Vote Smart's Synopsis:

Vote to amend and pass a bill that appropriates funds to various state agencies.

Highlights:

• Requires the commissioner to increase by 2 percent the fee-for-service payments under medical assistance and the MinnesotaCare program for services subject to the hospital, surgical center, or health care provider taxes (Article 8, Sec. 35).

• Requires the Board of Directors of MNsure to assess an individual’s eligibility for an advanced payment of the state-based health insurance tax credit, based on income for the relevant tax year (Article 9, Sec. 2).

• Requires, beginning 2021, a health carrier that has received notice from MNsure that an individual in their health plan is eligible for an advanced payment of the state-based health insurance premium tax credit to (Article 9, Sec. 2):

• Reduce the portion of the premium charged to the individual for the applicable months by the amount of the state-based health insurance tax credit determined by MNsure;

• Include the amount of advanced state-based health insurance premium tax credit determined by MNsure on each billing statement for which an advanced state-based health insurance tax credit has been applied; and

• Reconcile advanced payments of state-based health insurance premium tax credits with MNsure at least once a month.

• Requires the board to establish and administer the premium subsidy program to help eligible individuals pay for coverage when purchasing qualified health plans through MNsure in plan year 2020 and in each subsequent plan year (Article 9, Sec. 4).

• Requires the commissioner of human services, effective January 1, 2022, to establish an outpatient prescription drug formulary for MinnesotaCare, which must have a minimum of one drug in every United States Pharmacopeia category and class or the same number of prescription drugs in each category and class as the essential health benefit benchmark plan, whichever is greater (Article 9, Sec. 17).

• Requires a pharmacy that is enrolled to dispense prescription drugs to medical assistance enrollees, to participate as a provider in the MinnesotaCare outpatient prescription drug program (Article 9, Sec. 17).

• Requires the commissioner of human services, effective January 1, 2023, to establish a OneCare Buy-In coverage option that provides platinum level of coverage in accordance with the Affordable Care Act and benefits that are equal to 90 percent of the full actuarial value of the benefits provided under the OneCare Buy-In coverage option (Article 9, Sec. 20).

• Requires a person who is a wholesale drug distributor, a person who receives legend drugs for resale or use in Minnesota other than from a wholesale drug distributor that is subject to tax, or a person who sells or repairs hearing aids and related equipment or prescription eyewear, to be subject to the taxes in this chapter (Article 9, Sec. 25).

• Specifies that references to certain prescription requirements and health care providers prescribing Schedule II controlled substances do not extend to marijuana or tetrahydrocannabinols (Article 10, Sec. 5 & 6).

• Requires the commissioner of human services to implement an insulin assistance program by July 1, 2020, in order to (Article 10, Sec. 44):

• Pay participating pharmacies for insulin dispensed by a participating pharmacy to an eligible individual subject to a valid prescription; and

• Ensure pharmacy participation in the program in all areas of the state and maintain an up-to-date list of participating pharmacies on the department’s website.

• Requires the board to annually assess manufacturers a registration fee that in aggregate equals the total cost of the insulin assistance program for the previous fiscal year (Article 10, Sec. 30).

• Requires a health plan that provides prescription drug coverage, to provide coverage for a prescription drug in emergency situations under the terms of coverage that would apply had the prescription drug been dispensed according to a prescription (Article 10, Sec. 3).

• Prohibits a pharmacy benefit manager or a pharmacy benefit manager’s affiliates or subsidiaries from owning or having an ownership interest in a patient assistance program, unless the pharmacy benefit manager, affiliate, or subsidiary agrees to fair competition, no self-dealing, and no interference with prospective economic advantage, and establishes a firewall between the administrative functions and the mail order pharmacy (Article 10, Sec. 12).

• Prohibits a contract between a pharmacy benefit manager or health carrier and a pharmacy or pharmacist from prohibiting, restricting, or penalizing a pharmacy or pharmacist from disclosing to an enrollee any health care information that the pharmacy or pharmacists decides is appropriate concerning (Article 10, Sec. 16):

• The nature of treatment; 

• The risks or alternatives; 

• The availability of alternative therapies, consultations, or tests;

• The decision of utilization reviewers or similar persons to authorize or deny services; 

• The process that is used to authorize or deny health care services or benefits; or 

• Information on financial incentives and structures used by the health carrier or pharmacy benefit manager.

• Requires the board to publish a page on its website that provides regularly updated information, including (Article 10, Sec. 22):

• Pharmaceutical manufacturer patient assistance programs;

• The prescription drug assistance program established by the Minnesota Board of Aging;

• The emergency insulin assistance program;

• The websites through which individuals can access information concerning eligibility for and enrollment in Medicare, medical assistance, MinnesotaCare, and other government-funded programs that help pay for the cost of health care; and

• The program established under section 340b of the federal Public Health Services Act, United States Code, title 42, section 256b.

• Prohibits allowing a person under the age of 21 years to purchase or attempt to purchase tobacco, a tobacco-related device, an electronic delivery device, or a nicotine or lobelia delivery product (Article 12, Sec. 99).

• Defines “health maintenance organization” as a nonprofit corporation organized or a local governmental unit which provides comprehensive health maintenance services, or arranges for the provision of these services, to enrollees on the basis of a fixed prepaid sum without regard to the frequency or extent of services furnished to any particular enrollee (Article 13, Sec. 11).

• Expands protections for assisted living facility residents (Article 14, Sec. 5).

• Authorizes a resident in an assisted living facility a nursing home, or a boarding care home, or the resident’s representative to conduct electronic monitoring of their room or private living unit after August 1, 2021 (Article 14, Sec. 8).

• Requires every facility, upon execution of an assisted living contract, to provide the resident and the resident’s legal and designated representatives with the names and contact information, including telephone numbers and e-mail addresses, of (Article 14, Sec. 10):

• Nonprofit organizations that provide advocacy or legal services to residents; and

• The Office of Ombudsman for Long-Term Care, including both the state and regional contact information. 

• Appropriates funds for the following child care-related projects (Article 21, Section 2):

• Child care licensing inspections to ensure the health and safety of children in care, provide technical assistance to newly licensed programs, and monitor struggling programs more closely;

• Adding 2 data analysts in order to identify, detect, and prevent fraud and abuse in the child care assistance programs; 

• A system that will record, track, and report on investigative activity to strengthen fraud prevention and investigation activities for child care assistance programs; and

• Adding 2 additional law enforcement officers to conduct criminal investigations in child care assistance program cases.

• Appropriates funds to the Central Office of Continuing Care for Older Adults for (Article 21, Section 2):

• Creating a resident experience survey and family survey for all housing with services sites; and

• Developing the Home and Community-Based Report Card for assisted living.

• Appropriates funds to the following mental health grant projects (Article 21, Section 2):

• The Expansion of the Certified Community Behavioral Health Center (CCBHC);

• The Center for Victims of Torture;

• Mental Health Consultation;

• The Mobile Crisis Program;

• Recovery Community Organization grants; and

• Children’s Intensive Services Reform.

Full Bill Text