1.1.................... moves to amend H.F. No. 3237 as follows:
1.2Page 23, after line 31, insert:

1.3"ARTICLE 15
1.4PREPAID HEALTH PLANS

1.5    Section 1. Minnesota Statutes 2009 Supplement, section 256B.69, subdivision 5a,
1.6is amended to read:
1.7    Subd. 5a. Managed care contracts. (a) Managed care contracts under this section
1.8and sections 256L.12 and 256D.03, shall be entered into or renewed on a calendar year
1.9basis beginning January 1, 1996. Managed care contracts which were in effect on June
1.1030, 1995, and set to renew on July 1, 1995, shall be renewed for the period July 1, 1995
1.11through December 31, 1995 at the same terms that were in effect on June 30, 1995. The
1.12commissioner may issue separate contracts with requirements specific to services to
1.13medical assistance recipients age 65 and older.
1.14    (b) A prepaid health plan providing covered health services for eligible persons
1.15pursuant to chapters 256B, 256D, and 256L, is responsible for complying with the terms
1.16of its contract with the commissioner. Requirements applicable to managed care programs
1.17under chapters 256B, 256D, and 256L, established after the effective date of a contract
1.18with the commissioner take effect when the contract is next issued or renewed.
1.19    (c) Effective for services rendered on or after January 1, 2003, the commissioner
1.20shall withhold five percent of managed care plan payments under this section and
1.21county-based purchasing plan's payment rate under section 256B.692 for the prepaid
1.22medical assistance and general assistance medical care programs pending completion of
1.23performance targets. Each performance target must be quantifiable, objective, measurable,
1.24and reasonably attainable, except in the case of a performance target based on a federal
1.25or state law or rule. Criteria for assessment of each performance target must be outlined
1.26in writing prior to the contract effective date. The managed care plan must demonstrate,
2.1to the commissioner's satisfaction, that the data submitted regarding attainment of
2.2the performance target is accurate. The commissioner shall periodically change the
2.3administrative measures used as performance targets in order to improve plan performance
2.4across a broader range of administrative services. The performance targets must include
2.5measurement of plan efforts to contain spending on health care services and administrative
2.6activities. The commissioner may adopt plan-specific performance targets that take into
2.7account factors affecting only one plan, including characteristics of the plan's enrollee
2.8population. The withheld funds must be returned no sooner than July of the following
2.9year if performance targets in the contract are achieved. The commissioner may exclude
2.10special demonstration projects under subdivision 23.
2.11    (d) Effective for services rendered on or after January 1, 2009, through December 31,
2.122009, the commissioner shall withhold three percent of managed care plan payments under
2.13this section and county-based purchasing plan payments under section 256B.692 for the
2.14prepaid medical assistance and general assistance medical care programs. The withheld
2.15funds must be returned no sooner than July 1 and no later than July 31 of the following
2.16year. The commissioner may exclude special demonstration projects under subdivision 23.
2.17    The return of the withhold under this paragraph is not subject to the requirements of
2.18paragraph (c).
2.19(e) Effective for services provided on or after January 1, 2010, the commissioner
2.20shall require that managed care plans use the assessment and authorization processes,
2.21forms, timelines, standards, documentation, and data reporting requirements, protocols,
2.22billing processes, and policies consistent with medical assistance fee-for-service or the
2.23Department of Human Services contract requirements consistent with medical assistance
2.24fee-for-service or the Department of Human Services contract requirements for all
2.25personal care assistance services under section 256B.0659.
2.26(f) Effective for services rendered on or after January 1, 2010, through December
2.2731, 2010, the commissioner shall withhold 3.5 percent of managed care plan payments
2.28under this section and county-based purchasing plan payments under section 256B.692
2.29for the prepaid medical assistance program. The withheld funds must be returned no
2.30sooner than July 1 and no later than July 31 of the following year. The commissioner may
2.31exclude special demonstration projects under subdivision 23.
2.32(g) Effective for services rendered on or after January 1, 2011, through December
2.3331, 2011, the commissioner shall withhold four percent of managed care plan payments
2.34under this section and county-based purchasing plan payments under section 256B.692
2.35for the prepaid medical assistance program. The withheld funds must be returned no
3.1sooner than July 1 and no later than July 31 of the following year. The commissioner may
3.2exclude special demonstration projects under subdivision 23.
3.3(h) Effective for services rendered on or after January 1, 2012, through December
3.431, 2012, the commissioner shall withhold 4.5 percent of managed care plan payments
3.5under this section and county-based purchasing plan payments under section 256B.692
3.6for the prepaid medical assistance program. The withheld funds must be returned no
3.7sooner than July 1 and no later than July 31 of the following year. The commissioner may
3.8exclude special demonstration projects under subdivision 23.
3.9(i) Effective for services rendered on or after January 1, 2013, through December 31,
3.102013, the commissioner shall withhold 4.5 percent of managed care plan payments under
3.11this section and county-based purchasing plan payments under section 256B.692 for the
3.12prepaid medical assistance program. The withheld funds must be returned no sooner than
3.13July 1 and no later than July 31 of the following year. The commissioner may exclude
3.14special demonstration projects under subdivision 23.
3.15(j) Effective for services rendered on or after January 1, 2014, the commissioner
3.16shall withhold three percent of managed care plan payments under this section and
3.17county-based purchasing plan payments under section 256B.692 for the prepaid medical
3.18assistance and prepaid general assistance medical care programs. The withheld funds must
3.19be returned no sooner than July 1 and no later than July 31 of the following year. The
3.20commissioner may exclude special demonstration projects under subdivision 23.
3.21(k) A managed care plan or a county-based purchasing plan under section 256B.692
3.22may include as admitted assets under section 62D.044 any amount withheld under this
3.23section that is reasonably expected to be returned.
3.24(l) Contracts between the commissioner and a prepaid health plan are exempt from
3.25the set-aside and preference provisions of section 16C.16, subdivisions 6, paragraph
3.26(a), and 7.
3.27(m) The return of the withhold under paragraph (d) and paragraphs (f) to (j) is not
3.28subject to the requirements of paragraph (c)."
3.29Renumber the sections in sequence and correct the internal references
3.30Amend the title as follows:
3.31Page 1, line 8, after the first semicolon, insert "prepaid health plans;"