1.1.................... moves to amend H.F. No. 1362, the delete everything amendment
1.2(A09-0461), as follows:
1.3Page 55, after line 10, insert:

1.4    "Sec. 8. Minnesota Statutes 2008, section 62U.05, is amended to read:
1.6    Subdivision 1. Establishment of definitions. (a) By July 1, 2009, the commissioner
1.7of health shall establish uniform definitions for baskets of care beginning with a minimum
1.8of seven baskets of care. In selecting health conditions for which baskets of care should
1.9be defined, the commissioner shall consider coronary artery and heart disease, diabetes,
1.10asthma, and depression. In selecting health conditions, the commissioner shall also
1.11consider the prevalence of the health conditions, the cost of treating the health conditions,
1.12and 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.
1.16    (b) (c) The commissioner shall convene one or more work groups to assist in
1.17establishing these definitions. Each work group shall include members appointed by
1.18statewide associations representing relevant health care providers and health plan
1.19companies, and organizations that work to improve health care quality in Minnesota.
1.20    (c) (d) To the extent possible, the baskets of care must incorporate a patient-directed,
1.21decision-making support model.
1.22    Subd. 2. Package prices. (a) Beginning January 1, 2010, health care providers may
1.23establish 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).
1.26    (b) Beginning January 1, 2010, no health care provider or group of providers that
1.27has 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
2.4provider accepts as full payment for a health care service based upon the identity of the
2.5payer, upon a contractual relationship with a payer, upon the identity of the patient,
2.6or upon whether the patient has coverage through a group purchaser. This paragraph
2.7applies only to health care services provided to Minnesota residents or to non-Minnesota
2.8residents who obtain health insurance through a Minnesota employer. This paragraph does
2.9not apply to services paid for by Medicare, state public health care programs through
2.10fee-for-service or prepaid arrangements, workers' compensation, or no-fault automobile
2.11insurance. This paragraph does not affect the right of a provider to provide charity care
2.12or care for a reduced price due to financial hardship of the patient or due to the patient
2.13being a relative or friend of the provider.
2.14    Subd. 3. Quality measurements for baskets of care. (a) The commissioner
2.15shall 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
2.19works to improve health care quality to make recommendations about the use of existing
2.20measures or establishing new measures where no measures currently exist.
2.21    (b) Beginning July 1, 2010, the commissioner or the commissioner's designee
2.22shall 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
2.26accessible and understandable to the public, as this information becomes available."
2.27Page 61, after line 18, insert:

2.28    "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."
3.3Page 84, after line 20, insert
3.4    "(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
3.8care facilities."
3.9Page 102, after line 35, insert:

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."
3.18Renumber the sections in sequence and correct the internal references
3.19Amend the title accordingly