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. This form, which must be developed by the commissioner, requires enrollees to provide their name, address, and the name of their managed care or county-based purchasing plan, along with a signature attesting to the accuracy of the information.

If a completed verification form is not submitted by February 27, 2026, the commissioner will not return the withheld funds for that enrollee, will cease capitation payments for that enrollee starting with the April 2026 coverage month, and will disenroll the enrollee from medical assistance, subject to an appeal process. This new provision aims to ensure that managed care plans maintain accurate records of their enrollees and comply with verification requirements.

Statutes affected:
Introduction: 256B.69