.................... moves to amend H.F. No. 1362, the delete everything amendment
(A09-0461), as follows:
Page 55, after line 10, insert:
"Sec. 8. Minnesota Statutes 2008, section 62U.05, is amended to read:
1.562U.05 PROVIDER PRICING FOR BASKETS OF CARE.
Subdivision 1. Establishment of definitions.
(a) By July 1, 2009, the commissioner
of health shall establish uniform definitions for baskets of care beginning with a minimum
of seven baskets of care. In selecting health conditions for which baskets of care should
be defined, the commissioner shall consider coronary artery and heart disease, diabetes,
asthma, and depression. In selecting health conditions, the commissioner shall also
consider the prevalence of the health conditions, the cost of treating the health conditions,
and the potential for innovations to reduce cost and improve quality.
1.13 (b) By July 1, 2010, the commissioner of health shall establish a uniform definition
1.14for an obstetric basket of care, that includes prenatal care, delivery and related inpatient
1.15hospital services and facility charges, and postnatal care.
The commissioner shall convene one or more work groups to assist in
establishing these definitions. Each work group shall include members appointed by
statewide associations representing relevant health care providers and health plan
companies, and organizations that work to improve health care quality in Minnesota.
To the extent possible, the baskets of care must incorporate a patient-directed,
decision-making support model.
Subd. 2. Package prices.
(a) Beginning January 1, 2010, health care providers may
establish package prices for the baskets of care defined under subdivision 1, paragraph (a).
1.24Beginning January 1, 2011, health care providers may establish package prices for the
1.25obstetric basket of care defined under subdivision 1, paragraph (b)
(b) Beginning January 1, 2010, no health care provider or group of providers that
has established a package price for a basket of care
under this section defined under
2.1subdivision 1, paragraph (a), and beginning January 1, 2011, no health care provider
2.2or group of providers that has established a package price for the obstetric basket of
2.3care defined under subdivision 1, paragraph (b),
shall vary the payment amount that the
provider accepts as full payment for a health care service based upon the identity of the
payer, upon a contractual relationship with a payer, upon the identity of the patient,
or upon whether the patient has coverage through a group purchaser. This paragraph
applies only to health care services provided to Minnesota residents or to non-Minnesota
residents who obtain health insurance through a Minnesota employer. This paragraph does
not apply to services paid for by Medicare, state public health care programs through
fee-for-service or prepaid arrangements, workers' compensation, or no-fault automobile
insurance. This paragraph does not affect the right of a provider to provide charity care
or care for a reduced price due to financial hardship of the patient or due to the patient
being a relative or friend of the provider.
Subd. 3. Quality measurements for baskets of care.
(a) The commissioner
shall establish quality measurements for the defined baskets of care under subdivision
2.161, paragraph (a)
by December 31, 2009. The commissioner shall establish quality
2.17measurements for the obstetric basket of care defined under subdivision 1, paragraph
2.18(b) by December 31, 2010.
The commissioner may contract with an organization that
works to improve health care quality to make recommendations about the use of existing
measures or establishing new measures where no measures currently exist.
(b) Beginning July 1, 2010, the commissioner or the commissioner's designee
shall publish comparative price and quality information on the baskets of care defined
2.23in subdivision 1, paragraph (a), and beginning July 1, 2011, the commissioner or the
2.24commissioner's designees shall publish comparative price and quality information on the
2.25obstetric basket of care defined in subdivision 1, paragraph (b),
in a manner that is easily
accessible and understandable to the public, as this information becomes available."
Page 61, after line 18, insert:
"Sec. 18. BIRTHING CENTER STUDY.
2.29 The commissioner of health, in consultation with a working group representing
2.30relevant health care providers and consumers, shall study standards for the regulation of
2.31birthing centers, and shall present recommendations to the legislature by January 15,
2.322010. In developing regulatory standards, the commissioner and the working group shall
2.33consider methods of regulating birthing centers in other states, and shall address issues
2.34that include, but are not limited to, licensure and alternative approaches to regulation,
2.35quality of care, access to care, and provider liability. For purposes of this section, "birthing
2.36center" means a health care facility that has as its primary purpose performing low-risk
3.1deliveries, that is not a hospital or in a hospital, and in which births are planned to occur
3.2away from the mother's usual residence following a normal, uncomplicated pregnancy.
Page 84, after line 20, insert
"(d) The Health Services Policy Committee shall review caesarean section rates
3.5for the fee-for-service medical assistance population. The committee may develop
3.6evidence-based coverage policy related to the performance of caesarean sections,
3.7including but not limited to standards and guidelines for health care providers and health
Page 102, after line 35, insert:
"Sec. 36. [256B.755] FACILITY REIMBURSEMENT FOR BIRTHS.
3.11 Notwithstanding section 256.969, effective for services provided on or after January
3.121, 2010, the facility payment rate for labor, birthing, and puerperium services provided
3.13by the facility for a cesarean section with or without complications or comorbidities
3.14and for a vaginal delivery with complicating diagnoses shall be no greater than $5,169
3.15when the services are provided through a managed care plan contract under sections
3.16256B.69, 256B.692, or 256L.12, or provided on a fee-for-service basis. This rate does not
3.17include newborn care.
Renumber the sections in sequence and correct the internal references
Amend the title accordingly