Bill Text: MN SF1219 | 2013-2014 | 88th Legislature | Introduced
Bill Title: Medical assistance (MA) rate setting administrative expenses allocation limit establishment
Spectrum: Moderate Partisan Bill (Democrat 4-1)
Status: (Introduced - Dead) 2013-03-11 - Referred to Health, Human Services and Housing [SF1219 Detail]
Download: Minnesota-2013-SF1219-Introduced.html
1.2relating to human services; limiting the expenses that can be allocated as
1.3administrative for purposes of medical assistance rate setting;amending
1.4Minnesota Statutes 2012, section 256B.69, subdivision 5i.
1.5BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.6 Section 1. Minnesota Statutes 2012, section 256B.69, subdivision 5i, is amended to read:
1.7 Subd. 5i. Administrative expenses. (a) Managed care plan and county-based
1.8purchasing plan administrative costs for a prepaid health plan provided under this section
1.9or section256B.692 must not exceed by more than five percent that prepaid health plan's
1.10or county-based purchasing plan's actual calculated administrative spending for the
1.11previous calendar year as a percentage of total revenue. The penalty for exceeding this
1.12limit must be the amount of administrative spending in excess of 105 percent of the actual
1.13calculated amount. The commissioner may waive this penalty if the excess administrative
1.14spending is the result of unexpected shifts in enrollment or member needs or new program
1.15requirements.
1.16 (b)Expenses listed under section
62D.12, subdivision 9a, clause (4), are not
1.17allowable administrative expenses for rate-setting purposes under this section, unless
1.18approved by the commissioner. The following expenses are not allowable administrative
1.19expenses for rate-setting purposes under this section:
1.20(1) charitable contributions made by the managed care plan;
1.21(2) administrative expenses above an amount proportional to the percentage of the
1.22plan's state public health program revenue;
1.23(3) any marketing or advertising expenses; and
1.24(4) any expenses associated with lobbying public officials.
1.3administrative for purposes of medical assistance rate setting;amending
1.4Minnesota Statutes 2012, section 256B.69, subdivision 5i.
1.5BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.6 Section 1. Minnesota Statutes 2012, section 256B.69, subdivision 5i, is amended to read:
1.7 Subd. 5i. Administrative expenses. (a) Managed care plan and county-based
1.8purchasing plan administrative costs for a prepaid health plan provided under this section
1.9or section
1.10or county-based purchasing plan's actual calculated administrative spending for the
1.11previous calendar year as a percentage of total revenue. The penalty for exceeding this
1.12limit must be the amount of administrative spending in excess of 105 percent of the actual
1.13calculated amount. The commissioner may waive this penalty if the excess administrative
1.14spending is the result of unexpected shifts in enrollment or member needs or new program
1.15requirements.
1.16 (b)
1.17
1.18
1.19expenses for rate-setting purposes under this section:
1.20(1) charitable contributions made by the managed care plan;
1.21(2) administrative expenses above an amount proportional to the percentage of the
1.22plan's state public health program revenue;
1.23(3) any marketing or advertising expenses; and
1.24(4) any expenses associated with lobbying public officials.
