Bill Text: MN SF811 | 2011-2012 | 87th Legislature | Introduced
Bill Title: State employee group insurance plan (SEGIP) dependent eligibility verification audit (DEVA) services proposals and contract requirement
Sponsorship: Partisan Bill (Republican 1)
Status: (Introduced - Dead) 2011-03-14 - Referred to State Government Innovation and Veterans [SF811 Detail]
Download: Minnesota-2011-SF811-Introduced.html
1.2relating to state government; requiring the commissioner of management and
1.3budget to issue a request for proposals and enter into a contract for dependent
1.4audit verification for state employee health plans.
1.5BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.6 Section 1. STATE EMPLOYEE GROUP INSURANCE PLAN DEPENDENT
1.7ELIGIBILITY VERIFICATION AUDIT SERVICES.
1.8 Subdivision 1. Request for proposals. By ......., 2011, the commissioner of
1.9management and budget shall issue a request for proposals for a contract to provide
1.10dependent eligibility verification audit services for state-paid hospital, medical, and dental
1.11benefits provided to state employees and their dependents. The request for proposals
1.12must require that the vendor will:
1.13(1) conduct a document-model dependent eligibility verification audit of all plans
1.14offered under Minnesota Statutes, sections 43A.22 to 43A.31;
1.15(2) identify ineligible dependents covered by the plans and report those findings to
1.16the commissioner and third-party administrators of the state's employee health plans, as
1.17directed by the commissioner; and
1.18(3) implement a process for ongoing eligibility verification following the conclusion
1.19of the dependent eligibility verification audit required by this section.
1.20 Subd. 2. Additional vendor criteria. The request for proposals required by
1.21subdivision 1 must require the vendor to provide the following minimum capabilities and
1.22experience in performing the services described in subdivision 1:
1.23(1) a rules-based platform employing auto-adjudication for making objective
1.24eligibility determinations;
2.1(2) assigned eligibility advocates to assist employees through the verification
2.2process;
2.3(3) a formal claims and appeals process; and
2.4(4) experience in the performance of dependent eligibility verification audits for
2.5other states.
2.6 Subd. 3. Contract required. By ......., 2011, the commissioner must enter into
2.7a contract for the services specified in subdivision 1. The contract must incorporate a
2.8performance-based vendor financing option that compensates the vendor based on the
2.9amount of savings generated by the work performed under the contract.
1.3budget to issue a request for proposals and enter into a contract for dependent
1.4audit verification for state employee health plans.
1.5BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.6 Section 1. STATE EMPLOYEE GROUP INSURANCE PLAN DEPENDENT
1.7ELIGIBILITY VERIFICATION AUDIT SERVICES.
1.8 Subdivision 1. Request for proposals. By ......., 2011, the commissioner of
1.9management and budget shall issue a request for proposals for a contract to provide
1.10dependent eligibility verification audit services for state-paid hospital, medical, and dental
1.11benefits provided to state employees and their dependents. The request for proposals
1.12must require that the vendor will:
1.13(1) conduct a document-model dependent eligibility verification audit of all plans
1.14offered under Minnesota Statutes, sections 43A.22 to 43A.31;
1.15(2) identify ineligible dependents covered by the plans and report those findings to
1.16the commissioner and third-party administrators of the state's employee health plans, as
1.17directed by the commissioner; and
1.18(3) implement a process for ongoing eligibility verification following the conclusion
1.19of the dependent eligibility verification audit required by this section.
1.20 Subd. 2. Additional vendor criteria. The request for proposals required by
1.21subdivision 1 must require the vendor to provide the following minimum capabilities and
1.22experience in performing the services described in subdivision 1:
1.23(1) a rules-based platform employing auto-adjudication for making objective
1.24eligibility determinations;
2.1(2) assigned eligibility advocates to assist employees through the verification
2.2process;
2.3(3) a formal claims and appeals process; and
2.4(4) experience in the performance of dependent eligibility verification audits for
2.5other states.
2.6 Subd. 3. Contract required. By ......., 2011, the commissioner must enter into
2.7a contract for the services specified in subdivision 1. The contract must incorporate a
2.8performance-based vendor financing option that compensates the vendor based on the
2.9amount of savings generated by the work performed under the contract.
