This bill seeks to improve health insurance provisions in Minnesota by implementing new medical assistance rate adjustments for physician and professional services, increasing rates for certain residential services, and establishing a statewide reimbursement rate for behavioral health home services. Key features include an assessment on health plan companies to generate nonfederal funds for medical assistance and the authorization for the commissioner of human services to seek federal waivers. The bill amends several sections of Minnesota Statutes, particularly concerning hospital payment rates and introduces new reimbursement rates for obstetric and gynecologic services, effective January 1, 2026, or upon federal approval.

Significant changes include a minimum reimbursement rate for obstetric and gynecologic services, which must be at least equal to 100% of the Medicare Physician Fee Schedule, and a single statewide reimbursement rate for behavioral health home services, set at no less than $425 per member per month, effective January 1, 2028, or upon federal approval. The bill also mandates adjustments to capitation payments to managed care plans and county-based purchasing plans to reflect these rate increases. Additionally, it introduces provisions for primary care services to align with the Medicare guidelines and imposes an annual assessment on health plan companies from 2026 to 2029, with collected funds directed to the health care access fund. The bill also includes a repeal of a specific section of Minnesota Statutes related to payments for mental health services, effective January 1, 2027, or upon federal approval.

Statutes affected:
Introduction: 256B.0625, 256.969, 256B.0757, 256B.76, 256B.761
1st Engrossment: 256B.0625, 256.969, 256B.0757, 256B.76, 256B.761