Eligibility for MinnesotaCare is available to citizens or nationals of the United States, lawfully present noncitizens as defined in Code of Federal Regulations, title 8, section 103.12., and undocumented noncitizens.
This bill eliminates enrollee cost-sharing under MA, MinnesotaCare, and SEGIP plans effective January 1, 2024, and eliminates cost-sharing for private market individual and small group insurance plans, effective upon federal approval of an amendment to the state’s innovation waiver.
This bill eliminates enrollee cost-sharing under MA, MinnesotaCare, and SEGIP plans effective January 1, 2024, and eliminates cost-sharing for private market individual and small group insurance plans, effective upon federal approval of an amendment to the state’s innovation waiver.
This bill modifies the data submitted to the all-payer claims database (APCD) and allowable uses of data in the APCD. The APCD is a database of health care claims data for Minnesota residents, maintained by the Health Department and a data processor under contract with the department. Health plan companies, thirdparty administrators, and pharmacy benefit managers report data to the database, and the data may only be used for the purposes authorized in statute.
S.F. 302 modifies provisions governing the Minnesota All Payer Claims Database (MN APCD), which is a state repository for health care claims data maintained by the Minnesota Department of Health (MDH) and a private contractor. Under current law, health plan companies, third party administrators, and pharmacy benefit managers report claims data to the MN APCD, and the data may only be used for the purposes authorized in statute.
Under current law, most MA enrollees who are eligible as families and children, adults without children, and persons over age 65 are required to enroll in MA managed care and receive services from HMOs and county-based purchasing plans. Persons with disabilities are required to enroll in MA managed care, but may opt out and receive services under fee-for-service. This bill requires DHS to provide all persons currently required to enroll in MA managed care with the opportunity to opt out and receive care under fee-for-service.
Under current law, most MA enrollees who are eligible as families and children, adults without children, and persons over age 65 are required to enroll in MA managed care and receive services from HMOs and county-based purchasing plans. Persons with disabilities are required to enroll in MA managed care, but may opt out and receive services under fee-for-service. This bill requires DHS to provide all persons currently required to enroll in MA managed care with the opportunity to opt out and receive care under fee-for-service.
This bill requires health plans, medical assistance, and MinnesotaCare to cover additional diagnostic services or testing after a mammogram if a health care provider believes it is necessary
S.F. 329 requires no-cost diagnostic services and testing following a mammogram if a health care provider determines those are services necessary for an enrolled patient. S.F. 329 requires that those services are covered by health plans with no cost-sharing, no co-pay, no deductible, and no coinsurance.
This bill prohibits a health plan company from restricting an enrollee’s choice regarding where the enrollee receives services for the diagnosis, monitoring, and treatment of a rare disease or condition, and prohibits cost-sharing or limitations on diagnosing or treating a rare disease or condition that place a greater financial burden on the enrollee or are more restrictive than requirements for in-network care. It also requires medical assistance coverage for diagnosis, monitoring, and treating a rare disease or condition to comply with these requirements.
