1.1.................... moves to amend S. F. No. 1523, the second engrossment, as amended,
1.2as follows:
1.3Page 6, after line 2, insert:

"1.4    Sec. 7. Minnesota Statutes 2014, section 62Q.81, subdivision 4, is amended to read:
1.5    Subd. 4. Essential health benefits; definition. For purposes of this section,
1.6"essential health benefits" has the meaning given under section 1302(b) of the Affordable
1.7Care Act and includes:
1.8    (1) ambulatory patient services;
1.9    (2) emergency services;
1.10    (3) hospitalization;
1.11    (4) laboratory services;
1.12    (5) maternity and newborn care;
1.13    (6) mental health and substance use disorder services, including behavioral health
1.14treatment;
1.15    (7) pediatric services, including oral and vision care;
1.16    (8) prescription drugs;
1.17    (9) preventive and wellness services and chronic disease management;
1.18    (10) rehabilitative and habilitative services and devices, including services for
1.19autism spectrum disorder treatment specified pursuant to section 62A.3094; and
1.20    (11) additional essential health benefits included in the EHB-benchmark plan, as
1.21defined under the Affordable Care Act.
1.22EFFECTIVE DATE.This section is effective for health plans issued or renewed
1.23on or after January 1, 2017. If the federal government issues a formal determination
1.24that the services are a new state mandate and requires the state to cover the cost for
1.25autism spectrum disorder treatment services specified under Minnesota Statutes, section
1.2662A.3094, the inclusion of these services under this section, is repealed effective at the
1.27end of the health plan coverage year.

2.1    Sec. 8. Minnesota Statutes 2015 Supplement, section 252.27, subdivision 2a, is
2.2amended to read:
2.3    Subd. 2a. Contribution amount. (a) The natural or adoptive parents of a minor
2.4child, including a child determined eligible for medical assistance without consideration of
2.5parental income, must contribute to the cost of services used by making monthly payments
2.6on a sliding scale based on income, unless the child is married or has been married, parental
2.7rights have been terminated, or the child's adoption is subsidized according to chapter
2.8259A or through title IV-E of the Social Security Act. The parental contribution is a partial
2.9or full payment for medical services provided for diagnostic, therapeutic, curing, treating,
2.10mitigating, rehabilitation, maintenance, and personal care services as defined in United
2.11States Code, title 26, section 213, needed by the child with a chronic illness or disability.
2.12    (b) For households with adjusted gross income equal to or greater than 275 percent
2.13of federal poverty guidelines, the parental contribution shall be computed by applying the
2.14following schedule of rates to the adjusted gross income of the natural or adoptive parents:
2.15    (1) if the adjusted gross income is equal to or greater than 275 percent of federal
2.16poverty guidelines and less than or equal to 545 percent of federal poverty guidelines,
2.17the parental contribution shall be determined using a sliding fee scale established by the
2.18commissioner of human services which begins at 2.23 1.95 percent of adjusted gross
2.19income at 275 percent of federal poverty guidelines and increases to 6.08 5.32 percent of
2.20adjusted gross income for those with adjusted gross income up to 545 percent of federal
2.21poverty guidelines;
2.22    (2) if the adjusted gross income is greater than 545 percent of federal poverty
2.23guidelines and less than 675 percent of federal poverty guidelines, the parental
2.24contribution shall be 6.08 5.32 percent of adjusted gross income;
2.25    (3) if the adjusted gross income is equal to or greater than 675 percent of federal
2.26poverty guidelines and less than 975 percent of federal poverty guidelines, the parental
2.27contribution shall be determined using a sliding fee scale established by the commissioner
2.28of human services which begins at 6.08 5.32 percent of adjusted gross income at 675 percent
2.29of federal poverty guidelines and increases to 8.1 7.09 percent of adjusted gross income
2.30for those with adjusted gross income up to 975 percent of federal poverty guidelines; and
2.31    (4) if the adjusted gross income is equal to or greater than 975 percent of federal
2.32poverty guidelines, the parental contribution shall be 10.13 8.86 percent of adjusted
2.33gross income.
2.34    If the child lives with the parent, the annual adjusted gross income is reduced by
2.35$2,400 prior to calculating the parental contribution. If the child resides in an institution
2.36specified in section 256B.35, the parent is responsible for the personal needs allowance
3.1specified under that section in addition to the parental contribution determined under this
3.2section. The parental contribution is reduced by any amount required to be paid directly to
3.3the child pursuant to a court order, but only if actually paid.
3.4    (c) The household size to be used in determining the amount of contribution under
3.5paragraph (b) includes natural and adoptive parents and their dependents, including the
3.6child receiving services. Adjustments in the contribution amount due to annual changes
3.7in the federal poverty guidelines shall be implemented on the first day of July following
3.8publication of the changes.
3.9    (d) For purposes of paragraph (b), "income" means the adjusted gross income of the
3.10natural or adoptive parents determined according to the previous year's federal tax form,
3.11except, effective retroactive to July 1, 2003, taxable capital gains to the extent the funds
3.12have been used to purchase a home shall not be counted as income.
3.13    (e) The contribution shall be explained in writing to the parents at the time eligibility
3.14for services is being determined. The contribution shall be made on a monthly basis
3.15effective with the first month in which the child receives services. Annually upon
3.16redetermination or at termination of eligibility, if the contribution exceeded the cost of
3.17services provided, the local agency or the state shall reimburse that excess amount to
3.18the parents, either by direct reimbursement if the parent is no longer required to pay a
3.19contribution, or by a reduction in or waiver of parental fees until the excess amount is
3.20exhausted. All reimbursements must include a notice that the amount reimbursed may be
3.21taxable income if the parent paid for the parent's fees through an employer's health care
3.22flexible spending account under the Internal Revenue Code, section 125, and that the
3.23parent is responsible for paying the taxes owed on the amount reimbursed.
3.24    (f) The monthly contribution amount must be reviewed at least every 12 months;
3.25when there is a change in household size; and when there is a loss of or gain in income
3.26from one month to another in excess of ten percent. The local agency shall mail a written
3.27notice 30 days in advance of the effective date of a change in the contribution amount.
3.28A decrease in the contribution amount is effective in the month that the parent verifies a
3.29reduction in income or change in household size.
3.30    (g) Parents of a minor child who do not live with each other shall each pay the
3.31contribution required under paragraph (a). An amount equal to the annual court-ordered
3.32child support payment actually paid on behalf of the child receiving services shall be
3.33deducted from the adjusted gross income of the parent making the payment prior to
3.34calculating the parental contribution under paragraph (b).
3.35    (h) The contribution under paragraph (b) shall be increased by an additional five
3.36percent if the local agency determines that insurance coverage is available but not
4.1obtained for the child. For purposes of this section, "available" means the insurance is a
4.2benefit of employment for a family member at an annual cost of no more than five percent
4.3of the family's annual income. For purposes of this section, "insurance" means health
4.4and accident insurance coverage, enrollment in a nonprofit health service plan, health
4.5maintenance organization, self-insured plan, or preferred provider organization.
4.6    Parents who have more than one child receiving services shall not be required
4.7to pay more than the amount for the child with the highest expenditures. There shall
4.8be no resource contribution from the parents. The parent shall not be required to pay
4.9a contribution in excess of the cost of the services provided to the child, not counting
4.10payments made to school districts for education-related services. Notice of an increase in
4.11fee payment must be given at least 30 days before the increased fee is due.
4.12    (i) The contribution under paragraph (b) shall be reduced by $300 per fiscal year if,
4.13in the 12 months prior to July 1:
4.14    (1) the parent applied for insurance for the child;
4.15    (2) the insurer denied insurance;
4.16    (3) the parents submitted a complaint or appeal, in writing to the insurer, submitted
4.17a complaint or appeal, in writing, to the commissioner of health or the commissioner of
4.18commerce, or litigated the complaint or appeal; and
4.19    (4) as a result of the dispute, the insurer reversed its decision and granted insurance.
4.20    For purposes of this section, "insurance" has the meaning given in paragraph (h).
4.21    A parent who has requested a reduction in the contribution amount under this
4.22paragraph shall submit proof in the form and manner prescribed by the commissioner or
4.23county agency, including, but not limited to, the insurer's denial of insurance, the written
4.24letter or complaint of the parents, court documents, and the written response of the insurer
4.25approving insurance. The determinations of the commissioner or county agency under this
4.26paragraph are not rules subject to chapter 14.
"4.27Amend the title accordingly