support needs and desires contained in the person-centered plan or individual support plan; and
(ii) include goals that focus on community integration as appropriate for the individual.
(c) When establishing a rate for these services, the commissioner shall also consider an individual recipient's needs as identified in the individual support plan and the person's need for active treatment as defined under federal regulations. The pass-through payments for services during the day shall be paid separately by the commissioner and shall not be included in the computation of the ICF/DD facility total payment rate.
History:
1999 c 245 art 3 s 36; 1Sp2003 c 14 art 3 s 50; 2013 c 125 art 1 s 107; 2014 c 275 art 1 s 65; 1Sp2021 c 7 art 13 s 47
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256B — Medical Assistance For Needy Persons › Section 256B.502 — Rules.

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
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256B — Medical Assistance For Needy Persons › Section 256B.51 — Nursing Homes; Cost Of Home Care.

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 services may establish an experimental program to subsidize a limited number of eligible agencies or households which agree to carry out a planned program of in-home care for an elderly or physically disabled person. The household or agency to provide the services shall be selected by the person who will receive the services.
This program shall be limited to agencies or households caring for persons with a physical disability or persons 60 years of age or older, and who otherwise would require and be eligible for placement in a nursing home.
Subd. 2.
Grants.
Grants to eligible agencies or households shall be determined by the commissioner of human services. In determining the grants, the commissioner shall consider the cost of diagnostic assessments, homemaker services, specialized equipment, visiting nurses' or other pertinent therapists' costs, social services, day program costs, and related transportation expenses, not to exceed 50 percent of the average medical assistance reimbursement rate for nursing homes in the region of the person's residence.
Subd. 3.
Care plan required.
An individual care plan for the person shall be established and agreed upon by the person or agency providing the care, the person or agency receiving the subsidy, the person receiving the care, and the appropriate local welfare agency. The plan shall be periodically evaluated to determine the person's progress.
History:
1976 c 312 s 2; 1984 c 654 art 5 s 58; 2017 c 40 art 1 s 121
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256B — Medical Assistance For Needy Persons › Section 256B.691 — Risk-based Transportation Payments.

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 provide for payment for those services on a risk basis.
History:
1995 c 207 art 6 s 103; 2016 c 158 art 2 s 99
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256B — Medical Assistance For Needy Persons › Section 256B.6926 — State Monitoring.

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 Regulations, part 42, section 438.66, paragraph (b).
(b) The commissioner shall use data collected from the monitoring activities, including, at a minimum, the data identified in Code of Federal Regulations, part 42, section 438.66, paragraph (c), to improve the performance of the managed care program.
Subd. 2.
Readiness review.
The commissioner shall conduct a readiness review of each managed care organization that contracts with the commissioner to assess the managed care organization's ability and capacity to perform satisfactorily in the areas described in Code of Federal Regulations, part 42, section 438.66, paragraph (d), clauses (1) to (4). The review must be conducted and approval must be received from the Centers for Medicare and Medicaid Services prior to the commissioner entering into a contract with the managed care organization.
Subd. 3.
Report.
(a) The commissioner shall submit to the Centers for Medicare and Medicaid Services, no later than 180 days after each contract year, a report on the managed care program administered by the commissioner, regardless of the authority under which the program operates, with the initial report being submitted 180 days after the contract year following the release of the Centers for Medicare and Medicaid Services guidance. Each report must, at a minimum, assess the managed care program's operation in the areas identified in Code of Federal Regulations, part 42, section 438.66, paragraph (e), clause (2), and must be:
(1) provided to the Medicaid Citizens' Advisory Committee as required under Code of Federal Regulations, part 42, section 431.12;
(2) provided to the stakeholder consultation group as required under Code of Federal Regulations, part 42, section 438.70, to the extent the managed care program includes long-term services and supports; and
(3) published on the department's website.
(b) The report described under this subdivision may be used to meet the commissioner's reporting obligation under the managed care waiver authority for the managed care program.
Subd. 4.
Conflicts of interest.
The commissioner shall implement safeguards against conflicts of interest on behalf of state and local officers and employees and agents of the state who have responsibilities relating to managed care contracts. The safeguards must be at least as effective as the safeguards specified in United States Code, title 41, sections 2101 to 2107. The commissioner shall comply with Code of Federal Regulations, part 42, section 438.58, and United States Code, title 42, section 1396a, paragraph (a), clause (4), item (c), applicable to contracting officers, employees, or independent contractors.
History:
1Sp2017 c 6 art 15 s 5
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256B — Medical Assistance For Needy Persons › Section 256B.693 — State-operated Services; Managed Care.

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 shall identify the specific role to be assumed by state-operated services and the funding arrangement in which state-operated services shall effectively operate within the managed care initiative. The commissioner shall not approve or implement the initiative that consolidates funding appropriated for state-operated services with funding for managed care initiatives for persons with disabilities.
Subd. 2.
Study by the commissioner.
To help identify appropriate state-operated services for managed care systems, the commissioner of human services shall study the integration of state-operated services into public managed care systems and make recommendations to the legislature. The commissioner's study and recommendations shall include, but shall not be limited to, the following:
(1) identification of persons with disabilities on waiting lists for services, which could be provided by state-operated services;
(2) availability of crisis services to persons with disabilities;
(3) unmet service needs, which could be met by state-operated services; and
(4) deficiencies in managed care contracts and services, which hinder the placement and maintenance of persons with disabilities in community settings.
In conducting this study, the commissioner shall survey counties concerning their interest in and need for services that could be provided by state-operated services. The commissioner shall also consult with the appropriate exclusive bargaining unit representatives. The commissioner shall report findings to the legislature by February 1, 1998.
History:
1997 c 203 art 9 s 13
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256B — Medical Assistance For Needy Persons › Section 256B.694 — Sole-source Or Single-plan Managed Care Contract.

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 serve persons enrolled in state public health care programs, in order to promote better coordination or integration of health care services, social services and other community-based services, provided that all requirements applicable to health plan purchasing, including those in sections 256B.69 and 256B.692, are satisfied.
History:
1Sp2005 c 4 art 8 s 84; 2006 c 264 s 15; 2008 c 364 s 10; 2013 c 108 art 1 s 27; 2014 c 275 art 1 s 67
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256B — Medical Assistance For Needy Persons › Section 256B.70 — Demonstration Project Waiver.

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 prospective payment system for inpatient hospital service during the period of its participation in that project.
History:
1983 c 312 art 5 s 28; 1984 c 654 art 5 s 58; 1986 c 394 s 18; 2022 c 98 art 4 s 51