Bill Text: MN SF2660 | 2013-2014 | 88th Legislature | Engrossed
Bill Title: Medical assistance (MA) nonemergency medical transportation services covered service provisions modifications
Spectrum: Partisan Bill (Democrat 2-0)
Status: (Introduced - Dead) 2014-03-20 - Comm report: To pass as amended and re-refer to Finance [SF2660 Detail]
Download: Minnesota-2013-SF2660-Engrossed.html
1.2relating to human services; modifying nonemergency medical transportation
1.3services provisions;amending Minnesota Statutes 2012, section 256B.0625,
1.4subdivisions 17a, 18a, 18b, 18c, 18d, 18g, by adding a subdivision; Minnesota
1.5Statutes 2013 Supplement, section 256B.0625, subdivisions 17, 18e; repealing
1.6Minnesota Statutes 2013 Supplement, section 256B.0625, subdivision 18f.
1.7BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.8 Section 1. Minnesota Statutes 2013 Supplement, section 256B.0625, subdivision 17,
1.9is amended to read:
1.10 Subd. 17. Transportation costs. (a) "Nonemergency medical transportation
1.11service" means motor vehicle transportation provided by a public or private person
1.12that serves Minnesota health care program beneficiaries who do not require emergency
1.13ambulance service, as defined in section 144E.001, subdivision 3, to obtain covered
1.14medical services. Nonemergency medical transportation service includes, but is not
1.15limited to, special transportation service, defined in section 174.29, subdivision 1.
1.16(a) (b) Medical assistance covers medical transportation costs incurred solely for
1.17obtaining emergency medical care or transportation costs incurred by eligible persons in
1.18obtaining emergency or nonemergency medical care when paid directly to an ambulance
1.19company, common carrier, or other recognized providers of transportation services.
1.20Medical transportation must be provided by:
1.21(1)an ambulance nonemergency medical transportation providers who meet the
1.22requirements of this subdivision;
1.23(2) ambulances, as defined in section144E.001, subdivision 2 ;
1.24(2) special transportation; or
2.1(3)common carrier including, but not limited to, bus, taxicab, other commercial
2.2carrier, or private automobile taxicabs and public transit, as defined in section 174.22,
2.3subdivision 7; or
2.4(4) not-for-hire vehicles, including volunteer drivers.
2.5(b) (c) Medical assistance covers special transportation, as defined in Minnesota
2.6Rules, part 9505.0315, subpart 1, item F, if the recipient has a physical or mental
2.7impairment that would prohibit the recipient from safely accessing and using a bus,
2.8taxi, other commercial transportation, or private automobile. nonemergency medical
2.9transportation provided by nonemergency medical transportation providers enrolled in
2.10the Minnesota health care programs. All nonemergency medical transportation providers
2.11must comply with the operating standards for special transportation service as defined in
2.12sections 174.29 to 174.30 and Minnesota Rules, chapter 8840, and in consultation with
2.13the Minnesota Department of Transportation. All nonemergency medical transportation
2.14providers shall bill for nonemergency medical transportation services in accordance with
2.15Minnesota health care programs criteria. Publicly operated transit systems, volunteers,
2.16and not-for-hire vehicles are exempt from the requirements outlined in this paragraph.
2.17(d) The administrative agency of nonemergency medical transportation must:
2.18(1) adhere to the policies defined by the commissioner in consultation with the
2.19Nonemergency Medical Transportation Advisory Committee;
2.20(2) pay nonemergency medical transportation providers for services provided to
2.21Minnesota health care programs beneficiaries to obtain covered medical services;
2.22(3) provide data monthly to the commissioner on appeals, complaints, no-shows,
2.23canceled trips, and number of trips by mode; and
2.24(4) by July 1, 2016, in accordance with subdivision 18e, utilize a Web-based single
2.25administrative structure assessment tool that meets the technical requirements established
2.26by the commissioner, reconciles trip information with claims being submitted by
2.27providers, and ensures prompt payment for nonemergency medical transportation services.
2.28 (e) Until the commissioner implements the single administrative structure and
2.29delivery system under subdivision 18e, clients shall obtain their level-of-service certificate
2.30from the commissioner or an entity approved by the commissioner that does not dispatch
2.31rides for clients using modes under paragraph (h), clauses (4), (5), (6), and (7).
2.32 (f) The commissioner may use an order by the recipient's attending physician
2.33 or a medical or mental health professional to certify that the recipient requires
2.34special transportation services nonemergency medical transportation services. Special
2.35 Nonemergency medical transportation providers shall perform driver-assisted services for
2.36eligible individuals, when appropriate. Driver-assisted service includes passenger pickup
3.1at and return to the individual's residence or place of business, assistance with admittance
3.2of the individual to the medical facility, and assistance in passenger securement or in
3.3securing of wheelchairs or stretchers in the vehicle.Special Nonemergency medical
3.4transportation providers mustobtain written documentation from the health care service
3.5provider who is serving the recipient being transported, identifying the time that the
3.6recipient arrived. Special have trip logs, which include pickup and drop-off times, signed
3.7by the medical provider or client attesting mileage traveled to obtain covered medical
3.8services, whichever is deemed most appropriate. Nonemergency medical transportation
3.9providers may not bill for separate base rates for the continuation of a trip beyond the
3.10original destination.Special Nonemergency medical transportation providers must take
3.11recipients clients to the health care provider, using the most direct route, and must not
3.12exceed 30 miles for a trip to a primary care provider or 60 miles for a trip to a specialty
3.13care provider, unless therecipient client receives authorization from the local agency. The
3.14minimum medical assistance reimbursement rates for special transportation services are:
3.15(1)(i) $17 for the base rate and $1.35 per mile for special transportation services to
3.16eligible persons who need a wheelchair-accessible van;
3.17(ii) $11.50 for the base rate and $1.30 per mile for special transportation services to
3.18eligible persons who do not need a wheelchair-accessible van; and
3.19(iii) $60 for the base rate and $2.40 per mile, and an attendant rate of $9 per trip, for
3.20special transportation services to eligible persons who need a stretcher-accessible vehicle;
3.21(2) Clients requesting client mileage reimbursement must sign the trip log attesting
3.22mileage traveled to obtain covered medical services.
3.23(g) The covered modes of nonemergency medical transportation include
3.24transportation provided directly by clients or family members of clients with their own
3.25transportation, volunteers using their own vehicles, taxicabs, and public transit, or
3.26provided to a client who needs a stretcher-accessible vehicle, a lift/ramp equipped vehicle,
3.27a vehicle that is not stretcher-accessible or lift/ramp equipped designed to transport seven
3.28or fewer persons, and a protected vehicle that is not an ambulance or police car and has
3.29safety locks, a video recorder, and a transparent thermoplastic partition between the
3.30passenger and the vehicle driver.
3.31(h) The administrative agency shall use the level of service process established
3.32by the commissioner in consultation with the Nonemergency Medical Transportation
3.33Advisory Committee to determine the client's most appropriate mode of transportation.
3.34If public transit or a certified transportation provider is not available to provide the
3.35appropriate service mode for the client, the client may receive a onetime service upgrade.
3.36Clients can be found eligible for the most appropriate of the following modes:
4.1(1) client reimbursement, which includes client mileage reimbursement provided
4.2to clients who have their own transportation or family who provides transportation to
4.3the client;
4.4(2) volunteer transport, which includes transportation by volunteers using their
4.5own vehicle;
4.6(3) unassisted transport, which includes transportation provided to a client by a
4.7taxicab or public transit. If a taxicab or publicly operated transit system is not available,
4.8the client can receive transportation from another nonemergency medical transportation
4.9provider;
4.10(4) assisted transport, which includes transport provided to clients who require
4.11assistance by a nonemergency medical transportation provider;
4.12(5) lift-equipped/ramp transport, which includes transport provided to a client who
4.13is dependent on a device and requires a nonemergency medical transportation provider
4.14with a vehicle containing a lift or ramp;
4.15(6) protected transport, which includes transport to a client who has received a
4.16prescreening that has deemed other forms of transportation inappropriate and who requires
4.17a provider certified as a protected transport provider; and
4.18(7) stretcher transport, which includes transport for a client in a prone or supine
4.19position and requires a nonemergency medical transportation provider with a vehicle that
4.20can transport a client in a prone or supine position.
4.21(i) Local agencies shall administer and reimburse for modes defined in paragraph
4.22(h), clauses (1) to (3). The commissioner shall administer and reimburse for modes
4.23defined in paragraph (h), clauses (4) to (7). In accordance with subdivision 18e, by July 1,
4.242016, the local agency shall be the single administrative agency and shall administer and
4.25reimburse for modes defined in paragraph (h), clauses (1), (2), (3), (4), (5), (6), and (7).
4.26(j) The commissioner shall:
4.27(1) in consultation with the Nonemergency Medical Transportation Advisory
4.28Committee, verify that the mode and use of nonemergency medical transportation is
4.29appropriate;
4.30(2) verify that the client is going to an approved medical appointment; and
4.31(3) investigate all complaints and appeals.
4.32(k) The administrative agency shall pay for the services provided in this subdivision
4.33and seek reimbursement from the commissioner if appropriate. As vendors of medical
4.34care, local agencies are subject to the sanctions and monetary recovery actions in sections
4.35256B.041 and 256B.064, and all applicable Minnesota Rules.
5.1(l) Payments for nonemergency medical transportation shall be paid based on the
5.2client's assessed mode, not the type of vehicle used to provide the service. The medical
5.3assistance reimbursement rates for nonemergency medical transportation services payable
5.4by or on behalf of the commissioner for nonemergency medical transportation services are:
5.5(1) up to 80 percent of the Internal Revenue Service standard mileage rate for client
5.6reimbursement;
5.7(2) up to 200 percent of the Internal Revenue Service standard mileage rate for
5.8volunteer transport;
5.9(3) equivalent to the standard fare when provided by public transit and $11 for the
5.10base rate and $1.30 per mile for unassisted transport when provided by a nonemergency
5.11medical transportation provider;
5.12(4) $13 for the base rate and $1.30 per mile for assisted transport;
5.13(5) $17 for the base rate and $1.35 per mile for lift-equipped/ramp transport;
5.14(6) $75 for the base rate and $3.30 per mile for protected transport; and
5.15(7) $60 for the base rate, $2.40 per mile, and $9 per trip for an additional attendant
5.16for stretcher transport if deemed medically necessary.
5.17(m) The mileage reimbursement rates for nonemergency medical transportation in
5.18paragraph (l), clauses (3) to (7), are subject to a quarterly fuel adjustment. Reimbursement
5.19rates shall be adjusted quarterly by the commissioner within existing, identified, and
5.20available appropriations when the statewide average price of regular grade gasoline is over
5.21$3.50 per gallon, as calculated by the Oil Price Information Service. The average price of
5.22regular grade gasoline is determined on the first Monday of the last month of the quarter,
5.23with the corresponding rate adjustment effective on the first day of the following month.
5.24Rate adjustments shall be one percent for each ten-cent increment change in the statewide
5.25average price of regular grade gasoline.
5.26(n) The base rates forspecial nonemergency medical transportation services in areas
5.27defined under RUCA to be super rural shall be equal to the reimbursement rate established
5.28inclause (1) paragraph (l), clauses (1) to (7), plus 11.3 percent;, and
5.29(3) for special nonemergency medical transportation services in areas defined under
5.30RUCA to be rural or super rural areas:
5.31(i) for a trip equal to 17 miles or less, mileage reimbursement shall be equal to 125
5.32percent of the respective mileage rate inclause (1) paragraph (l), clauses (1) to (7); and
5.33(ii) for a trip between 18 and 50 miles, mileage reimbursement shall be equal to
5.34112.5 percent of the respective mileage rate inclause (1) paragraph (l), clauses (1) to (7).
6.1(c) (o) For purposes of reimbursement rates for special nonemergency medical
6.2transportation services under paragraph (b), the zip code of the recipient's place of residence
6.3shall determine whether the urban, rural, or super rural reimbursement rate applies.
6.4(d) (p) For purposes of this subdivision, "rural urban commuting area" or "RUCA"
6.5means a census-tract based classification system under which a geographical area is
6.6determined to be urban, rural, or super rural.
6.7(e) (q) Effective for services provided on or after between September 1, 2011, and
6.8June 30, 2014, nonemergency transportation rates, including special transportation, taxi,
6.9and other commercial carriers, are reduced 4.5 percent. Payments made to managed care
6.10plans and county-based purchasing plans must be reduced for services provided on or after
6.11January 1, 2012, to reflect this reduction.
6.12 Sec. 2. Minnesota Statutes 2012, section 256B.0625, subdivision 17a, is amended to
6.13read:
6.14 Subd. 17a. Payment for ambulance services. (a) Medical assistance covers
6.15ambulance services. Providers shall bill ambulance services according to Medicare
6.16criteria. Nonemergency ambulance services shall not be paid as emergencies. Effective
6.17for services rendered on or after July 1, 2001, medical assistance payments for ambulance
6.18services shall be paid at the Medicare reimbursement rate or at the medical assistance
6.19payment rate in effect on July 1, 2000, whichever is greater.
6.20(b) Effective for services providedon or after between September 1, 2011, and June
6.2130, 2014, ambulance services payment rates are reduced 4.5 percent. Payments made to
6.22managed care plans and county-based purchasing plans must be reduced for services
6.23provided on or after January 1, 2012, to reflect this reduction.
6.24 Sec. 3. Minnesota Statutes 2012, section 256B.0625, subdivision 18a, is amended to
6.25read:
6.26 Subd. 18a. Access to medical services. (a) Medical assistance reimbursement for
6.27meals for persons traveling to receive medical care may not exceed $5.50 for breakfast,
6.28$6.50 for lunch, or $8 for dinner.
6.29 (b) Medical assistance reimbursement for lodging for persons traveling to receive
6.30medical care may not exceed $50 per day unless prior authorized by the local agency.
6.31 (c) Medical assistance direct mileage reimbursement to the eligible person or the
6.32eligible person's driver may not exceed20 cents 80 percent of the Internal Revenue
6.33Service standard mileage rate per mile.
7.1 (d) Regardless of the number of employees that an enrolled health care provider
7.2may have, medical assistance covers sign and oral language interpreter services when
7.3provided by an enrolled health care provider during the course of providing a direct,
7.4person-to-person covered health care service to an enrolled recipient with limited English
7.5proficiency or who has a hearing loss and uses interpreting services. Coverage for
7.6face-to-face oral language interpreter services shall be provided only if the oral language
7.7interpreter used by the enrolled health care provider is listed in the registry or roster
7.8established under section144.058 .
7.9 Sec. 4. Minnesota Statutes 2012, section 256B.0625, subdivision 18b, is amended to
7.10read:
7.11 Subd. 18b. Broker dispatching prohibition. The commissioner shall not use a
7.12broker or coordinator for any purpose related to nonemergency medical transportation
7.13services under subdivision 18.
7.14 Sec. 5. Minnesota Statutes 2012, section 256B.0625, subdivision 18c, is amended to
7.15read:
7.16 Subd. 18c. Nonemergency Medical Transportation Advisory Committee.
7.17(a) The Nonemergency Medical Transportation Advisory Committee shall advise the
7.18commissioner on the administration of nonemergency medical transportation covered
7.19under medical assistance. The advisory committee shall meet at least quarterly the first
7.20year following January 1, 2015, and at least biannually thereafter and may meet more
7.21frequently as required by the commissioner. The advisory committee shall annually
7.22elect a chair from among its members, who shall work with the commissioner or the
7.23commissioner's designee to establish the agenda for each meeting. The commissioner, or
7.24the commissioner's designee, shall attend all advisory committee meetings.
7.25(b) The Nonemergency Medical Transportation Advisory Committee shall advise
7.26and make recommendations to the commissioner on:
7.27(1)the development of, and periodic updates to, a the nonemergency medical
7.28transportation policy manualfor nonemergency medical transportation services;
7.29(2) policies and a funding source for reimbursing no-load miles;
7.30(3) policies to prevent waste, fraud, and abuse, and to improve the efficiency of the
7.31nonemergency medical transportation system;
7.32(4) other issues identified in the 2011 evaluation report by the Office of the
7.33Legislative Auditor on medical nonemergency transportation; and
8.1(5) (2) other aspects of the nonemergency medical transportation system, as
8.2requested by the commissioner.; and
8.3(3) other aspects of the nonemergency medical transportation system, as requested by:
8.4(i) a committee member, who may request an item to be placed on the agenda for
8.5a future meeting. The request may be considered by the committee and voted upon.
8.6If the motion carries, the meeting agenda item may be developed for presentation to
8.7the committee; and
8.8(ii) a member of the public, who may approach the committee by letter or e-mail
8.9requesting that an item be placed on a future meeting agenda. The request may be
8.10considered by the committee and voted upon. If the motion carries, the agenda item may
8.11be developed for presentation to the committee.
8.12(c) The Nonemergency Medical Transportation Advisory Committee shall
8.13coordinate its activities with the Minnesota Council on Transportation Access established
8.14under section174.285 . The chair of the advisory committee, or the chair's designee, shall
8.15attend all meetings of the Minnesota Council on Transportation Access.
8.16(d) The Nonemergency Medical Transportation Advisory Committee shall expire
8.17December 1,2014 2019.
8.18 Sec. 6. Minnesota Statutes 2012, section 256B.0625, subdivision 18d, is amended to
8.19read:
8.20 Subd. 18d. Advisory committee members. (a) The Nonemergency Medical
8.21Transportation Advisory Committee consists of:
8.22(1)two voting members who represent counties, at least one of whom must represent
8.23a county or counties other than Anoka, Carver, Chisago, Dakota, Hennepin, Isanti,
8.24Ramsey, Scott, Sherburne, Washington, and Wright four voting members who represent
8.25counties, utilizing the rural urban commuting area classification system. As defined in
8.26subdivision 17, these members shall be designated as follows:
8.27(i) two counties within the 11-county metropolitan area;
8.28(ii) one county representing the rural area of the state; and
8.29(iii) one county representing the super rural area of the state.
8.30The Association of Minnesota Counties shall appoint one county within the 11-county
8.31metropolitan area and one county representing the super rural area of the state. The
8.32Minnesota Inter-County Association shall appoint one county within the 11-county
8.33metropolitan area and one county representing the rural area of the state;
9.1(2)four three voting members who represent medical assistance recipients, including
9.2persons with physical and developmental disabilities, persons with mental illness, seniors,
9.3children, and low-income individuals;
9.4(3) four voting members who represent providers that deliver nonemergency medical
9.5transportation services to medical assistance enrollees;
9.6(4) two voting members of the house of representatives, one from the majority
9.7party and one from the minority party, appointed by the speaker of the house, and two
9.8voting members from the senate, one from the majority party and one from the minority
9.9party, appointed by the Subcommittee on Committees of the Committee on Rules and
9.10Administration;
9.11(5) one voting member who represents demonstration providers as defined in section
9.12256B.69, subdivision 2
;
9.13(6) one voting member who represents an organization that contracts with state or
9.14local governments to coordinate transportation services for medical assistance enrollees;
9.15and
9.16(7) one voting member who represents the Minnesota State Council on Disability;
9.17(8) the commissioner of transportation or the commissioner's designee, who shall
9.18serve as a voting member;
9.19(9) one voting member appointed by the Minnesota Ambulance Association; and
9.20(10) one voting member appointed by the Minnesota Hospital Association.
9.21(b) Members of the advisory committee shall not be employed by the Department of
9.22Human Services. Members of the advisory committee shall receive no compensation.
9.23 Sec. 7. Minnesota Statutes 2013 Supplement, section 256B.0625, subdivision 18e,
9.24is amended to read:
9.25 Subd. 18e. Single administrative structure and delivery system.(a) The
9.26commissioner shall implement a single administrative structure and delivery system
9.27for nonemergency medical transportation, beginning the latter of the date the single
9.28administrative assessment tool required in this paragraph is available for use, as
9.29determined by the commissioner or by July 1,2014 2016. The single administrative
9.30structure and delivery system must:
9.31(1) eliminate the distinction between access transportation services and special
9.32transportation services;
9.33(2) enable all medical assistance recipients to follow the same process to obtain
9.34nonemergency medical transportation, regardless of their level of need;
10.1(3) provide a single oversight framework for all providers of nonemergency medical
10.2transportation; and
10.3(4) provide flexibility in service delivery, recognizing that clients fall along a
10.4continuum of needs and resources.
10.5(b) The commissioner shall present to the legislature, by January 15, 2014,
10.6legislation necessary to implement the single administrative structure and delivery system
10.7for nonemergency medical transportation.
10.8(c) In developing the single administrative structure and delivery system and the draft
10.9legislation, the commissioner shall consult with the Nonemergency Medical Transportation
10.10Advisory Committee. In coordination with the Department of Transportation, the
10.11commissioner shall develop and authorize a Web-based single administrative structure
10.12and assessment tool, which must operate 24 hours a day, seven days a week, to facilitate
10.13the enrollee assessment process for nonemergency medical transportation services.
10.14The Web-based tool shall facilitate the transportation eligibility determination process
10.15initiated by clients and client advocates; shall include an accessible automated intake
10.16and assessment process and real-time identification of level of service eligibility; and
10.17shall authorize an appropriate and auditable mode of transportation authorization. The
10.18tool shall provide a single framework for reconciling trip information with claiming and
10.19collecting complaints regarding inappropriate level of need determinations, inappropriate
10.20transportation modes utilized, and interference with accessing nonemergency medical
10.21transportation. The Web-based single administrative structure shall operate on a trial
10.22basis for one year from implementation and, if approved by the commissioner, shall be
10.23permanent thereafter. The commissioner shall seek input from the Nonemergency Medical
10.24Transportation Advisory Committee to ensure the software is effective and user-friendly
10.25and make recommendations regarding funding of the single administrative system.
10.26 Sec. 8. Minnesota Statutes 2012, section 256B.0625, subdivision 18g, is amended to
10.27read:
10.28 Subd. 18g. Use of standardized measures.The commissioner, in consultation
10.29with the Nonemergency Medical Transportation Advisory Committee, shall establish
10.30performance measures to assess the cost-effectiveness and quality of nonemergency
10.31medical transportation. At a minimum, performance measures should include the number
10.32of unique participants served by type of transportation provider, number of trips provided
10.33by type of transportation provider, and cost per trip by type of transportation provider. The
10.34commissioner must also consider the measures identified in the January 2012 Department
10.35of Human Services report to the legislature on nonemergency medical transportation.
11.1 Beginning in calendar year2013 2015, the commissioner shall collect, audit, and analyze
11.2performance data on nonemergency medical transportation annually and report this
11.3information on the agency's Web site. The commissioner shall periodically supplement
11.4this information with the results of consumer surveys of the quality of services, and shall
11.5make these survey findings available to the public on the agency Web site.
11.6 Sec. 9. Minnesota Statutes 2012, section 256B.0625, is amended by adding a
11.7subdivision to read:
11.8 Subd. 18h. Managed care. The following subdivisions do not apply to managed
11.9care plans and county-based purchasing plans:
11.10 (1) subdivision 17, paragraphs (d) to (m);
11.11 (2) subdivision 18e; and
11.12 (3) subdivision 18g.
11.13 Sec. 10. WAIVER APPLICATIONS FOR NONEMERGENCY MEDICAL
11.14TRANSPORTATION SERVICE PROVIDERS.
11.15 Subdivision 1. Definitions. For purposes of this section, the following definitions
11.16apply:
11.17(1) "new provider" is a nonemergency medical transportation service provider that
11.18was not required to comply with special transportation service operating standards before
11.19the effective date of this act; and
11.20(2) "commissioner" is the commissioner of human services.
11.21 Subd. 2. Application for and terms of variance. A new provider may apply to the
11.22commissioner, on a form supplied by the commissioner for this purpose, for a variance
11.23from special transportation service operating standards. The commissioner may grant or
11.24deny the variance application. Variances expire on the earlier of, February 1, 2016, or the
11.25date that the commissioner of transportation begins certifying new providers under the
11.26terms of this act and successor legislation.
11.27 Subd. 3. Information concerning variances. The commissioner shall periodically
11.28transmit to the Department of Transportation the number of variance applications received
11.29and the number granted.
11.30 Subd. 4. Report by commissioner of transportation. On or before February
11.311, 2015, the commissioner of transportation shall report to the chairs and ranking
11.32minority members of the senate and house of representatives committees and divisions
11.33with jurisdiction over transportation and human services concerning implementing this
11.34act. The report must contain recommendations of the commissioner of transportation
12.1concerning statutes, session laws, and rules that must be amended, repealed, enacted, or
12.2adopted to implement the terms of this act. The recommendations must include, without
12.3limitation, the amount of the fee that would be required to cover the costs of Department of
12.4Transportation supervision of inspection and certification, as well as any needed statutory
12.5rulemaking or other authority to be granted to the commissioner of transportation.
12.6 Sec. 11. REPEALER.
12.7Minnesota Statutes 2013 Supplement, section 256B.0625, subdivision 18f, is
12.8repealed.
12.9 Sec. 12. EFFECTIVE DATE.
12.10Sections 1 to 10 are effective August 1, 2014.
1.3services provisions;amending Minnesota Statutes 2012, section 256B.0625,
1.4subdivisions 17a, 18a, 18b, 18c, 18d, 18g, by adding a subdivision; Minnesota
1.5Statutes 2013 Supplement, section 256B.0625, subdivisions 17, 18e; repealing
1.6Minnesota Statutes 2013 Supplement, section 256B.0625, subdivision 18f.
1.7BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.8 Section 1. Minnesota Statutes 2013 Supplement, section 256B.0625, subdivision 17,
1.9is amended to read:
1.10 Subd. 17. Transportation costs. (a) "Nonemergency medical transportation
1.11service" means motor vehicle transportation provided by a public or private person
1.12that serves Minnesota health care program beneficiaries who do not require emergency
1.13ambulance service, as defined in section 144E.001, subdivision 3, to obtain covered
1.14medical services. Nonemergency medical transportation service includes, but is not
1.15limited to, special transportation service, defined in section 174.29, subdivision 1.
1.16
1.17obtaining emergency medical care or transportation costs incurred by eligible persons in
1.18obtaining emergency or nonemergency medical care when paid directly to an ambulance
1.19company, common carrier, or other recognized providers of transportation services.
1.20Medical transportation must be provided by:
1.21(1)
1.22requirements of this subdivision;
1.23(2) ambulances, as defined in section
1.24
2.1(3)
2.2
2.3subdivision 7; or
2.4(4) not-for-hire vehicles, including volunteer drivers.
2.5
2.6
2.7
2.8
2.9transportation provided by nonemergency medical transportation providers enrolled in
2.10the Minnesota health care programs. All nonemergency medical transportation providers
2.11must comply with the operating standards for special transportation service as defined in
2.12sections 174.29 to 174.30 and Minnesota Rules, chapter 8840, and in consultation with
2.13the Minnesota Department of Transportation. All nonemergency medical transportation
2.14providers shall bill for nonemergency medical transportation services in accordance with
2.15Minnesota health care programs criteria. Publicly operated transit systems, volunteers,
2.16and not-for-hire vehicles are exempt from the requirements outlined in this paragraph.
2.17(d) The administrative agency of nonemergency medical transportation must:
2.18(1) adhere to the policies defined by the commissioner in consultation with the
2.19Nonemergency Medical Transportation Advisory Committee;
2.20(2) pay nonemergency medical transportation providers for services provided to
2.21Minnesota health care programs beneficiaries to obtain covered medical services;
2.22(3) provide data monthly to the commissioner on appeals, complaints, no-shows,
2.23canceled trips, and number of trips by mode; and
2.24(4) by July 1, 2016, in accordance with subdivision 18e, utilize a Web-based single
2.25administrative structure assessment tool that meets the technical requirements established
2.26by the commissioner, reconciles trip information with claims being submitted by
2.27providers, and ensures prompt payment for nonemergency medical transportation services.
2.28 (e) Until the commissioner implements the single administrative structure and
2.29delivery system under subdivision 18e, clients shall obtain their level-of-service certificate
2.30from the commissioner or an entity approved by the commissioner that does not dispatch
2.31rides for clients using modes under paragraph (h), clauses (4), (5), (6), and (7).
2.32 (f) The commissioner may use an order by the recipient's attending physician
2.33 or a medical or mental health professional to certify that the recipient requires
2.34
2.35 Nonemergency medical transportation providers shall perform driver-assisted services for
2.36eligible individuals, when appropriate. Driver-assisted service includes passenger pickup
3.1at and return to the individual's residence or place of business, assistance with admittance
3.2of the individual to the medical facility, and assistance in passenger securement or in
3.3securing of wheelchairs or stretchers in the vehicle.
3.4transportation providers must
3.5
3.6
3.7by the medical provider or client attesting mileage traveled to obtain covered medical
3.8services, whichever is deemed most appropriate. Nonemergency medical transportation
3.9providers may not bill for separate base rates for the continuation of a trip beyond the
3.10original destination.
3.11
3.12exceed 30 miles for a trip to a primary care provider or 60 miles for a trip to a specialty
3.13care provider, unless the
3.14
3.15
3.16
3.17
3.18
3.19
3.20
3.21
3.22mileage traveled to obtain covered medical services.
3.23(g) The covered modes of nonemergency medical transportation include
3.24transportation provided directly by clients or family members of clients with their own
3.25transportation, volunteers using their own vehicles, taxicabs, and public transit, or
3.26provided to a client who needs a stretcher-accessible vehicle, a lift/ramp equipped vehicle,
3.27a vehicle that is not stretcher-accessible or lift/ramp equipped designed to transport seven
3.28or fewer persons, and a protected vehicle that is not an ambulance or police car and has
3.29safety locks, a video recorder, and a transparent thermoplastic partition between the
3.30passenger and the vehicle driver.
3.31(h) The administrative agency shall use the level of service process established
3.32by the commissioner in consultation with the Nonemergency Medical Transportation
3.33Advisory Committee to determine the client's most appropriate mode of transportation.
3.34If public transit or a certified transportation provider is not available to provide the
3.35appropriate service mode for the client, the client may receive a onetime service upgrade.
3.36Clients can be found eligible for the most appropriate of the following modes:
4.1(1) client reimbursement, which includes client mileage reimbursement provided
4.2to clients who have their own transportation or family who provides transportation to
4.3the client;
4.4(2) volunteer transport, which includes transportation by volunteers using their
4.5own vehicle;
4.6(3) unassisted transport, which includes transportation provided to a client by a
4.7taxicab or public transit. If a taxicab or publicly operated transit system is not available,
4.8the client can receive transportation from another nonemergency medical transportation
4.9provider;
4.10(4) assisted transport, which includes transport provided to clients who require
4.11assistance by a nonemergency medical transportation provider;
4.12(5) lift-equipped/ramp transport, which includes transport provided to a client who
4.13is dependent on a device and requires a nonemergency medical transportation provider
4.14with a vehicle containing a lift or ramp;
4.15(6) protected transport, which includes transport to a client who has received a
4.16prescreening that has deemed other forms of transportation inappropriate and who requires
4.17a provider certified as a protected transport provider; and
4.18(7) stretcher transport, which includes transport for a client in a prone or supine
4.19position and requires a nonemergency medical transportation provider with a vehicle that
4.20can transport a client in a prone or supine position.
4.21(i) Local agencies shall administer and reimburse for modes defined in paragraph
4.22(h), clauses (1) to (3). The commissioner shall administer and reimburse for modes
4.23defined in paragraph (h), clauses (4) to (7). In accordance with subdivision 18e, by July 1,
4.242016, the local agency shall be the single administrative agency and shall administer and
4.25reimburse for modes defined in paragraph (h), clauses (1), (2), (3), (4), (5), (6), and (7).
4.26(j) The commissioner shall:
4.27(1) in consultation with the Nonemergency Medical Transportation Advisory
4.28Committee, verify that the mode and use of nonemergency medical transportation is
4.29appropriate;
4.30(2) verify that the client is going to an approved medical appointment; and
4.31(3) investigate all complaints and appeals.
4.32(k) The administrative agency shall pay for the services provided in this subdivision
4.33and seek reimbursement from the commissioner if appropriate. As vendors of medical
4.34care, local agencies are subject to the sanctions and monetary recovery actions in sections
4.35256B.041 and 256B.064, and all applicable Minnesota Rules.
5.1(l) Payments for nonemergency medical transportation shall be paid based on the
5.2client's assessed mode, not the type of vehicle used to provide the service. The medical
5.3assistance reimbursement rates for nonemergency medical transportation services payable
5.4by or on behalf of the commissioner for nonemergency medical transportation services are:
5.5(1) up to 80 percent of the Internal Revenue Service standard mileage rate for client
5.6reimbursement;
5.7(2) up to 200 percent of the Internal Revenue Service standard mileage rate for
5.8volunteer transport;
5.9(3) equivalent to the standard fare when provided by public transit and $11 for the
5.10base rate and $1.30 per mile for unassisted transport when provided by a nonemergency
5.11medical transportation provider;
5.12(4) $13 for the base rate and $1.30 per mile for assisted transport;
5.13(5) $17 for the base rate and $1.35 per mile for lift-equipped/ramp transport;
5.14(6) $75 for the base rate and $3.30 per mile for protected transport; and
5.15(7) $60 for the base rate, $2.40 per mile, and $9 per trip for an additional attendant
5.16for stretcher transport if deemed medically necessary.
5.17(m) The mileage reimbursement rates for nonemergency medical transportation in
5.18paragraph (l), clauses (3) to (7), are subject to a quarterly fuel adjustment. Reimbursement
5.19rates shall be adjusted quarterly by the commissioner within existing, identified, and
5.20available appropriations when the statewide average price of regular grade gasoline is over
5.21$3.50 per gallon, as calculated by the Oil Price Information Service. The average price of
5.22regular grade gasoline is determined on the first Monday of the last month of the quarter,
5.23with the corresponding rate adjustment effective on the first day of the following month.
5.24Rate adjustments shall be one percent for each ten-cent increment change in the statewide
5.25average price of regular grade gasoline.
5.26(n) The base rates for
5.27defined under RUCA to be super rural shall be equal to the reimbursement rate established
5.28in
5.29
5.30RUCA to be rural or super rural areas:
5.31(i) for a trip equal to 17 miles or less, mileage reimbursement shall be equal to 125
5.32percent of the respective mileage rate in
5.33(ii) for a trip between 18 and 50 miles, mileage reimbursement shall be equal to
5.34112.5 percent of the respective mileage rate in
6.1
6.2transportation services under paragraph (b), the zip code of the recipient's place of residence
6.3shall determine whether the urban, rural, or super rural reimbursement rate applies.
6.4
6.5means a census-tract based classification system under which a geographical area is
6.6determined to be urban, rural, or super rural.
6.7
6.8June 30, 2014, nonemergency transportation rates, including special transportation, taxi,
6.9and other commercial carriers, are reduced 4.5 percent. Payments made to managed care
6.10plans and county-based purchasing plans must be reduced for services provided on or after
6.11January 1, 2012, to reflect this reduction.
6.12 Sec. 2. Minnesota Statutes 2012, section 256B.0625, subdivision 17a, is amended to
6.13read:
6.14 Subd. 17a. Payment for ambulance services. (a) Medical assistance covers
6.15ambulance services. Providers shall bill ambulance services according to Medicare
6.16criteria. Nonemergency ambulance services shall not be paid as emergencies. Effective
6.17for services rendered on or after July 1, 2001, medical assistance payments for ambulance
6.18services shall be paid at the Medicare reimbursement rate or at the medical assistance
6.19payment rate in effect on July 1, 2000, whichever is greater.
6.20(b) Effective for services provided
6.2130, 2014, ambulance services payment rates are reduced 4.5 percent. Payments made to
6.22managed care plans and county-based purchasing plans must be reduced for services
6.23provided on or after January 1, 2012, to reflect this reduction.
6.24 Sec. 3. Minnesota Statutes 2012, section 256B.0625, subdivision 18a, is amended to
6.25read:
6.26 Subd. 18a. Access to medical services. (a) Medical assistance reimbursement for
6.27meals for persons traveling to receive medical care may not exceed $5.50 for breakfast,
6.28$6.50 for lunch, or $8 for dinner.
6.29 (b) Medical assistance reimbursement for lodging for persons traveling to receive
6.30medical care may not exceed $50 per day unless prior authorized by the local agency.
6.31 (c) Medical assistance direct mileage reimbursement to the eligible person or the
6.32eligible person's driver may not exceed
6.33Service standard mileage rate per mile.
7.1 (d) Regardless of the number of employees that an enrolled health care provider
7.2may have, medical assistance covers sign and oral language interpreter services when
7.3provided by an enrolled health care provider during the course of providing a direct,
7.4person-to-person covered health care service to an enrolled recipient with limited English
7.5proficiency or who has a hearing loss and uses interpreting services. Coverage for
7.6face-to-face oral language interpreter services shall be provided only if the oral language
7.7interpreter used by the enrolled health care provider is listed in the registry or roster
7.8established under section
7.9 Sec. 4. Minnesota Statutes 2012, section 256B.0625, subdivision 18b, is amended to
7.10read:
7.11 Subd. 18b. Broker dispatching prohibition. The commissioner shall not use a
7.12broker or coordinator for any purpose related to nonemergency medical transportation
7.13services under subdivision 18.
7.14 Sec. 5. Minnesota Statutes 2012, section 256B.0625, subdivision 18c, is amended to
7.15read:
7.16 Subd. 18c. Nonemergency Medical Transportation Advisory Committee.
7.17(a) The Nonemergency Medical Transportation Advisory Committee shall advise the
7.18commissioner on the administration of nonemergency medical transportation covered
7.19under medical assistance. The advisory committee shall meet at least quarterly the first
7.20year following January 1, 2015, and at least biannually thereafter and may meet more
7.21frequently as required by the commissioner. The advisory committee shall annually
7.22elect a chair from among its members, who shall work with the commissioner or the
7.23commissioner's designee to establish the agenda for each meeting. The commissioner, or
7.24the commissioner's designee, shall attend all advisory committee meetings.
7.25(b) The Nonemergency Medical Transportation Advisory Committee shall advise
7.26and make recommendations to the commissioner on:
7.27(1)
7.28transportation policy manual
7.29
7.30
7.31
7.32
7.33
8.1
8.2requested by the commissioner
8.3(3) other aspects of the nonemergency medical transportation system, as requested by:
8.4(i) a committee member, who may request an item to be placed on the agenda for
8.5a future meeting. The request may be considered by the committee and voted upon.
8.6If the motion carries, the meeting agenda item may be developed for presentation to
8.7the committee; and
8.8(ii) a member of the public, who may approach the committee by letter or e-mail
8.9requesting that an item be placed on a future meeting agenda. The request may be
8.10considered by the committee and voted upon. If the motion carries, the agenda item may
8.11be developed for presentation to the committee.
8.12(c) The Nonemergency Medical Transportation Advisory Committee shall
8.13coordinate its activities with the Minnesota Council on Transportation Access established
8.14under section
8.15attend all meetings of the Minnesota Council on Transportation Access.
8.16(d) The Nonemergency Medical Transportation Advisory Committee shall expire
8.17December 1,
8.18 Sec. 6. Minnesota Statutes 2012, section 256B.0625, subdivision 18d, is amended to
8.19read:
8.20 Subd. 18d. Advisory committee members. (a) The Nonemergency Medical
8.21Transportation Advisory Committee consists of:
8.22(1)
8.23
8.24
8.25counties, utilizing the rural urban commuting area classification system. As defined in
8.26subdivision 17, these members shall be designated as follows:
8.27(i) two counties within the 11-county metropolitan area;
8.28(ii) one county representing the rural area of the state; and
8.29(iii) one county representing the super rural area of the state.
8.30The Association of Minnesota Counties shall appoint one county within the 11-county
8.31metropolitan area and one county representing the super rural area of the state. The
8.32Minnesota Inter-County Association shall appoint one county within the 11-county
8.33metropolitan area and one county representing the rural area of the state;
9.1(2)
9.2persons with physical and developmental disabilities, persons with mental illness, seniors,
9.3children, and low-income individuals;
9.4(3) four voting members who represent providers that deliver nonemergency medical
9.5transportation services to medical assistance enrollees;
9.6(4) two voting members of the house of representatives, one from the majority
9.7party and one from the minority party, appointed by the speaker of the house, and two
9.8voting members from the senate, one from the majority party and one from the minority
9.9party, appointed by the Subcommittee on Committees of the Committee on Rules and
9.10Administration;
9.11(5) one voting member who represents demonstration providers as defined in section
9.13(6) one voting member who represents an organization that contracts with state or
9.14local governments to coordinate transportation services for medical assistance enrollees;
9.15
9.16(7) one voting member who represents the Minnesota State Council on Disability;
9.17(8) the commissioner of transportation or the commissioner's designee, who shall
9.18serve as a voting member;
9.19(9) one voting member appointed by the Minnesota Ambulance Association; and
9.20(10) one voting member appointed by the Minnesota Hospital Association.
9.21(b) Members of the advisory committee shall not be employed by the Department of
9.22Human Services. Members of the advisory committee shall receive no compensation.
9.23 Sec. 7. Minnesota Statutes 2013 Supplement, section 256B.0625, subdivision 18e,
9.24is amended to read:
9.25 Subd. 18e. Single administrative structure and delivery system.
9.26commissioner shall implement a single administrative structure and delivery system
9.27for nonemergency medical transportation, beginning the latter of the date the single
9.28administrative assessment tool required in this paragraph is available for use, as
9.29determined by the commissioner or by July 1,
9.30
9.31
9.32
9.33
9.34
10.1
10.2
10.3
10.4
10.5
10.6
10.7
10.8
10.9
10.10
10.11commissioner shall develop and authorize a Web-based single administrative structure
10.12and assessment tool, which must operate 24 hours a day, seven days a week, to facilitate
10.13the enrollee assessment process for nonemergency medical transportation services.
10.14The Web-based tool shall facilitate the transportation eligibility determination process
10.15initiated by clients and client advocates; shall include an accessible automated intake
10.16and assessment process and real-time identification of level of service eligibility; and
10.17shall authorize an appropriate and auditable mode of transportation authorization. The
10.18tool shall provide a single framework for reconciling trip information with claiming and
10.19collecting complaints regarding inappropriate level of need determinations, inappropriate
10.20transportation modes utilized, and interference with accessing nonemergency medical
10.21transportation. The Web-based single administrative structure shall operate on a trial
10.22basis for one year from implementation and, if approved by the commissioner, shall be
10.23permanent thereafter. The commissioner shall seek input from the Nonemergency Medical
10.24Transportation Advisory Committee to ensure the software is effective and user-friendly
10.25and make recommendations regarding funding of the single administrative system.
10.26 Sec. 8. Minnesota Statutes 2012, section 256B.0625, subdivision 18g, is amended to
10.27read:
10.28 Subd. 18g. Use of standardized measures.
10.29
10.30
10.31
10.32
10.33
10.34
10.35
11.1 Beginning in calendar year
11.2performance data on nonemergency medical transportation annually and report this
11.3information on the agency's Web site. The commissioner shall periodically supplement
11.4this information with the results of consumer surveys of the quality of services, and shall
11.5make these survey findings available to the public on the agency Web site.
11.6 Sec. 9. Minnesota Statutes 2012, section 256B.0625, is amended by adding a
11.7subdivision to read:
11.8 Subd. 18h. Managed care. The following subdivisions do not apply to managed
11.9care plans and county-based purchasing plans:
11.10 (1) subdivision 17, paragraphs (d) to (m);
11.11 (2) subdivision 18e; and
11.12 (3) subdivision 18g.
11.13 Sec. 10. WAIVER APPLICATIONS FOR NONEMERGENCY MEDICAL
11.14TRANSPORTATION SERVICE PROVIDERS.
11.15 Subdivision 1. Definitions. For purposes of this section, the following definitions
11.16apply:
11.17(1) "new provider" is a nonemergency medical transportation service provider that
11.18was not required to comply with special transportation service operating standards before
11.19the effective date of this act; and
11.20(2) "commissioner" is the commissioner of human services.
11.21 Subd. 2. Application for and terms of variance. A new provider may apply to the
11.22commissioner, on a form supplied by the commissioner for this purpose, for a variance
11.23from special transportation service operating standards. The commissioner may grant or
11.24deny the variance application. Variances expire on the earlier of, February 1, 2016, or the
11.25date that the commissioner of transportation begins certifying new providers under the
11.26terms of this act and successor legislation.
11.27 Subd. 3. Information concerning variances. The commissioner shall periodically
11.28transmit to the Department of Transportation the number of variance applications received
11.29and the number granted.
11.30 Subd. 4. Report by commissioner of transportation. On or before February
11.311, 2015, the commissioner of transportation shall report to the chairs and ranking
11.32minority members of the senate and house of representatives committees and divisions
11.33with jurisdiction over transportation and human services concerning implementing this
11.34act. The report must contain recommendations of the commissioner of transportation
12.1concerning statutes, session laws, and rules that must be amended, repealed, enacted, or
12.2adopted to implement the terms of this act. The recommendations must include, without
12.3limitation, the amount of the fee that would be required to cover the costs of Department of
12.4Transportation supervision of inspection and certification, as well as any needed statutory
12.5rulemaking or other authority to be granted to the commissioner of transportation.
12.6 Sec. 11. REPEALER.
12.7Minnesota Statutes 2013 Supplement, section 256B.0625, subdivision 18f, is
12.8repealed.
12.9 Sec. 12. EFFECTIVE DATE.
12.10Sections 1 to 10 are effective August 1, 2014.
