This bill amends Minnesota Statutes 2024, section 256B.69, subdivision 5a, to establish a new medical assistance capitation payment withhold related to the verification of coverage for managed care plans and county-based purchasing plans. Effective for services provided on or after January 1, 2026, the commissioner will withhold two percent of the capitation payment for each medical assistance enrollee until a verification of coverage form is submitted and signed by the enrollee. The withheld funds will be returned no sooner than July 1 and no later than July 31 of the following year, contingent upon the submission of the required verification form by February 27, 2026.

Additionally, if a completed verification form is not received by the commissioner by the specified date, the bill outlines specific consequences: the withheld funds for that enrollee will not be returned to the plan, capitation payments for that enrollee will cease effective with the April 2026 coverage month, and the enrollee will be disenrolled from medical assistance, with the option for an appeal. This new provision aims to enhance accountability and ensure that managed care plans maintain accurate records of their enrollees.

Statutes affected:
Introduction: 256B.69