.................... moves to amend H.F. No. 3467, the second engrossment, as follows:
Page 21, line 14, after "account
" insert ": (1)
Page 21, line 15, delete ", and
" and insert "; (2)
Page 21, line 17, after "initiative
" insert "; and (3) all state savings resulting from
1.5implementation of the vendor contract under section 256B.0563, minus any payments to
1.6the vendor made under the terms of the revenue sharing agreement
Page 21, after line 26, insert:
Sec. 2. [256B.0563] ELIGIBILITY VERIFICATION.
1.9 Subdivision 1. Verification required; vendor contract. (a) The commissioner shall
1.10ensure that medical assistance and MinnesotaCare eligibility determinations through the
1.11MNsure information technology system and through agency eligibility determination
1.12systems include the computerized verification of income, residency, identity, and, when
1.14(b) The commissioner shall contract with a vendor to verify the eligibility of all
1.15persons enrolled in medical assistance and MinnesotaCare during a specified audit period.
1.16This contract shall be exempt from sections 16C.08, subdivision 2, clause (1); 16C.09,
1.17paragraph (a), clause (1); 43A.047, paragraph (a), and any other law to the contrary.
1.18(c) The contract must require the vendor to comply with enrollee data privacy
1.19requirements and to use encryption to safeguard enrollee identity. The contract must also
1.20provide penalties for vendor noncompliance.
1.21(d) The contract must include a revenue sharing agreement, under which vendor
1.22compensation is limited to a portion of any savings to the state resulting from the vendor's
1.23implementation of eligibility verification initiatives under this section.
1.24(e) The commissioner shall use existing resources to fund any agency administrative
1.25and technology-related costs incurred as a result of implementing this section.
1.26 Subd. 2. Verification process; vendor duties. (a) The verification process
1.27implemented by the vendor must include, but is not limited to, data matches of the
2.1name, date of birth, address, and Social Security number of each medical assistance and
2.2MinnesotaCare enrollee against relevant information in federal and state data sources,
2.3including the federal data hub established under the Affordable Care Act. In designing the
2.4verification process, the vendor, to the extent feasible, shall incorporate procedures that are
2.5compatible and coordinated with, and build upon or improve, existing procedures used by
2.6the MNsure information technology system and agency eligibility determination systems.
2.7(b) The vendor, upon preliminary determination that an enrollee is eligible or
2.8ineligible, shall notify the commissioner. Within 20 business days of this notification, the
2.9commissioner shall accept the preliminary determination or reject it with a stated reason.
2.10The commissioner shall retain final authority over eligibility determinations. The vendor
2.11shall keep a record of all preliminary determinations of ineligibility communicated to
2.13(c) The vendor shall recommend to the commissioner an eligibility verification
2.14process that will allow ongoing verification of enrollee eligibility under the MNsure
2.15information technology system and agency eligibility determination systems.
2.16(d) The commissioner and the vendor, following the conclusion of the initial
2.17contract period, shall jointly submit an eligibility verification audit report to the chairs
2.18and ranking minority members of the legislative committees with jurisdiction over health
2.19and human services policy and finance. The report shall include, but is not limited to,
2.20information, in the form of unidentified summary data, on preliminary determinations
2.21of eligibility or ineligibility communicated by the vendor; the actions taken on those
2.22preliminary determinations by the commissioner; and the commissioner's reasons for
2.23rejecting preliminary determinations by the vendor. The report must also include the
2.24recommendations for ongoing verification of enrollee eligibility required under paragraph
2.26(e) An eligibility verification vendor contract shall be awarded for an initial one-year
2.27period. The commissioner shall renew the contract for up to three additional one-year
2.28periods and require additional eligibility verification audits, if the commissioner or the
2.29legislative auditor determines that the MNsure information technology system and agency
2.30eligibility determination systems cannot effectively verify the eligibility of medical
2.31assistance and MinnesotaCare enrollees.
Renumber the sections in sequence and correct the internal references
Amend the title accordingly