This bill amends Minnesota Statutes to establish requirements for the county-administered rural medical assistance (CARMA) program. It mandates that any modifications to the administration or coverage of medical assistance benefits must be explicitly stated and accompanied by a written estimate of local fiscal impacts published by the commissioner. Specifically, the bill introduces new provisions that stipulate that modifications do not apply to CARMA unless they meet these criteria, ensuring that counties are informed of potential financial implications before changes take effect.

Additionally, the bill revises the payment mechanisms for counties administering CARMA, removing previous language that limited payments for benefits and services to not exceed what would have been paid to health plans under medical assistance. The new language emphasizes the need for a structured payment system governed by contracts, including risk management strategies and collaborative rate-setting processes. The effective date for these changes aligns with the provisions of Laws 2025, ensuring timely implementation of the new requirements.