1.1.................... moves to amend H.F. No. 2614, the delete everything amendment
1.2(H2614DE2) as follows:
1.3Page 12, delete section 1
1.4Page 14, line 25, delete everything after the period
1.5Page 14, delete lines 26 to 28
1.6Page 17, delete "$6,000,000" and insert "$6,200,000"
1.7Page 26, line 31, delete "65" and insert "100"
1.8Page 27, line 1, delete "or postpartum care"
1.9Page 28, delete section 20 and insert:

1.10    "Sec. 20. Minnesota Statutes 2008, section 256B.0644, as amended by Laws 2010,
1.11chapter 200, article 1, section 6, is amended to read:
1.12256B.0644 REIMBURSEMENT UNDER OTHER STATE HEALTH CARE
1.13PROGRAMS.
1.14    (a) A vendor of medical care, as defined in section 256B.02, subdivision 7, and a
1.15health maintenance organization, as defined in chapter 62D, must participate as a provider
1.16or contractor in the medical assistance program, general assistance medical care program,
1.17and MinnesotaCare as a condition of participating as a provider in health insurance plans
1.18and programs or contractor for state employees established under section 43A.18, the
1.19public employees insurance program under section 43A.316, for health insurance plans
1.20offered to local statutory or home rule charter city, county, and school district employees,
1.21the workers' compensation system under section 176.135, and insurance plans provided
1.22through the Minnesota Comprehensive Health Association under sections 62E.01 to
1.2362E.19 . The limitations on insurance plans offered to local government employees shall
1.24not be applicable in geographic areas where provider participation is limited by managed
1.25care contracts with the Department of Human Services.
1.26    (b) For providers other than health maintenance organizations, participation in the
1.27medical assistance program means that:
2.1     (1) the provider accepts new medical assistance, general assistance medical care,
2.2and MinnesotaCare patients;
2.3    (2) for providers other than dental service providers, at least 20 percent of the
2.4provider's patients are covered by medical assistance, general assistance medical care,
2.5and MinnesotaCare as their primary source of coverage; or
2.6    (3) for dental service providers, at least ten percent of the provider's patients are
2.7covered by medical assistance, general assistance medical care, and MinnesotaCare as
2.8their primary source of coverage, or the provider accepts new medical assistance and
2.9MinnesotaCare patients who are children with special health care needs. For purposes
2.10of this section, "children with special health care needs" means children up to age 18
2.11who: (i) require health and related services beyond that required by children generally;
2.12and (ii) have or are at risk for a chronic physical, developmental, behavioral, or emotional
2.13condition, including: bleeding and coagulation disorders; immunodeficiency disorders;
2.14cancer; endocrinopathy; developmental disabilities; epilepsy, cerebral palsy, and other
2.15neurological diseases; visual impairment or deafness; Down syndrome and other genetic
2.16disorders; autism; fetal alcohol syndrome; and other conditions designated by the
2.17commissioner after consultation with representatives of pediatric dental providers and
2.18consumers.
2.19    (c) Patients seen on a volunteer basis by the provider at a location other than
2.20the provider's usual place of practice may be considered in meeting the participation
2.21requirement in this section. The commissioner shall establish participation requirements
2.22for health maintenance organizations. The commissioner shall provide lists of participating
2.23medical assistance providers on a quarterly basis to the commissioner of management and
2.24budget, the commissioner of labor and industry, and the commissioner of commerce. Each
2.25of the commissioners shall develop and implement procedures to exclude as participating
2.26providers in the program or programs under their jurisdiction those providers who do
2.27not participate in the medical assistance program. The commissioner of management
2.28and budget shall implement this section through contracts with participating health and
2.29dental carriers.
2.30    (d) Any hospital or other provider that is participating in a coordinated care
2.31delivery system under section 256D.031, subdivision 6, or receives payments from the
2.32uncompensated care pool under section 256D.031, subdivision 8, shall not refuse to
2.33provide services to any patient enrolled in general assistance medical care regardless of
2.34the availability or the amount of payment.
3.1    (e) (d) For purposes of paragraphs (a) and (b), participation in the general assistance
3.2medical care program applies only to pharmacy providers dispensing prescription drugs
3.3according to section 256D.03, subdivision 3.
3.4EFFECTIVE DATE.This section is effective 30 days after federal approval of the
3.5amendments in this article to Minnesota Statutes, sections 256B.055, subdivision 15, and
3.6256B.056, subdivision 4, or January 1, 2011, whichever is later, and all remaining unspent
3.7appropriations for the program established by Laws 2010, chapter 200, are transferred
3.8to the health care access fund."
3.9Page 34, line 25, delete "2.0" and insert "1.4"
3.10Page 35, after line 2, insert:

3.11    "Sec. 27. Minnesota Statutes 2008, section 256B.69, subdivision 20, as amended by
3.12Laws 2010, chapter 200, article 1, section 10, is amended to read:
3.13    Subd. 20. Ombudsperson. (a) The commissioner shall designate an ombudsperson
3.14to advocate for persons required to enroll in prepaid health plans under this section. The
3.15ombudsperson shall advocate for recipients enrolled in prepaid health plans through
3.16complaint and appeal procedures and ensure that necessary medical services are provided
3.17either by the prepaid health plan directly or by referral to appropriate social services. At
3.18the time of enrollment in a prepaid health plan, the local agency shall inform recipients
3.19about the ombudsperson program and their right to a resolution of a complaint by the
3.20prepaid health plan if they experience a problem with the plan or its providers.
3.21    (b) The commissioner shall designate an ombudsperson to advocate for persons
3.22enrolled in a care coordination delivery system under section 256D.031. The
3.23ombudsperson shall advocate for recipients enrolled in a care coordination delivery
3.24system through the state appeal process and assist enrollees in accessing necessary
3.25medical services through the care coordination delivery systems directly or by referral to
3.26appropriate services. At the time of enrollment in a care coordination delivery system, the
3.27local agency shall inform recipients about the ombudsperson program.
3.28EFFECTIVE DATE.This section is effective 30 days after federal approval of the
3.29amendments in this article to Minnesota Statutes, sections 256B.055, subdivision 15, and
3.30256B.056, subdivision 4, or January 1, 2011, whichever is later, and all remaining unspent
3.31appropriations for the program established by Laws 2010, chapter 200, are transferred
3.32to the health care access fund."
3.33Page 36, line 36, delete " delivered in" and insert "billed by physicians employed by
3.34and"
3.35Page 37, line 1, delete everything after "organization"
4.1Page 37, line 2, delete everything before "shall"
4.2Page 55, delete section 57
4.3Page 55, delete section 58 and insert:

4.4    "Sec. 59. REPEALER; TRANSFER.
4.5(a) Laws 2010, chapter 200, article 1, section 12, subdivisions 1, 2, 3, 4, 5, 6, 7, 8,
4.6and 9, are repealed.
4.7(b) Laws 2010, chapter 200, article 1, sections 18; and 19, are repealed.
4.8(c) Minnesota Statutes 2008, section 256D.03, subdivisions 3a, 3b, 5, 6, 7, and 8,
4.9and Minnesota Statutes 2009 Supplement, section 256D.03, subdivision 3, are repealed.
4.10EFFECTIVE DATE.Paragraphs (a) and (b) are effective 30 days after federal
4.11approval of the amendments in this article to Minnesota Statutes, sections 256B.055,
4.12subdivision 15, and 256B.056, subdivision 4, or January 1, 2011, whichever is later, and
4.13all remaining unspent appropriations for the program established by Laws 2010, chapter
4.14200, are transferred to the health care access fund. Paragraph (c) is effective 30 days
4.15after federal approval of the amendments in this article to Minnesota Statutes, sections
4.16256B.055, subdivision 15, and 256B.056, subdivision 4, or January 1, 2011, whichever
4.17is later."
4.18Page 62, delete section 5
4.19Page 63, delete section 6
4.20Page 66, delete sections 8 and 9
4.21Page 68, line 24, delete "and separate" and delete "from" and insert "and"
4.22Page 68, line 25, after "management" insert "and make changes to improve the
4.23funding for administrative functions"
4.24Page 68, line 29, after the first comma, insert "provision for assignment of one case
4.25manager at a time per person,"
4.26Page 72, after line 30, insert:

4.27    "Sec. 5. Minnesota Statutes 2009 Supplement, section 256J.425, subdivision 3, is
4.28amended to read:
4.29    Subd. 3. Hard-to-employ participants. (a) An assistance unit subject to the time
4.30limit in section 256J.42, subdivision 1, is eligible to receive months of assistance under
4.31a hardship extension if the participant who reached the time limit belongs to any of the
4.32following groups:
4.33    (1) a person who is diagnosed by a licensed physician, psychological practitioner, or
4.34other qualified professional, as developmentally disabled or mentally ill, and the condition
4.35severely limits the person's ability to obtain or maintain suitable employment;
5.1    (2) a person who:
5.2    (i) has been assessed by a vocational specialist or the county agency to be
5.3unemployable for purposes of this subdivision; or
5.4    (ii) has an IQ below 80 who has been assessed by a vocational specialist or a county
5.5agency to be employable, but the condition severely limits the person's ability to obtain or
5.6maintain suitable employment. The determination of IQ level must be made by a qualified
5.7professional. In the case of a non-English-speaking person: (A) the determination must
5.8be made by a qualified professional with experience conducting culturally appropriate
5.9assessments, whenever possible; (B) the county may accept reports that identify an
5.10IQ range as opposed to a specific score; (C) these reports must include a statement of
5.11confidence in the results;
5.12    (3) a person who is determined by a qualified professional to be learning disabled,
5.13and the condition severely limits the person's ability to obtain or maintain suitable
5.14employment. For purposes of the initial approval of a learning disability extension, the
5.15determination must have been made or confirmed within the previous 12 months. In the
5.16case of a non-English-speaking person: (i) the determination must be made by a qualified
5.17professional with experience conducting culturally appropriate assessments, whenever
5.18possible; and (ii) these reports must include a statement of confidence in the results. If a
5.19rehabilitation plan for a participant extended as learning disabled is developed or approved
5.20by the county agency, the plan must be incorporated into the employment plan. However,
5.21a rehabilitation plan does not replace the requirement to develop and comply with an
5.22employment plan under section 256J.521; or
5.23    (4) a person who has been granted a family violence waiver, and who is complying
5.24with an employment plan under section 256J.521, subdivision 3.
5.25    (b) For purposes of this section chapter, "severely limits the person's ability to obtain
5.26or maintain suitable employment" means:
5.27    (1) that a qualified professional has determined that the person's condition prevents
5.28the person from working 20 or more hours per week; or
5.29    (2) for a person who meets the requirements of paragraph (a), clause (2), item (ii), or
5.30clause (3), a qualified professional has determined the person's condition:
5.31    (i) significantly restricts the range of employment that the person is able to perform;
5.32or
5.33    (ii) significantly interferes with the person's ability to obtain or maintain suitable
5.34employment for 20 or more hours per week."
5.35Page 78, delete section 5
5.36Page 79, after line 10, insert:

6.1    "Sec. 7. Minnesota Statutes 2008, section 62Q.76, subdivision 1, is amended to read:
6.2    Subdivision 1. Applicability. For purposes of sections 62Q.76 to 62Q.79 62Q.791,
6.3the terms defined in this section contract, health care provider, dental plan, dental
6.4organization, dentist, and enrollee have the meanings given them in sections 62Q.733
6.5and 62Q.76.

6.6    Sec. 8. [62Q.791] CONTRACTS WITH DENTAL CARE PROVIDERS.
6.7    (a) Notwithstanding any other provision of law, no contract of any dental
6.8organization licensed under chapter 62C for provision of dental care services may:
6.9    (1) require, directly or indirectly, that a dentist or health care provider provide dental
6.10care services to its enrollees at a fee set by the dental organization, unless the services
6.11provided are covered dental care services for enrollees under the dental plan or contract; or
6.12    (2) prohibit, directly or indirectly, the dentist or health care provider from offering or
6.13providing dental care services that are not covered dental care services under the dental
6.14plan or contract, on terms and conditions acceptable to the enrollee and the dentist or
6.15health care provider. For purposes of this section, "covered dental care services" means
6.16dental care services that are expressly covered under the dental plan or contract, including
6.17dental care services that are subject to contractual limitations such as deductibles,
6.18co-payments, annual maximums, and waiting periods.
6.19    (b) When making payment or otherwise adjudicating any claim for dental care
6.20services provided to an enrollee, a dental organization or dental plan must clearly identify
6.21on an explanation of benefits form or other form of claim resolution the amount, if any,
6.22that is the enrollee's responsibility to pay to the enrollee's dentist or health care provider.
6.23    (c) This section does not apply to any contract for the provision of dental care
6.24services under any public program sponsored or funded by the state or federal government.
6.25EFFECTIVE DATE.This section is effective August 1, 2010."
6.26Page 82, after line 22, insert:

6.27    "Sec. 15. [254B.13] PILOT PROJECTS; CHEMICAL HEALTH CARE.
6.28    Subdivision 1. Authorization for pilot projects. The commissioner of human
6.29services may approve and implement pilot projects developed under the planning process
6.30required under Laws 2009, chapter 79, article 7, section 26, to provide alternatives to and
6.31enhance coordination of the delivery of chemical health services required under section
6.32254B.03.
6.33    Subd. 2. Program design and implementation. (a) The commissioner of
6.34human services and counties participating in the pilot projects shall continue to work in
7.1partnership to refine and implement the pilot projects initiated under Laws 2009, chapter
7.279, article 7, section 26.
7.3    (b) The commissioner and counties participating in the pilot projects shall
7.4complete the planning phase by June 30, 2010, and, if approved by the commissioner for
7.5implementation, enter into agreements governing the operation of the pilot projects with
7.6implementation scheduled no earlier than July 1, 2010.
7.7    Subd. 3. Program evaluation. The commissioner of human services shall evaluate
7.8pilot projects under this section and report the results of the evaluation to the legislative
7.9committees with jurisdiction over chemical health by June 30, 2013. Evaluation of the
7.10pilot projects must be based on outcome evaluation criteria negotiated with the projects
7.11prior to implementation.
7.12    Subd. 4. Notice of project discontinuation. Each county's participation in the
7.13pilot project may be discontinued for any reason by the county or the commissioner of
7.14human services after 30 days' written notice to the other party. Any unspent funds held
7.15for the exiting county's pro rata share in the special revenue fund under the authority
7.16in subdivision 5, paragraph (c), shall be transferred to the general fund following
7.17discontinuation of the pilot project.
7.18    Subd. 5. Duties of commissioner. (a) Notwithstanding any other provisions in
7.19this chapter, the commissioner may authorize pilot projects to use chemical dependency
7.20treatment funds to pay for services:
7.21    (1) in addition to those authorized under section 254B.03, subdivision 2, paragraph
7.22(a); and
7.23    (2) by vendors in addition to those authorized under section 254B.05 when not
7.24providing chemical dependency treatment services.
7.25    (b) State expenditures for chemical dependency services and any other services
7.26provided by or through the pilot projects must not be greater than chemical dependency
7.27treatment fund expenditures expected in the absence of the pilot projects. The
7.28commissioner may restructure the schedule of payments between the state and participating
7.29counties under the local agency share and division of cost provisions under section
7.30254B.03, subdivisions 3 and 4, as necessary to facilitate the operation of the pilot projects.
7.31    (c) To the extent that state fiscal year expenditures within a pilot project region are
7.32less than expected in the absence of the pilot projects, the commissioner may deposit
7.33these unexpended funds in the special revenue fund and make these funds available for
7.34expenditure by the pilot counties the following year. To the extent that treatment and pilot
7.35project ancillary services expenditures within the pilot project exceed the amount expected
8.1in the absence of the pilot projects, the pilot counties are responsible for the portion of
8.2nontreatment expenditures in excess of otherwise expected expenditures.
8.3    (d) The commissioner may waive administrative rule requirements which are
8.4incompatible with the implementation of the pilot project.
8.5    (e) The commissioner shall not approve or enter into any agreement related to pilot
8.6projects authorized under this section which puts current or future federal funding at risk.
8.7    Subd. 6. Duties of county board. The county board, or other county entity that is
8.8approved to administer a pilot project, shall:
8.9    (1) administer the pilot project in a manner consistent with the objectives described
8.10in subdivision 2 and the planning process in subdivision 5;
8.11    (2) ensure that no one is denied chemical dependency treatment services for which
8.12they would otherwise be eligible under section 254A.03, subdivision 3; and
8.13    (3) provide the commissioner of human services with timely and pertinent
8.14information as negotiated in agreements governing operation of the pilot projects."
8.15Page 83, delete section 16
8.16Page 84, delete section 17 and insert:

8.17    "Sec. 17. REPEALER.
8.18Minnesota Statutes 2008, sections 254B.02, subdivisions 2, 3, and 4; and 254B.09,
8.19subdivisions 4, 5, and 7, and Laws 2009, chapter 79, article 7, section 26, subdivision 3,
8.20 are repealed."
8.21Page 105, line 2, after "centers," insert "the American College of Obstetricians and
8.22Gynecologists, the American Academy of Pediatrics, the Minnesota Hospital Association,
8.23and the Minnesota Ambulance Association,"
8.24Page 113, after line 20, insert:
8.25    "(c) Task force members must be appointed by July 1, 2010. The task force must
8.26hold its first meeting by July 15, 2010."
8.27Page 123, delete lines 20 to 23
8.28Page 127, delete lines 6 to 9
8.29Page 127, line 10, delete "(d)" and insert "(c)"
8.30Page 127, line 15, delete "(e)" and insert "(d)"
8.31Page 127, line 17, before the period, insert ", and $6,000,000 in each of fiscal years
8.322012 and 2013"
8.33Page 127, line 18, delete "(f)" and insert "(e)"
8.34Page 127, line 24, delete "(g)" and insert "(f)"
8.35Page 127, delete lines 32 and 33
8.36Page 128, delete lines 1 to 4
9.1Page 131, after line 15, insert:
9.2"Of this appropriation, $74,000 in fiscal
9.3year 2011 is to restore unallotments for the
9.4Office of Unlicensed Complementary and
9.5Alternative Health Care Practice."
9.6Page 131, after line 22, insert:
9.7"Health Care Reform Task Force.
9.8$200,000 from the general fund is for
9.9expenses related to the Health Care Reform
9.10Task Force established under article 7,
9.11section 6."
9.12Page 131, line 25, delete "commerce" and insert "health"
9.13Page 131, delete lines 31 to 35
9.14Page 132, delete lines 1 and 2
9.15Page 133, after line 25, insert:

9.16

"Sec. 5. Office of the Legislative Auditor

$

-0-

$

200,000

9.17$200,000 or an amount equal to 90 percent
9.18of the nonfederal administrative staff funds
9.19expended by the commissioner of human
9.20services related to the preparation and
9.21drafting of fiscal notes during fiscal year
9.222009, is transferred from the Department
9.23of Human Services to the Office of the
9.24Legislative Auditor, and appropriated for
9.25the fiscal year beginning July 1, 2011, for
9.26completion of the duties described in section
9.273.98."
9.28Page 160, line 17, delete "$44,265,000" and insert "$38,475,000" and delete
9.29"$5,570,000" and insert "$14,758,000"
9.30Page 160, line 18, delete "$23,613,000" and insert "$35,058,000"
9.31Page 160, after line 18, insert:
9.32"EFFECTIVE DATE.This section is effective upon federal approval of the
9.33amendments to Minnesota Statutes, sections 256B.055, subdivision 15, and 256B.056,
9.34subdivision 4."
9.35Correct the section totals and the appropriation summary
10.1Renumber the sections in sequence and correct the internal references
10.2Amend the title accordingly