1.1.................... moves to amend H.F. No. 2614, the delete everything amendment
1.2(H2614DE2) as follows:
1.3Page 14, line 21, delete "2.5" and insert "3.0"
1.4Page 14, line 23, delete "2.5" and insert "3.0"
1.5Page 18, line 27, after the period, insert "Hospitals that, prior to December 31, 2007,
1.6received payment to support the training of residents from an approved graduate medical
1.7residency training program pursuant to 42 United States Code, section 256e, are not
1.8subject to the provisions of this paragraph."
1.9Page 35, after line 22, insert:

1.10    "Sec. 29. Minnesota Statutes 2008, section 256B.75, is amended to read:
1.11256B.75 HOSPITAL OUTPATIENT REIMBURSEMENT.
1.12    (a) For outpatient hospital facility fee payments for services rendered on or after
1.13October 1, 1992, the commissioner of human services shall pay the lower of (1) submitted
1.14charge, or (2) 32 percent above the rate in effect on June 30, 1992, except for those
1.15services for which there is a federal maximum allowable payment. Effective for services
1.16rendered on or after January 1, 2000, payment rates for nonsurgical outpatient hospital
1.17facility fees and emergency room facility fees shall be increased by eight percent over the
1.18rates in effect on December 31, 1999, except for those services for which there is a federal
1.19maximum allowable payment. Services for which there is a federal maximum allowable
1.20payment shall be paid at the lower of (1) submitted charge, or (2) the federal maximum
1.21allowable payment. Total aggregate payment for outpatient hospital facility fee services
1.22shall not exceed the Medicare upper limit. If it is determined that a provision of this
1.23section conflicts with existing or future requirements of the United States government with
1.24respect to federal financial participation in medical assistance, the federal requirements
1.25prevail. The commissioner may, in the aggregate, prospectively reduce payment rates to
1.26avoid reduced federal financial participation resulting from rates that are in excess of
1.27the Medicare upper limitations.
2.1    (b) Notwithstanding paragraph (a), payment for outpatient, emergency, and
2.2ambulatory surgery hospital facility fee services for critical access hospitals designated
2.3under section 144.1483, clause (10), shall be paid on a cost-based payment system that is
2.4based on the cost-finding methods and allowable costs of the Medicare program.
2.5    (c) Effective for services provided on or after July 1, 2003, rates that are based
2.6on the Medicare outpatient prospective payment system shall be replaced by a budget
2.7neutral prospective payment system that is derived using medical assistance data. The
2.8commissioner shall provide a proposal to the 2003 legislature to define and implement
2.9this provision.
2.10    (d) For fee-for-service services provided on or after July 1, 2002, the total payment,
2.11before third-party liability and spenddown, made to hospitals for outpatient hospital
2.12facility services is reduced by .5 percent from the current statutory rate.
2.13    (e) In addition to the reduction in paragraph (d), the total payment for fee-for-service
2.14services provided on or after July 1, 2003, made to hospitals for outpatient hospital
2.15facility services before third-party liability and spenddown, is reduced five percent from
2.16the current statutory rates. Facilities defined under section 256.969, subdivision 16, are
2.17excluded from this paragraph.
2.18    (f) In addition to the reductions in paragraphs (d) and (e), the total payment for
2.19fee-for-service services provided on or after July 1, 2008, made to hospitals for outpatient
2.20hospital facility services before third-party liability and spenddown, is reduced three
2.21percent from the current statutory rates. Mental health services and facilities defined under
2.22section 256.969, subdivision 16, are excluded from this paragraph.
2.23    (g) Notwithstanding any contrary provision in this section, payment for all outpatient
2.24and emergency services provided by any hospital that, prior to December 31, 2007, has
2.25received payment to support the training of residents from an approved graduate medical
2.26residency training program under title 42, United States Code, section 256e, must be paid
2.27at a rate that is a function of each hospital's base year costs incurred in providing those
2.28services. For fiscal years 2011, 2012, and 2013, the rate must be the rate determined by the
2.29commissioner to maintain payments at the rates that were being paid in fiscal year 2010.
2.30Payment rates for subsequent fiscal years are as follows:
2.31    (1) 2014: 50 percent of costs;
2.32    (2) 2015: 60 percent of costs;
2.33    (3) 2016: 70 percent of costs;
2.34    (4) 2017: 80 percent of costs;
2.35    (5) 2018: 90 percent of costs; and
2.36    (6) 2019 and thereafter: 100 percent of costs."
3.1Renumber the sections in sequence and correct the internal references
3.2Amend the title accordingly