Bill Text: MN SF717 | 2011-2012 | 87th Legislature | Introduced
Bill Title: Prepaid health plans medical assistance (MA) program antitrust laws applicability provision
Sponsorship: Partisan Bill (Republican 1)
Status: (Introduced - Dead) 2011-03-10 - Referred to Health and Human Services [SF717 Detail]
Download: Minnesota-2011-SF717-Introduced.html
1.2relating to human services; specifying applicability of antitrust laws to the
1.3prepaid medical assistance program;amending Minnesota Statutes 2010, section
1.4256B.69, subdivision 5k.
1.5BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.6 Section 1. Minnesota Statutes 2010, section 256B.69, subdivision 5k, is amended to
1.7read:
1.8 Subd. 5k. Actuarial soundness. (a) Rates paid to managed care plans and
1.9county-based purchasing plans shall satisfy requirements for actuarial soundness. In order
1.10to comply with this subdivision, the rates must:
1.11(1) be neither inadequate nor excessive;
1.12(2) satisfy federal requirements;
1.13(3) in the case of contracts with incentive arrangements, not exceed 105 percent of
1.14the approved capitation payments attributable to the enrollees or services covered by
1.15the incentive arrangement;
1.16(4) be developed in accordance with generally accepted actuarial principles and
1.17practices;
1.18(5) be appropriate for the populations to be covered and the services to be furnished
1.19under the contract;and
1.20(6) be certified as meeting the requirements of federal regulations by actuaries who
1.21meet the qualification standards established by the American Academy of Actuaries and
1.22follow the practice standards established by the Actuarial Standards Board; and
2.1(7) not be based upon or the result of any violation of sections 325D.49 to 325D.66
2.2by any managed care plan or county-based purchasing plan. The exemption in section
2.3325D.55, subdivision 2, paragraph (a), does not apply to this section.
2.4(b) Each year within 30 days of the establishment of plan rates the commissioner
2.5shall report to the chairs and ranking minority members of the senate Health and Human
2.6Services Budget Division and the house of representatives Health Care and Human
2.7Services Finance Division to certify how each of these conditions have been met by
2.8the new payment rates.
1.3prepaid medical assistance program;amending Minnesota Statutes 2010, section
1.4256B.69, subdivision 5k.
1.5BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.6 Section 1. Minnesota Statutes 2010, section 256B.69, subdivision 5k, is amended to
1.7read:
1.8 Subd. 5k. Actuarial soundness. (a) Rates paid to managed care plans and
1.9county-based purchasing plans shall satisfy requirements for actuarial soundness. In order
1.10to comply with this subdivision, the rates must:
1.11(1) be neither inadequate nor excessive;
1.12(2) satisfy federal requirements;
1.13(3) in the case of contracts with incentive arrangements, not exceed 105 percent of
1.14the approved capitation payments attributable to the enrollees or services covered by
1.15the incentive arrangement;
1.16(4) be developed in accordance with generally accepted actuarial principles and
1.17practices;
1.18(5) be appropriate for the populations to be covered and the services to be furnished
1.19under the contract;
1.20(6) be certified as meeting the requirements of federal regulations by actuaries who
1.21meet the qualification standards established by the American Academy of Actuaries and
1.22follow the practice standards established by the Actuarial Standards Board; and
2.1(7) not be based upon or the result of any violation of sections 325D.49 to 325D.66
2.2by any managed care plan or county-based purchasing plan. The exemption in section
2.3325D.55, subdivision 2, paragraph (a), does not apply to this section.
2.4(b) Each year within 30 days of the establishment of plan rates the commissioner
2.5shall report to the chairs and ranking minority members of the senate Health and Human
2.6Services Budget Division and the house of representatives Health Care and Human
2.7Services Finance Division to certify how each of these conditions have been met by
2.8the new payment rates.
