SF 6

06/07/25  REVISOR  DTT/LN  25-05697      as introduced
  SENATE
  STATE OF MINNESOTA
  SPECIAL SESSION  S.F. No. 6
       (SENATE AUTHORS: WIKLUND)
  DATE       D-PG  OFFICIAL STATUS
       06/09/2025        8 Introduction and first reading
  10 Laid on table
1.1A bill for an act
1.2relating to state government; amending provisions on the Department of Health
1.3finance and policy, health licensing boards, pharmacy benefits, the Office of
1.4Emergency Medical Services, general health policy, health and education facilities,
1.5health care benefits, economic supports, child protection and welfare, early care
1.6and learning, licensing and certification, behavioral health, background studies,
1.7the Department of Human Services program integrity, and homelessness; making
1.8technical and conforming changes; providing for criminal penalties; providing for
1.9civil penalties; providing for rulemaking; establishing task forces; requiring reports;
1.10      appropriating money; amending Minnesota Statutes 2024, sections 3.732,
1.11      subdivision 1; 10A.01, subdivision 35; 13.46, subdivisions 2, 3, as amended;
1.12      62A.673, subdivision 2; 62D.21; 62D.211; 62J.461, subdivisions 3, 4, 5; 62J.51,
1.13      subdivision 19a; 62J.581; 62J.84, subdivisions 2, 3, 6, 10, 11, 12, 13, 14, 15;
1.14      62K.10, subdivisions 2, 5, 6; 62M.17, subdivision 2; 103I.005, subdivision 17b;
1.15      103I.101, subdivisions 2, 5, 6, by adding a subdivision; 103I.208, subdivisions 1,
1.16      1a, 2; 103I.235, subdivision 1; 103I.525, subdivisions 2, 6, 8; 103I.531, subdivisions
1.17      2, 6, 8; 103I.535, subdivisions 2, 6, 8; 103I.541, subdivisions 2b, 2c, 4; 103I.545,
1.18      subdivisions 1, 2; 103I.601, subdivisions 2, 4; 136A.25; 136A.26; 136A.27;
1.19      136A.28; 136A.29, subdivisions 1, 3, 6, 9, 10, 14, 19, 20, 21, 22, by adding a
1.20      subdivision; 136A.32, subdivisions 1, 4, by adding a subdivision; 136A.33;
1.21      136A.34, subdivisions 3, 4; 136A.36; 136A.38; 136A.41; 136A.42; 136F.67,
1.22      subdivision 1; 138.912, subdivisions 1, 2, 3, 4, 6; 142A.02, subdivision 1; 142A.03,
1.23      subdivision 2, by adding a subdivision; 142A.09, subdivision 1; 142A.42; 142A.76,
1.24      subdivisions 2, 3; 142B.01, subdivision 15, by adding a subdivision; 142B.05,
1.25      subdivision 3; 142B.10, subdivision 14; 142B.16, subdivisions 2, 5; 142B.171,
1.26      subdivision 2; 142B.18, subdivision 6; 142B.30, subdivision 1; 142B.41, by adding
1.27      a subdivision; 142B.47; 142B.51, subdivision 2; 142B.65, subdivisions 8, 9;
1.28      142B.66, subdivision 3; 142B.70, subdivisions 7, 8; 142B.80; 142C.06, by adding
1.29      a subdivision; 142C.11, subdivision 8; 142C.12, subdivisions 1, 6; 142D.21, by
1.30      adding a subdivision; 142D.23, subdivision 3; 142D.31, subdivision 2; 142E.03,
1.31      subdivision 3; 142E.11, subdivisions 1, 2; 142E.13, subdivision 2; 142E.15,
1.32      subdivision 1; 142E.16, subdivisions 3, 7; 142F.14; 144.064, subdivision 3;
1.33      144.0758, subdivision 3; 144.1205, subdivisions 2, 4, 8, 9, 10; 144.121, subdivisions
1.34      1a, 2, 5, by adding subdivisions; 144.1215, by adding a subdivision; 144.122;
1.35      144.1222, subdivisions 1a, 2d; 144.125, subdivision 1; 144.3831, subdivision 1;
1.36      144.50, by adding a subdivision; 144.55, subdivision 1a; 144.554; 144.555,
1.37      subdivisions 1a, 1b; 144.562, subdivisions 2, 3; 144.563; 144.608, subdivision 2;
1.38      144.615, subdivision 8; 144.966, subdivision 2, as amended; 144.98, subdivisions
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       06/07/25  REVISOR  DTT/LN  25-05697  as introduced
2.1      8, 9; 144.99, subdivision 1; 144A.43, subdivision 15, by adding a subdivision;
2.2      144A.474, subdivisions 9, 11; 144A.475, subdivisions 3, 3a, 3b, 3c; 144A.71,
2.3      subdivision 2; 144A.753, subdivision 1; 144E.35; 144G.08, subdivision 45;
2.4      144G.20, subdivisions 3, 13, 16, 17; 144G.30, subdivision 7; 144G.31, subdivisions
2.5      2, 4, 5; 144G.45, subdivision 6; 145.8811; 145.901, subdivision 1; 145.9269,
2.6      subdivision 2; 145.987, subdivisions 1, 2; 145C.01, by adding subdivisions;
2.7      145C.17; 147.01, subdivision 7; 147.037, by adding a subdivision; 147A.02;
2.8      147D.03, subdivision 1; 148.108, subdivision 1, by adding subdivisions; 148.191,
2.9      subdivision 2; 148.241; 148.512, subdivision 17a; 148.5192, subdivision 3;
2.10     148.5194, subdivision 3b; 148.56, subdivision 1, by adding a subdivision; 148.6401;
2.11     148.6402, subdivisions 1, 7, 8, 13, 14, 16, 16a, 19, 20, 23, 25, by adding
2.12     subdivisions; 148.6403; 148.6404; 148.6405; 148.6408, subdivision 2, by adding
2.13     a subdivision; 148.6410, subdivision 2, by adding a subdivision; 148.6412,
2.14     subdivisions 2, 3; 148.6415; 148.6418; 148.6420, subdivision 1; 148.6423,
2.15     subdivisions 1, 2, by adding a subdivision; 148.6425, subdivision 2, by adding
2.16     subdivisions; 148.6428; 148.6432, subdivisions 1, 2, 3, 4, by adding a subdivision;
2.17     148.6435; 148.6438; 148.6443, subdivisions 3, 4, 5, 6, 7, 8; 148.6445, by adding
2.18     subdivisions; 148.6448, subdivisions 1, 2, 4, 6; 148.6449, subdivisions 1, 2, 7;
2.19     148B.53, subdivision 3; 148E.180, subdivisions 1, 5, 7, by adding subdivisions;
2.20     149A.02, by adding a subdivision; 150A.105, by adding a subdivision; 151.01,
2.21     subdivisions 15, 23; 151.065, subdivisions 1, 3, 6; 151.101; 151.555, subdivisions
2.22     6, 10; 152.12, subdivision 1; 153B.85, subdivisions 1, 3; 156.015, by adding
2.23     subdivisions; 157.16, subdivisions 2, 2a, 3, 3a, by adding a subdivision; 174.30,
2.24     subdivision 3; 214.06, by adding a subdivision; 245.095, by adding a subdivision;
2.25     245.0962, subdivision 1; 245.4661, subdivisions 2, 6, 7; 245.4871, subdivision 5;
2.26     245.4889, subdivision 1, as amended; 245.975, subdivision 1; 245A.04, subdivision
2.27     1, as amended; 245A.05; 245A.07, subdivision 2; 245A.18, subdivision 1; 245C.02,
2.28     subdivision 15a, by adding a subdivision; 245C.05, subdivisions 1, 5, 5a; 245C.08,
2.29     subdivisions 1, 5; 245C.10, subdivision 9, by adding a subdivision; 245C.13,
2.30     subdivision 2; 245C.14, by adding a subdivision; 245C.15, subdivisions 1, 4a, by
2.31     adding a subdivision; 245C.22, subdivisions 3, 8; 256.045, subdivision 7; 256.9657,
2.32     by adding a subdivision; 256.969, subdivision 2f; 256.983, subdivision 4;
2.33     256B.0371, subdivision 3; 256B.04, subdivisions 12, 14, 21; 256B.051, subdivision
2.34     3; 256B.0625, subdivisions 2, 3b, 8, 8a, 8e, 13, 13c, 13d, 13e, 17, 30, 54, by adding
2.35     subdivisions; 256B.064, subdivision 1a, as amended; 256B.0659, subdivision 21;
2.36     256B.0757, subdivision 5, by adding a subdivision; 256B.1973, subdivision 5, by
2.37     adding a subdivision; 256B.4912, subdivision 1; 256B.69, subdivisions 3a, 6d, by
2.38     adding a subdivision; 256B.692, subdivision 2; 256B.76, subdivisions 1, 6, by
2.39     adding a subdivision; 256B.761; 256B.766; 256B.85, subdivision 12; 256I.03,
2.40     subdivision 11a; 256L.03, subdivision 3b; 256R.01, by adding a subdivision;
2.41     260.65; 260.66, subdivision 1; 260.691, subdivision 1; 260.692; 260.810,
2.42     subdivisions 1, 2; 260.821, subdivision 2; 260C.001, subdivision 2; 260C.007,
2.43     subdivision 19; 260C.141, subdivision 1; 260C.150, subdivision 3; 260C.178,
2.44     subdivision 1, as amended; 260C.201, subdivisions 1, as amended, 2, as amended;
2.45     260C.202, subdivision 2, by adding subdivisions; 260C.204; 260C.221, subdivision
2.46     2; 260C.223, subdivisions 1, 2; 260C.329, subdivisions 3, 8; 260C.451, subdivision
2.47     9; 260C.452, subdivision 4; 260E.03, subdivision 15; 260E.09; 260E.14,
2.48     subdivisions 2, 3; 260E.20, subdivisions 1, 3; 260E.24, subdivisions 1, 2; 295.50,
2.49     subdivision 3; 325M.34; 326.72, subdivision 1; 326.75, subdivisions 3, 3a; 327.15,
2.50     subdivisions 2, 3, 4, by adding a subdivision; 354B.20, subdivision 7; 518A.46,
2.51     subdivision 7; 609A.015, subdivision 4; 609A.055, subdivision 3; Laws 2021,
2.52     First Special Session chapter 7, article 1, section 39; article 2, section 81; Laws
2.53     2023, chapter 70, article 20, section 2, subdivision 30; Laws 2024, chapter 127,
2.54     article 67, section 4; proposing coding for new law in Minnesota Statutes, chapters
2.55     62Q; 135A; 142B; 144; 144E; 145; 145C; 148; 153; 256B; 260E; 295; 306; 307;
2.56     325M; proposing coding for new law as Minnesota Statutes, chapter 148G;
2.57     repealing Minnesota Statutes 2024, sections 62K.10, subdivision 3; 103I.550;
2.58     136A.29, subdivision 4; 148.108, subdivisions 2, 3, 4; 148.6402, subdivision 22a;
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       06/07/25  REVISOR  DTT/LN  25-05697  as introduced
3.1148.6420, subdivisions 2, 3, 4; 148.6423, subdivisions 4, 5, 7, 8, 9; 148.6425,
3.2subdivision 3; 148.6430; 148.6445, subdivisions 5, 6, 8; 156.015, subdivision 1;
3.3256B.0625, subdivisions 18b, 18e, 18h, 38; Laws 2023, chapter 70, article 16,
3.4section 22; Minnesota Rules, parts 2500.1150; 2500.2030; 4695.2900; 6800.5100,
3.5subpart 5; 6800.5400, subparts 5, 6; 6900.0250, subparts 1, 2; 9100.0400, subparts
3.61, 3; 9100.0500; 9100.0600; 9503.0030, subpart 1, item B.
3.7  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
3.8ARTICLE 1
3.9DEPARTMENT OF HEALTH FINANCE
3.10   Section 1. Minnesota Statutes 2024, section 62D.21, is amended to read:
3.11     62D.21 FEES.
3.12     Every health maintenance organization subject to sections 62D.01 to 62D.30 shall pay
3.13 to the commissioner of health the following fees as prescribed by the commissioner of health
3.14 pursuant to section 144.122 for the following:
3.15     (1) filing an application for a certificate of authority: $10,000;
3.16     (2) filing an amendment to a certificate of authority: $125;
3.17     (3) filing each annual report: $400; and
3.18     (4) other filings, as specified by rule.
3.19     (4) filing each quarterly report: $200; and
3.20     (5) filing annual plan review documents, amendments to plan documents, and quality
3.21 plans: $125.
3.22     EFFECTIVE DATE. This section is effective January 1, 2026.
3.23   Sec. 2. Minnesota Statutes 2024, section 62D.211, is amended to read:
3.24     62D.211 RENEWAL FEE.
3.25     Each health maintenance organization subject to sections 62D.01 to 62D.30 shall submit
3.26 to the commissioner of health each year before June 15 a certificate of authority renewal
3.27 fee in the amount of $10,000 $30,000 each plus 20 88 cents per person enrolled in the health
3.28 maintenance organization on December 31 of the preceding year. The commissioner may
3.29 adjust the renewal fee in rule under the provisions of chapter 14.
3.30     EFFECTIVE DATE. This section is effective January 1, 2026.
       Article 1 Sec. 2.  3
       06/07/25  REVISOR  DTT/LN  25-05697  as introduced
4.1    Sec. 3. Minnesota Statutes 2024, section 103I.101, subdivision 6, is amended to read:
4.2      Subd. 6. Fees for variances. The commissioner shall charge a nonrefundable application
4.3  fee of $275 $325 to cover the administrative cost of processing a request for a variance or
4.4  modification of rules adopted by the commissioner under this chapter.
4.5    Sec. 4. Minnesota Statutes 2024, section 103I.208, subdivision 1, is amended to read:
4.6      Subdivision 1. Well notification fee. The well notification fee to be paid by a property
4.7  owner is:
4.8      (1) for construction of a water supply well, $275 $325, which includes the state core
4.9  function fee;
4.10     (2) for a well sealing, $75 $125 for each well or temporary boring, which includes the
4.11 state core function fee, except that: (i) a single notification and fee of $75 $125 is required
4.12 for all temporary borings on a single property and sealed within 72 hours of start of
4.13 construction; and (ii) temporary borings less than 25 feet in depth are exempt from the
4.14 notification and fee requirements in this chapter;
4.15     (3) for construction of a dewatering well, $275 $330, which includes the state core
4.16 function fee, for each dewatering well, except a dewatering project comprising five or more
4.17 dewatering wells shall be assessed a single fee of $1,375 $1,620 for the dewatering wells
4.18 recorded on the notification; and
4.19     (4) for construction of an environmental well, $275 $330, which includes the state core
4.20 function fee, except that a single fee of $275 is required for all environmental wells recorded
4.21 on the notification that are located on a single property, and except that no fee is required
4.22 for construction of a temporary boring for each environmental well, except an environmental
4.23 well site project comprising five or more environmental wells shall be assessed a single fee
4.24 of $1,620 for the environmental wells recorded on the notification.
4.25   Sec. 5. Minnesota Statutes 2024, section 103I.208, subdivision 1a, is amended to read:
4.26     Subd. 1a. State core function fee. The state core function fee to be collected by the
4.27 state and delegated community health boards and used to support state core functions is:
4.28     (1) for a new well, $20 $40; and
4.29     (2) for a well sealing, $5 $15.
       Article 1 Sec. 5.  4
       06/07/25  REVISOR  DTT/LN  25-05697  as introduced
5.1    Sec. 6. Minnesota Statutes 2024, section 103I.208, subdivision 2, is amended to read:
5.2      Subd. 2. Permit fee. (a) The permit fee to be paid by a property owner is:
5.3      (1) for a water supply well that is not in use under a maintenance permit, $175 $225
5.4  annually;
5.5      (2) for an environmental well that is unsealed under a maintenance permit, $175 annually
5.6  except no fee is required for an environmental well owned by a federal agency, state agency,
5.7  or local unit of government that is unsealed under a maintenance permit. "Local unit of
5.8  government" means a statutory or home rule charter city, town, county, or soil and water
5.9  conservation district, a watershed district, an organization formed for the joint exercise of
5.10 powers under section 471.59, a community health board, or other special purpose district
5.11 or authority with local jurisdiction in water and related land resources management;
5.12     (3) for environmental wells on an environmental well site that are unsealed under a
5.13 maintenance permit,:
5.14     $175 (i) $225 annually for one to ten environmental wells per site regardless of the
5.15 number of environmental wells located on site;
5.16     (ii) $325 annually for 11 to 20 environmental wells per site; and
5.17     (iii) $425 annually for 21 or more environmental wells per site;
5.18     (4) for a groundwater thermal exchange device, in addition to the notification fee for
5.19 water supply wells, $275 $350 for systems using 20 gallons per minute or less and $590
5.20 for systems using over 20 gallons per minute, which includes the state core function fee;
5.21     (5) for a bored geothermal heat exchanger with less than ten tons of heating/cooling
5.22 capacity, $275 $350;
5.23     (6) for a bored geothermal heat exchanger with ten to 50 tons of heating/cooling capacity,
5.24 $515 $590;
5.25     (7) for a bored geothermal heat exchanger with greater than 50 tons of heating/cooling
5.26 capacity, $740 $815;
5.27     (8) for a dewatering well that is unsealed under a maintenance permit, $175 $330 annually
5.28 for each dewatering well, except a dewatering project comprising more than five or more
5.29 dewatering wells shall be issued a single permit for $875 $1,620 annually for dewatering
5.30 wells recorded on the permit;
5.31     (9) for an elevator boring, $275 $325 for each boring; and
       Article 1 Sec. 6.  5
       06/07/25  REVISOR  DTT/LN  25-05697  as introduced
6.1      (10) for a submerged closed loop heat exchanger system, in addition to the notification
6.2  fee for water supply wells, $3,250, which includes the state core function fee.
6.3      (b) For purposes of this subdivision, an environmental well site includes all of the
6.4  environmental wells on a single property. A single property is considered one tax parcel or
6.5  multiple contiguous parcels with the same owner.
6.6    Sec. 7. Minnesota Statutes 2024, section 103I.235, subdivision 1, is amended to read:
6.7      Subdivision 1. Disclosure of wells to buyer. (a) Before signing an agreement to sell or
6.8  transfer real property, the seller must disclose in writing to the buyer information about the
6.9  status and location of all known wells on the property, by delivering to the buyer either a
6.10 statement by the seller that the seller does not know of any wells on the property, or a
6.11 disclosure statement indicating the legal description and county, and a map drawn from
6.12 available information showing the location of each well to the extent practicable. In the
6.13 disclosure statement, the seller must indicate, for each well, whether the well is in use, not
6.14 in use, or sealed.
6.15     (b) At the time of closing of the sale, the disclosure statement information, name and
6.16 mailing address of the buyer, and the quartile, section, township, and range in which each
6.17 well is located must be provided on a well disclosure certificate signed by the seller or a
6.18 person authorized to act on behalf of the seller.
6.19     (c) A well disclosure certificate need not be provided if the seller does not know of any
6.20 wells on the property and the deed or other instrument of conveyance contains the statement:
6.21 "The Seller certifies that the Seller does not know of any wells on the described real
6.22 property."
6.23     (d) If a deed is given pursuant to a contract for deed, the well disclosure certificate
6.24 required by this subdivision shall be signed by the buyer or a person authorized to act on
6.25 behalf of the buyer. If the buyer knows of no wells on the property, a well disclosure
6.26 certificate is not required if the following statement appears on the deed followed by the
6.27 signature of the grantee or, if there is more than one grantee, the signature of at least one
6.28 of the grantees: "The Grantee certifies that the Grantee does not know of any wells on the
6.29 described real property." The statement and signature of the grantee may be on the front or
6.30 back of the deed or on an attached sheet and an acknowledgment of the statement by the
6.31 grantee is not required for the deed to be recordable.
6.32     (e) This subdivision does not apply to the sale, exchange, or transfer of real property:
6.33     (1) that consists solely of a sale or transfer of severed mineral interests; or
       Article 1 Sec. 7.  6
       06/07/25  REVISOR  DTT/LN  25-05697  as introduced
7.1      (2) that consists of an individual condominium unit as described in chapters 515 and
7.2  515B.
7.3      (f) For an area owned in common under chapter 515 or 515B the association or other
7.4  responsible person must report to the commissioner by July 1, 1992, the location and status
7.5  of all wells in the common area. The association or other responsible person must notify
7.6  the commissioner within 30 days of any change in the reported status of wells.
7.7      (g) If the seller fails to provide a required well disclosure certificate, the buyer, or a
7.8  person authorized to act on behalf of the buyer, may sign a well disclosure certificate based
7.9  on the information provided on the disclosure statement required by this section or based
7.10 on other available information.
7.11     (h) A county recorder or registrar of titles may not record a deed or other instrument of
7.12 conveyance dated after October 31, 1990, for which a certificate of value is required under
7.13 section 272.115, or any deed or other instrument of conveyance dated after October 31,
7.14 1990, from a governmental body exempt from the payment of state deed tax, unless the
7.15 deed or other instrument of conveyance contains the statement made in accordance with
7.16 paragraph (c) or (d) or is accompanied by the well disclosure certificate containing all the
7.17 information required by paragraph (b) or (d). The county recorder or registrar of titles must
7.18 not accept a certificate unless it contains all the required information. The county recorder
7.19 or registrar of titles shall note on each deed or other instrument of conveyance accompanied
7.20 by a well disclosure certificate that the well disclosure certificate was received. The notation
7.21 must include the statement "No wells on property" if the disclosure certificate states there
7.22 are no wells on the property. The well disclosure certificate shall not be filed or recorded
7.23 in the records maintained by the county recorder or registrar of titles. After noting "No wells
7.24 on property" on the deed or other instrument of conveyance, the county recorder or registrar
7.25 of titles shall destroy or return to the buyer the well disclosure certificate. The county
7.26 recorder or registrar of titles shall collect from the buyer or the person seeking to record a
7.27 deed or other instrument of conveyance, a fee of $50 $54 for receipt of a completed well
7.28 disclosure certificate. By the tenth day of each month, the county recorder or registrar of
7.29 titles shall transmit the well disclosure certificates to the commissioner of health. By the
7.30 tenth day after the end of each calendar quarter, the county recorder or registrar of titles
7.31 shall transmit to the commissioner of health $42.50 $46.50 of the fee for each well disclosure
7.32 certificate received during the quarter. The commissioner shall maintain the well disclosure
7.33 certificate for at least six years. The commissioner may store the certificate as an electronic
7.34 image. A copy of that image shall be as valid as the original.
       Article 1 Sec. 7.  7
       06/07/25  REVISOR  DTT/LN  25-05697  as introduced
8.1      (i) No new well disclosure certificate is required under this subdivision if the buyer or
8.2  seller, or a person authorized to act on behalf of the buyer or seller, certifies on the deed or
8.3  other instrument of conveyance that the status and number of wells on the property have
8.4  not changed since the last previously filed well disclosure certificate. The following
8.5  statement, if followed by the signature of the person making the statement, is sufficient to
8.6  comply with the certification requirement of this paragraph: "I am familiar with the property
8.7  described in this instrument and I certify that the status and number of wells on the described
8.8  real property have not changed since the last previously filed well disclosure certificate."
8.9  The certification and signature may be on the front or back of the deed or on an attached
8.10 sheet and an acknowledgment of the statement is not required for the deed or other instrument
8.11 of conveyance to be recordable.
8.12     (j) The commissioner in consultation with county recorders shall prescribe the form for
8.13 a well disclosure certificate and provide well disclosure certificate forms to county recorders
8.14 and registrars of titles and other interested persons.
8.15     (k) Failure to comply with a requirement of this subdivision does not impair:
8.16     (1) the validity of a deed or other instrument of conveyance as between the parties to
8.17 the deed or instrument or as to any other person who otherwise would be bound by the deed
8.18 or instrument; or
8.19     (2) the record, as notice, of any deed or other instrument of conveyance accepted for
8.20 filing or recording contrary to the provisions of this subdivision.
8.21   Sec. 8. Minnesota Statutes 2024, section 103I.525, subdivision 2, is amended to read:
8.22     Subd. 2. Certification fee. (a) The application fee for certification as a representative
8.23 of a well contractor is $75 $100. The commissioner may not act on an application until the
8.24 application fee is paid.
8.25     (b) The renewal fee for certification as a representative of a well contractor is $75 $100.
8.26 The commissioner may not renew a certification until the renewal fee is paid.
8.27     (c) A certified representative must file an application and a renewal application fee to
8.28 renew the certification by the date stated in the certification. The renewal application must
8.29 include information that the certified representative has met continuing education
8.30 requirements established by the commissioner by rule.
8.31   Sec. 9. Minnesota Statutes 2024, section 103I.525, subdivision 6, is amended to read:
8.32     Subd. 6. License fee. The fee for a well contractor's license is $250 $300.
       Article 1 Sec. 9.  8
       06/07/25  REVISOR  DTT/LN  25-05697  as introduced
9.1    Sec. 10. Minnesota Statutes 2024, section 103I.525, subdivision 8, is amended to read:
9.2      Subd. 8. Renewal. (a) A licensee must file an application and a renewal application fee
9.3  to renew the license by the date stated in the license.
9.4      (b) The renewal application fee for a well contractor's license is $250 $300.
9.5      (c) The renewal application must include information that the certified representative
9.6  of the applicant has met continuing education requirements established by the commissioner
9.7  by rule.
9.8      (d) At the time of the renewal, the commissioner must have on file all properly completed
9.9  well and boring construction reports, well and boring sealing reports, reports of elevator
9.10 borings, water sample analysis reports, well and boring permits, and well notifications for
9.11 work conducted by the licensee since the last license renewal.
9.12   Sec. 11. Minnesota Statutes 2024, section 103I.531, subdivision 2, is amended to read:
9.13     Subd. 2. Certification fee. (a) The application fee for certification as a representative
9.14 of a limited well/boring contractor is $75 $100. The commissioner may not act on an
9.15 application until the application fee is paid.
9.16     (b) The renewal fee for certification as a representative of a limited well/boring contractor
9.17 is $75 $100. The commissioner may not renew a certification until the renewal fee is paid.
9.18     (c) The fee for three or more limited well/boring contractor certifications is $225 $275.
9.19     (d) A certified representative must file an application and a renewal application fee to
9.20 renew the certification by the date stated in the certification. The renewal application must
9.21 include information that the certified representative has met continuing education
9.22 requirements established by the commissioner by rule.
9.23   Sec. 12. Minnesota Statutes 2024, section 103I.531, subdivision 6, is amended to read:
9.24     Subd. 6. License fee. The fee for a limited well/boring contractor's license is $75 $100.
9.25 The fee for three or more limited well/boring contractor licenses is $225 $275.
9.26   Sec. 13. Minnesota Statutes 2024, section 103I.531, subdivision 8, is amended to read:
9.27     Subd. 8. Renewal. (a) A person must file an application and a renewal application fee
9.28 to renew the limited well/boring contractor's license by the date stated in the license.
9.29     (b) The renewal application fee for a limited well/boring contractor's license is $75 $100.
       Article 1 Sec. 13.  9
06/07/25  REVISOR  DTT/LN  25-05697  as introduced
10.1      (c) The renewal application must include information that the certified representative
10.2  of the applicant has met continuing education requirements established by the commissioner
10.3  by rule.
10.4      (d) At the time of the renewal, the commissioner must have on file all properly completed
10.5  well and boring construction reports, well and boring sealing reports, well and boring
10.6  permits, water quality sample reports, and well notifications for work conducted by the
10.7  licensee since the last license renewal.
10.8    Sec. 14. Minnesota Statutes 2024, section 103I.535, subdivision 2, is amended to read:
10.9      Subd. 2. Certification fee. (a) The application fee for certification as a representative
10.10 of an elevator boring contractor is $75 $100. The commissioner may not act on an application
10.11 until the application fee is paid.
10.12     (b) The renewal fee for certification as a representative of an elevator boring contractor
10.13 is $75 $100. The commissioner may not renew a certification until the renewal fee is paid.
10.14     (c) A certified representative must file an application and a renewal application fee to
10.15 renew the certification by the date stated in the certification. The renewal application must
10.16 include information that the certified representative has met continuing education
10.17 requirements established by the commissioner by rule.
10.18   Sec. 15. Minnesota Statutes 2024, section 103I.535, subdivision 6, is amended to read:
10.19     Subd. 6. License fee. The fee for an elevator boring contractor's license is $75 $100.
10.20   Sec. 16. Minnesota Statutes 2024, section 103I.535, subdivision 8, is amended to read:
10.21     Subd. 8. Renewal. (a) A person must file an application and a renewal application fee
10.22 to renew the license by the date stated in the license.
10.23     (b) The renewal application fee for an elevator boring contractor's license is $75 $100.
10.24     (c) The renewal application must include information that the certified representative
10.25 of the applicant has met continuing education requirements established by the commissioner
10.26 by rule.
10.27     (d) At the time of renewal, the commissioner must have on file all reports and permits
10.28 for elevator boring work conducted by the licensee since the last license renewal.
Article 1 Sec. 16.  10
06/07/25  REVISOR  DTT/LN  25-05697  as introduced
11.1    Sec. 17. Minnesota Statutes 2024, section 103I.541, subdivision 2b, is amended to read:
11.2      Subd. 2b. Issuance of license. If a person employs a certified representative, submits
11.3  the bond under subdivision 3, and pays the license fee of $75 $100 for an environmental
11.4  well contractor license, the commissioner shall issue an environmental well contractor
11.5  license to the applicant. The fee for an individual registration is $75 $100. The commissioner
11.6  may not act on an application until the application fee is paid.
11.7    Sec. 18. Minnesota Statutes 2024, section 103I.541, subdivision 2c, is amended to read:
11.8      Subd. 2c. Certification fee. (a) The application fee for certification as a representative
11.9  of an environmental well contractor is $75 $100. The commissioner may not act on an
11.10 application until the application fee is paid.
11.11     (b) The renewal fee for certification as a representative of an environmental well
11.12 contractor is $75 $100. The commissioner may not renew a certification until the renewal
11.13 fee is paid.
11.14     (c) A certified representative must file an application and a renewal application fee to
11.15 renew the certification by the date stated in the certification. The renewal application must
11.16 include information that the certified representative has met continuing education
11.17 requirements established by the commissioner by rule.
11.18   Sec. 19. Minnesota Statutes 2024, section 103I.541, subdivision 4, is amended to read:
11.19     Subd. 4. License renewal. (a) A person must file an application and a renewal application
11.20 fee to renew the license by the date stated in the license.
11.21     (b) The renewal application fee for an environmental well contractor's license is $75
11.22 $100.
11.23     (c) The renewal application must include information that the certified representative
11.24 of the applicant has met continuing education requirements established by the commissioner
11.25 by rule.
11.26     (d) At the time of the renewal, the commissioner must have on file all well and boring
11.27 construction reports, well and boring sealing reports, well permits, and notifications for
11.28 work conducted by the licensed person since the last license renewal.
Article 1 Sec. 19.  11
06/07/25  REVISOR  DTT/LN  25-05697  as introduced
12.1    Sec. 20. Minnesota Statutes 2024, section 103I.545, subdivision 1, is amended to read:
12.2      Subdivision 1. Drilling machine. (a) A person may not use a drilling machine such as
12.3  a cable tool, rotary tool, hollow rod tool, or auger for a drilling activity requiring a license
12.4  under this chapter unless the drilling machine is registered with the commissioner.
12.5      (b) A person must apply for the registration on forms prescribed by the commissioner
12.6  and submit a $75 $125 registration fee.
12.7      (c) A registration is valid for one year.
12.8    Sec. 21. Minnesota Statutes 2024, section 103I.545, subdivision 2, is amended to read:
12.9      Subd. 2. Hoist. (a) A person may not use a machine such as a hoist for an activity
12.10 requiring a license under this chapter to repair wells or borings, seal wells or borings, or
12.11 install pumps unless the machine is registered with the commissioner.
12.12     (b) A person must apply for the registration on forms prescribed by the commissioner
12.13 and submit a $75 $125 registration fee.
12.14     (c) A registration is valid for one year.
12.15   Sec. 22. Minnesota Statutes 2024, section 103I.601, subdivision 2, is amended to read:
12.16     Subd. 2. License required to make borings. (a) Except as provided in paragraph (d),
12.17 a person must not make an exploratory boring without an explorer's license. The fee for an
12.18 explorer's license is $75 $100. The explorer's license is valid until the date prescribed in the
12.19 license by the commissioner.
12.20     (b) A person must file an application and renewal application fee to renew the explorer's
12.21 license by the date stated in the license. The renewal application fee is $75 $100.
12.22     (c) If the licensee submits an application fee after the required renewal date, the licensee:
12.23     (1) must include a late fee of $75; and
12.24     (2) may not conduct activities authorized by an explorer's license until the renewal
12.25 application, renewal application fee, late fee, and sealing reports required in subdivision 9
12.26 are submitted.
12.27     (d) An explorer must designate a responsible individual to supervise and oversee the
12.28 making of exploratory borings.
Article 1 Sec. 22.  12
06/07/25  REVISOR  DTT/LN  25-05697  as introduced
13.1      (1) Before an individual supervises or oversees an exploratory boring, the individual
13.2  must file an application and application fee of $75 $100 to qualify as a certified responsible
13.3  individual.
13.4      (2) The individual must take and pass an examination relating to construction, location,
13.5  and sealing of exploratory borings. A professional engineer or geoscientist licensed under
13.6  sections 326.02 to 326.15 or a professional geologist certified by the American Institute of
13.7  Professional Geologists is not required to take the examination required in this subdivision,
13.8  but must be certified as a responsible individual to supervise an exploratory boring.
13.9      (3) The individual must file an application and a renewal fee of $75 $100 to renew the
13.10 responsible individual's certification by the date stated in the certification. If the certified
13.11 responsible individual submits an application fee after the renewal date, the certified
13.12 responsible individual must include a late fee of $75 and may not supervise or oversee
13.13 exploratory borings until the renewal application, application fee, and late fee are submitted.
13.14   Sec. 23. Minnesota Statutes 2024, section 103I.601, subdivision 4, is amended to read:
13.15     Subd. 4. Notification and map of borings. (a) By ten days before beginning exploratory
13.16 boring, an explorer must submit to the commissioner of health a notification of the proposed
13.17 boring map and a fee of $275 $325 for each boring constructed.
13.18     (b) By ten days before beginning exploratory boring, an explorer must submit to the
13.19 commissioners of health and natural resources a county road map on a single sheet of paper
13.20 that is 8-1/2 by 11 inches in size and having a scale of one-half inch equal to one mile, as
13.21 prepared by the Department of Transportation, or a 7.5 minute series topographic map
13.22 (1:24,000 scale), as prepared by the United States Geological Survey, showing the location
13.23 of each proposed exploratory boring to the nearest estimated 40 acre parcel. Exploratory
13.24 boring that is proposed on the map may not be commenced later than 180 days after
13.25 submission of the map, unless a new map is submitted.
13.26   Sec. 24. [144.063] DEMENTIA SERVICES PROGRAM ESTABLISHED.
13.27     The commissioner of health shall establish the dementia services program to:
13.28     (1) facilitate the coordination and support of:
13.29     (i) state-funded policies and programs that relate to Alzheimer's disease and related
13.30 forms of dementia;
13.31     (ii) outreach programs and services between state agencies, local public health
13.32 departments, Tribal Nations, educational institutions, and community groups for the purpose
Article 1 Sec. 24.  13
06/07/25  REVISOR        DTT/LN  25-05697  as introduced
14.1  of fostering public awareness and education regarding Alzheimer's disease and related forms
14.2  of dementia; and
14.3      (iii) services and activities between groups that are interested in dementia research,
14.4  programs, and services, including area agencies on aging, service providers, advocacy
14.5  groups, legal services, emergency personnel, law enforcement, local public health
14.6  departments, Tribal Nations, and state colleges and universities;
14.7      (2) facilitate the coordination, review, publication, and implementation of and updates
14.8  to the Minnesota Dementia Strategic Plan;
14.9      (3) use and share data related to the impact of Alzheimer's disease and related forms of
14.10 dementia in Minnesota to guide statewide action; and
14.11     (4) incorporate early detection and risk reduction strategies into existing department-led
14.12 public health programs.
14.13   Sec. 25. Minnesota Statutes 2024, section 144.064, subdivision 3, is amended to read:
14.14     Subd. 3. Commissioner duties. (a) The commissioner shall make available to health
14.15 care practitioners, women who may become pregnant, expectant parents, and parents of
14.16 infants up-to-date and evidence-based information about congenital CMV that has been
14.17 reviewed by experts with knowledge of the disease. The information shall include the
14.18 following:
14.19     (1) the recommendation to consider testing for congenital CMV if the parent or legal
14.20 guardian of the infant elected not to have newborn screening performed under section
14.21 144.125, the infant failed a newborn hearing screening, or pregnancy history suggests
14.22 increased risk for congenital CMV infection;
14.23     (2) the incidence of CMV;
14.24     (3) the transmission of CMV to pregnant women and women who may become pregnant;
14.25     (4) birth defects caused by congenital CMV;
14.26     (5) available preventative measures to avoid the infection of women who are pregnant
14.27 or may become pregnant; and
14.28     (6) resources available for families of children born with congenital CMV.
14.29     (b) The commissioner shall follow existing department practice, inclusive of community
14.30 engagement, to ensure that the information in paragraph (a) is culturally and linguistically
14.31 appropriate for all recipients.
Article 1 Sec. 25.  14
06/07/25  REVISOR  DTT/LN  25-05697  as introduced
15.1      (c) The commissioner shall establish an outreach program to:
15.2      (1) educate women who may become pregnant, expectant parents, and parents of infants
15.3  about CMV; and
15.4      (2) raise awareness for CMV among health care practitioners.
15.5      (d) The Advisory Committee on Heritable and Congenital Disorders established under
15.6  section 144.1255 shall review congenital CMV for inclusion on the list of tests to be
15.7  performed under section 144.125. If the committee recommends and the commissioner
15.8  approves the recommendation of adding congenital CMV to the newborn screening panel,
15.9  the commissioner shall publish the addition in the State Register and the per specimen fee
15.10 for screening under section 144.125, subdivision 1, paragraph (c), shall be increased by
15.11 $43, for a total of $220 per specimen, effective upon publication in the State Register.
15.12   Sec. 26. Minnesota Statutes 2024, section 144.0758, subdivision 3, is amended to read:
15.13     Subd. 3. Eligible grantees. (a) Organizations eligible to receive grant funding under
15.14 this section are Minnesota's Tribal Nations in accordance with paragraph (b) and urban
15.15 American Indian community-based organizations in accordance with paragraph (c).
15.16     (b) Minnesota's Tribal Nations may choose to receive funding under this section according
15.17 to a noncompetitive funding formula specified by the commissioner.
15.18     (c) Urban American Indian community-based organizations are eligible to apply for
15.19 funding under this section by submitting a proposal for consideration by the commissioner.
15.20   Sec. 27. Minnesota Statutes 2024, section 144.1205, subdivision 2, is amended to read:
15.21     Subd. 2. Initial and annual fee. (a) A licensee must pay an initial fee that is equivalent
15.22 to the annual fee upon issuance of the initial license.
15.23     (b) A licensee must pay an annual fee at least 60 days before the anniversary date of the
15.24 issuance of the license. The annual fee is as follows:
15.25TYPE  LICENSE FEE
15.26$25,896
15.27 Academic broad scope - type A, B, or C  $34,500
15.28$31,075
15.29 Academic broad scope - type A, B, or C (4-8 locations)  $41,400
15.30$36,254
15.31 Academic broad scope - type A, B, or C (9 or more locations)  $48,300
15.32$25,896
15.33 Medical broad scope - type A  $34,500
Article 1 Sec. 27.  15
06/07/25  REVISOR       DTT/LN  25-05697       as introduced
16.1$31,075
16.2  Medical broad scope - type A (4-8 locations)  $41,400
16.3$36,254
16.4  Medical broad scope - type A (9 or more locations)  $48,300
16.5  Medical - diagnostic, diagnostic and therapeutic, mobile nuclear
16.6  medicine, eye applicators, high dose rate afterloaders, and  $4,784
16.7  medical therapy emerging technologies  $6,600
16.8  Medical - diagnostic, diagnostic and therapeutic, mobile nuclear
16.9  medicine, eye applicators, high dose rate afterloaders, and  $5,740
16.10 medical therapy emerging technologies (4-8 locations)  $7,900
16.11 Medical - diagnostic, diagnostic and therapeutic, mobile nuclear
16.12 medicine, eye applicators, high dose rate afterloaders, and  $6,697
16.13 medical therapy emerging technologies (9 or more locations)  $9,200
16.14$11,648
16.15 Teletherapy  $15,500
16.16$11,648
16.17 Gamma knife  $15,500
16.18$2,600
16.19 Veterinary medicine  $3,500
16.20$2,600
16.21 In vitro testing lab  $3,500
16.22$11,440
16.23 Nuclear pharmacy  $15,300
16.24$13,728
16.25 Nuclear pharmacy (5 or more locations)  $18,300
16.26$4,992
16.27 Radiopharmaceutical distribution (10 CFR 32.72)  $6,700
16.28 Radiopharmaceutical processing and distribution (10 CFR  $11,440
16.29 32.72)  $15,300
16.30 Radiopharmaceutical processing and distribution (10 CFR  $13,728
16.31 32.72) (5 or more locations)  $18,300
16.32$4,992
16.33 Medical sealed sources - distribution (10 CFR 32.74)  $6,700
16.34 Medical sealed sources - processing and distribution (10 CFR  $11,440
16.35 32.74)  $15,300
16.36 Medical sealed sources - processing and distribution (10 CFR  $13,728
16.37 32.74) (5 or more locations)  $18,300
16.38$4,888
16.39 Well logging - sealed sources  $6,600
16.40 Measuring systems - (fixed gauge, portable gauge, gas  $2,600
16.41 chromatograph, other)  $3,800
16.42 Measuring systems - (fixed gauge, portable gauge, gas  $3,120
16.43 chromatograph, other) (4-8 locations)  $4,500
16.44 Measuring systems - (fixed gauge, portable gauge, gas  $3,640
16.45 chromatograph, other) (9 or more locations)  $5,200
Article 1 Sec. 27.  16
06/07/25  REVISOR        DTT/LN  25-05697       as introduced
17.1$1,976
17.2  X-ray fluorescent analyzer  $2,700
17.3$25,896
17.4  Manufacturing and distribution - type A broad scope  $34,500
17.5  Manufacturing and distribution - type A broad scope (4-8  $31,075
17.6  locations)  $41,400
17.7  Manufacturing and distribution - type A broad scope (9 or more        $36,254
17.8  locations)  $48,300
17.9$22,880
17.10 Manufacturing and distribution - type B or C broad scope  $30,500
17.11 Manufacturing and distribution - type B or C broad scope (4-8  $27,456
17.12 locations)  $36,600
17.13 Manufacturing and distribution - type B or C broad scope (9  $32,032
17.14 or more locations)  $42,700
17.15$6,864
17.16 Manufacturing and distribution - other  $9,200
17.17$8,236
17.18 Manufacturing and distribution - other (4-8 locations)  $11,000
17.19$9,609
17.20 Manufacturing and distribution - other (9 or more locations)  $12,800
17.21$24,232
17.22 Nuclear laundry  $32,300
17.23$6,448
17.24 Decontamination services  $8,600
17.25$2,600
17.26 Leak test services only  $3,500
17.27$2,600
17.28 Instrument calibration service only  $3,500
17.29$6,448
17.30 Service, maintenance, installation, source changes, etc.  $8,600
17.31$7,800
17.32 Waste disposal service, prepackaged only  $10,400
17.33$10,816
17.34 Waste disposal  $14,400
17.35$2,288
17.36 Distribution - general licensed devices (sealed sources)  $3,100
17.37$1,456
17.38 Distribution - general licensed material (unsealed sources)  $2,000
17.39$12,792
17.40 Industrial radiography - fixed or temporary location  $17,200
17.41 Industrial radiography - fixed or temporary location (5 or more       $16,629
17.42 locations)  $22,300
17.43$3,744
17.44 Irradiators, self-shielding  $5,000
17.45$6,968
17.46 Irradiators, other, less than 10,000 curies  $9,300
Article 1 Sec. 27.  17
06/07/25  REVISOR  DTT/LN  25-05697  as introduced
18.1$12,376
18.2  Research and development - type A, B, or C broad scope  $16,500
18.3  Research and development - type A, B, or C broad scope (4-8  $14,851
18.4  locations)  $19,800
18.5  Research and development - type A, B, or C broad scope (9 or  $17,326
18.6  more locations)  $23,100
18.7$5,824
18.8  Research and development - other  $7,800
18.9$2,600
18.10 Storage - no operations  $3,500
18.11$759
18.12 Source material - shielding  $1,100
18.13$4,784
18.14 Special nuclear material plutonium - neutron source in device  $6,400
18.15 Pacemaker by-product and/or special nuclear material - medical  $4,784
18.16 (institution)  $6,400
18.17 Pacemaker by-product and/or special nuclear material -  $6,864
18.18 manufacturing and distribution  $9,200
18.19$4,992
18.20 Accelerator-produced radioactive material  $6,700
18.21$500
18.22 Nonprofit educational institutions  $700
18.23   Sec. 28. Minnesota Statutes 2024, section 144.1205, subdivision 4, is amended to read:
18.24     Subd. 4. Initial and renewal application fee. A licensee must pay an initial and a
18.25 renewal application fee according to this subdivision.
18.26TYPE  APPLICATION FEE
18.27$6,808
18.28 Academic broad scope - type A, B, or C  $9,100
18.29$4,508
18.30 Medical broad scope - type A  $6,000
18.31 Medical - diagnostic, diagnostic and therapeutic, mobile nuclear
18.32 medicine, eye applicators, high dose rate afterloaders, and  $1,748
18.33 medical therapy emerging technologies  $2,350
18.34$6,348
18.35 Teletherapy  $8,450
18.36$6,348
18.37 Gamma knife  $8,450
18.38$1,104
18.39 Veterinary medicine  $1,500
18.40$1,104
18.41 In vitro testing lab  $1,500
18.42$5,612
18.43 Nuclear pharmacy  $7,500
Article 1 Sec. 28.  18
06/07/25  REVISOR        DTT/LN  25-05697       as introduced
19.1$2,484
19.2  Radiopharmaceutical distribution (10 CFR 32.72)  $3,350
19.3  Radiopharmaceutical processing and distribution (10 CFR  $5,612
19.4  32.72)  $7,500
19.5$2,484
19.6  Medical sealed sources - distribution (10 CFR 32.74)  $3,350
19.7  Medical sealed sources - processing and distribution (10 CFR  $5,612
19.8  32.74)  $7,500
19.9$1,840
19.10 Well logging - sealed sources  $2,450
19.11 Measuring systems - (fixed gauge, portable gauge, gas  $1,104
19.12 chromatograph, other)  $1,500
19.13$671
19.14 X-ray fluorescent analyzer  $900
19.15$6,854
19.16 Manufacturing and distribution - type A, B, and C broad scope  $9,150
19.17$2,668
19.18 Manufacturing and distribution - other  $3,550
19.19$11,592
19.20 Nuclear laundry  $15,450
19.21$3,036
19.22 Decontamination services  $4,050
19.23$1,104
19.24 Leak test services only  $1,500
19.25$1,104
19.26 Instrument calibration service only  $1,500
19.27$3,036
19.28 Service, maintenance, installation, source changes, etc.  $4,050
19.29$2,576
19.30 Waste disposal service, prepackaged only  $3,450
19.31$1,748
19.32 Waste disposal  $2,350
19.33$1,012
19.34 Distribution - general licensed devices (sealed sources)  $1,350
19.35$598
19.36 Distribution - general licensed material (unsealed sources)  $800
19.37$3,036
19.38 Industrial radiography - fixed or temporary location  $4,050
19.39$1,656
19.40 Irradiators, self-shielding  $2,250
19.41$3,404
19.42 Irradiators, other, less than 10,000 curies  $4,550
19.43$5,704
19.44 Research and development - type A, B, or C broad scope  $7,600
19.45$2,760
19.46 Research and development - other  $3,700
Article 1 Sec. 28.  19
06/07/25  REVISOR  DTT/LN  25-05697  as introduced
20.1$1,104
20.2  Storage - no operations  $1,500
20.3$156
20.4  Source material - shielding  $250
20.5$1,380
20.6  Special nuclear material plutonium - neutron source in device  $1,850
20.7  Pacemaker by-product and/or special nuclear material - medical  $1,380
20.8  (institution)  $1,850
20.9  Pacemaker by-product and/or special nuclear material -  $2,668
20.10 manufacturing and distribution  $3,550
20.11$4,715
20.12 Accelerator-produced radioactive material  $6,300
20.13$345
20.14 Nonprofit educational institutions  $500
20.15   Sec. 29. Minnesota Statutes 2024, section 144.1205, subdivision 8, is amended to read:
20.16     Subd. 8. Reciprocity fee. A licensee submitting an application for reciprocal recognition
20.17 of a materials license issued by another agreement state or the United States Nuclear
20.18 Regulatory Commission for a period of 180 days or less during a calendar year must pay
20.19 $2,400 $3,200. For a period of 181 days or more, the licensee must obtain a license under
20.20 subdivision 4.
20.21   Sec. 30. Minnesota Statutes 2024, section 144.1205, subdivision 9, is amended to read:
20.22     Subd. 9. Fees for license amendments. A licensee must pay a fee of $600 $800 to
20.23 amend a license as follows:
20.24     (1) to amend a license requiring review including, but not limited to, addition of isotopes,
20.25 procedure changes, new authorized users, or a new radiation safety officer; or
20.26     (2) to amend a license requiring review and a site visit including, but not limited to,
20.27 facility move or addition of processes.
20.28   Sec. 31. Minnesota Statutes 2024, section 144.1205, subdivision 10, is amended to read:
20.29     Subd. 10. Fees for general license registrations. A person required to register generally
20.30 licensed devices according to Minnesota Rules, part 4731.3215, must pay an annual
20.31 registration fee of $450 $600.
20.32   Sec. 32. Minnesota Statutes 2024, section 144.121, subdivision 1a, is amended to read:
20.33     Subd. 1a. Fees for ionizing radiation-producing equipment. (a) A facility with ionizing
20.34 radiation-producing equipment and other sources of ionizing radiation must pay an initial
Article 1 Sec. 32.  20
06/07/25  REVISOR  DTT/LN  25-05697  as introduced
21.1  or annual renewal registration fee consisting of a base facility fee of $100 $155 and an
21.2  additional fee for each x-ray tube, as follows:
21.3      (1) medical or veterinary equipment  $ 100
21.4130
21.5      (2) dental x-ray equipment  $    40
21.660
21.7      (3) x-ray equipment not used on  $ 100
21.8humans or animals  130
21.9      (4) devices with sources of ionizing  $ 100
21.10radiation not used on humans or  130
21.11animals
21.12     (5) security screening system  $ 100
21.13160
21.14     (6) radiation therapy and accelerator  $ 1,000
21.15x-ray equipment
21.16     (7) industrial accelerator x-ray  $ 300
21.17equipment
21.18     (b) A facility with radiation therapy and accelerator equipment must pay an initial or
21.19 annual registration fee of $500. A facility with an industrial accelerator must pay an initial
21.20 or annual registration fee of $150.
21.21     (c) (b) Electron microscopy equipment is exempt from the registration fee requirements
21.22 of this section.
21.23     (d) (c) For purposes of this section, a security screening system means ionizing
21.24 radiation-producing equipment designed and used for security screening of humans who
21.25 are in the custody of a correctional or detention facility, and used by the facility to image
21.26 and identify contraband items concealed within or on all sides of a human body. For purposes
21.27 of this section, a correctional or detention facility is a facility licensed under section 241.021
21.28 and operated by a state agency or political subdivision charged with detection, enforcement,
21.29 or incarceration in respect to state criminal and traffic laws. The commissioner shall adopt
21.30 rules to establish requirements for the use of security screening systems. Notwithstanding
21.31 section 14.125, the authority to adopt these rules does not expire.
21.32   Sec. 33. Minnesota Statutes 2024, section 144.121, is amended by adding a subdivision
21.33 to read:
21.34     Subd. 1e. Fee for service provider of ionizing radiation-producing equipment. A
21.35 service provider of ionizing radiation-producing equipment and other sources of ionizing
21.36 radiation must pay an initial or annual renewal fee of $115.
Article 1 Sec. 33.  21
06/07/25  REVISOR  DTT/LN  25-05697  as introduced
22.1    Sec. 34. Minnesota Statutes 2024, section 144.121, subdivision 2, is amended to read:
22.2      Subd. 2. Inspections. Periodic radiation safety inspections of the x-ray equipment and
22.3  other sources of ionizing radiation shall be made by the commissioner of health. The
22.4  frequency of safety inspections shall be prescribed by the commissioner on the basis of
22.5  based on the frequency of radiation exposure risk to occupational and public health from
22.6  use of the x-ray equipment and other source of ionizing radiation, provided that each source
22.7  shall be inspected at least once every four years.
22.8    Sec. 35. Minnesota Statutes 2024, section 144.121, subdivision 5, is amended to read:
22.9      Subd. 5. Examination for individual operating x-ray systems. (a) An individual in a
22.10 facility with x-ray systems for use on living humans that is registered under subdivision 1
22.11 may not operate, nor may the facility allow the individual to operate, x-ray systems unless
22.12 the individual has passed a national or state examination.
22.13     (b) Individuals who may operate x-ray systems include:
22.14     (1) an individual who has passed the American Registry of Radiologic Technologists
22.15 (ARRT) registry for radiography examination;
22.16     (2) an individual who has passed the American Chiropractic Registry of Radiologic
22.17 Technologists (ACRRT) registry examination and is limited to radiography of spines and
22.18 extremities;
22.19     (3) a registered limited scope x-ray operator and a registered bone densitometry equipment
22.20 operator who passed the examination requirements in paragraphs (d) and (e) and practices
22.21 according to subdivision 5a;
22.22     (4) an x-ray operator who has the original certificate or the original letter of passing the
22.23 examination that was required before January 1, 2008, under Minnesota Statutes 2008,
22.24 section 144.121, subdivision 5a, paragraph (b), clause (1);
22.25     (5) an individual who has passed the American Registry of Radiologic Technologists
22.26 (ARRT) registry for radiation therapy examination according to subdivision 5e;
22.27     (6) a cardiovascular technologist according to subdivision 5c;
22.28     (7) a nuclear medicine technologist according to subdivision 5d;
22.29     (8) an individual who has passed the examination for a dental hygienist under section
22.30 150A.06 and only operates dental x-ray systems;
Article 1 Sec. 35.  22
06/07/25  REVISOR        DTT/LN  25-05697  as introduced
23.1      (9) an individual who has passed the examination for a dental therapist under section
23.2  150A.06 and only operates dental x-ray systems;
23.3      (10) an individual who has passed the examination for a dental assistant under section
23.4  150A.06 and only operates dental x-ray systems;
23.5      (11) an individual who has passed the examination under Minnesota Rules, part
23.6  3100.8500, subpart 3 3100.1320, and only operates dental x-ray systems; and
23.7      (12) a qualified practitioner who is licensed by a health-related licensing board with
23.8  active practice authority and is working within the practitioner's scope of practice.
23.9      (c) Except for individuals under clauses (3) and (4), an individual who is participating
23.10 in a training or educational program in any of the occupations listed in paragraph (b) is
23.11 exempt from the examination requirement within the scope and for the duration of the
23.12 training or educational program.
23.13     (d) The Minnesota examination for limited scope x-ray operators must include:
23.14     (1) radiation protection, radiation physics and radiobiology, equipment operation and
23.15 quality assurance, image acquisition and technical evaluation, and patient interactions and
23.16 management; and
23.17     (2) at least one of the following regions of the human anatomy: chest, extremities, skull
23.18 and sinus, spine, or podiatry. The examinations must include the anatomy of, and radiographic
23.19 positions and projections for, the specific regions.
23.20     (e) The examination for bone densitometry equipment operators must include:
23.21     (1) osteoporosis, bone physiology, bone health and patient education, patient preparation,
23.22 fundamental principals, biological effects of radiation, units of measurements, radiation
23.23 protection in bone densitometry, fundamentals of x-ray production, quality control, measuring
23.24 bone mineral testing, determining quality in bone mineral testing, file and database
23.25 management; and
23.26     (2) dual x-ray absorptiometry scanning of the lumbar spine, proximal femur, and forearm.
23.27 The examination must include the anatomy, scan acquisition, and scan analysis for these
23.28 three procedures.
23.29     (f) A limited scope x-ray operator, and a bone densitometry equipment operator, who
23.30 are required to take an examination under this subdivision must submit to the commissioner
23.31 a registration application for the examination and a $25 processing fee. The processing fee
Article 1 Sec. 35.  23
06/07/25  REVISOR        DTT/LN  25-05697  as introduced
24.1  shall be deposited in the state treasury and credited to the state government special revenue
24.2  fund.
24.3    Sec. 36. Minnesota Statutes 2024, section 144.121, is amended by adding a subdivision
24.4  to read:
24.5      Subd. 10. Service provider practice; service technician. (a) A service technician is a
24.6  service provider who performs one or more of the following, including but not limited to:
24.7  assembly, installation, calibration, equipment performance evaluation, preventive
24.8  maintenance, repair, replacement, or disabling of ionizing radiation-producing equipment
24.9  and other sources of ionizing radiation. A service technician may not perform an equipment
24.10 performance evaluation on computed tomography, medical cone beam computed tomography,
24.11 and fluoroscopy equipment.
24.12     (b) In order to provide service technician services, a service provider must register with
24.13 the commissioner as a service technician, meet the applicable requirements in Minnesota
24.14 Rules, chapter 4732, and pay the fee in subdivision 1e.
24.15   Sec. 37. Minnesota Statutes 2024, section 144.121, is amended by adding a subdivision
24.16 to read:
24.17     Subd. 11. Service provider practice; vendor. (a) A vendor is a service provider who
24.18 performs one or more of the following services, including but not limited to: sales, leasing,
24.19 lending, transferring, disposal, or demonstration of ionizing radiation-producing equipment
24.20 and other sources of ionizing radiation.
24.21     (b) In order to provide vendor services, a service provider must register with the
24.22 commissioner as a vendor, meet the applicable requirements in Minnesota Rules, chapter
24.23 4732, and pay the fee in subdivision 1e.
24.24   Sec. 38. Minnesota Statutes 2024, section 144.121, is amended by adding a subdivision
24.25 to read:
24.26     Subd. 12. Service provider practice; qualified medical physicist. (a) A qualified
24.27 medical physicist is a service provider who provides medical physics services and must be
24.28 certified in diagnostic medical physics, diagnostic radiological physics, radiological physics,
24.29 diagnostic imaging physics, or diagnostic radiology physics by the American Board of
24.30 Radiology, the American Board of Medical Physics, or the Canadian College of Physicists
24.31 in Medicine.
Article 1 Sec. 38.  24
06/07/25  REVISOR  DTT/LN  25-05697  as introduced
25.1      (b) In order to provide medical physics services a service provider must register with
25.2  the commissioner as a qualified medical physicist, meet the applicable requirements in
25.3  Minnesota Rules, chapter 4732, and pay the fee in subdivision 1e.
25.4    Sec. 39. Minnesota Statutes 2024, section 144.121, is amended by adding a subdivision
25.5  to read:
25.6      Subd. 13. Service provider practice; qualified expert. (a) A qualified expert is a service
25.7  provider who provides expert physics services, and must be certified in the appropriate
25.8  fields or specialties in which physics services are provided by the American Board of Health
25.9  Physics, the American Board of Medical Physics, the American Board of Radiology, the
25.10 American Board of Science in Nuclear Medicine, or the Canadian College of Physicists in
25.11 Medicine.
25.12     (b) In order to provide health physics services, a service provider must register with the
25.13 commissioner as a qualified expert, meet the applicable requirements in Minnesota Rules,
25.14 chapter 4732, and pay the fee in subdivision 1e.
25.15   Sec. 40. Minnesota Statutes 2024, section 144.121, is amended by adding a subdivision
25.16 to read:
25.17     Subd. 14. Service provider practice; physicist assistant. (a) A physicist assistant is a
25.18 service provider who provides expert physics or medical physics services under the
25.19 supervision of a qualified expert or a qualified medical physicist and must be deemed
25.20 competent by a qualified expert or a qualified medical physicist in the appropriate fields or
25.21 specialties in which services are provided.
25.22     (b) In order to provide health physics or medical physics services under the supervision
25.23 of a qualified expert or a qualified medical physicist, a physicist assistant must register with
25.24 the commissioner as a physicist assistant, meet the applicable requirements in Minnesota
25.25 Rules, chapter 4732, and pay the fee under subdivision 1e.
25.26     (c) Supervision as used in this subdivision refers to either personal or general supervision
25.27 of a physicist assistant by a qualified expert or a qualified medical physicist according to
25.28 Minnesota Rules, chapter 4732.
25.29     (d) An individual registered with the commissioner before January 1, 2025, under
25.30 Minnesota Rules, part 4732.0275, to perform expert physics services independently or
25.31 medical physics services independently may continue to register and perform these services
25.32 as a physicist assistant without supervision if the individual:
Article 1 Sec. 40.  25
06/07/25  REVISOR        DTT/LN  25-05697  as introduced
26.1      (1) holds a master's degree from an accredited college or university in medical physics,
26.2  radiological sciences, or an equivalent field involving graduate study in physics applied to
26.3  the application of radiation to humans;
26.4      (2) has at least two years of full-time practical training or supervised experience under
26.5  an individual who meets the qualifications under subdivision 12 or 13; and
26.6      (3) pays the fee in subdivision 1e.
26.7    Sec. 41. Minnesota Statutes 2024, section 144.121, is amended by adding a subdivision
26.8  to read:
26.9      Subd. 15. Service provider compliance. A service provider registered with the
26.10 commissioner under Minnesota Rules, chapter 4732, must, upon renewal of registration,
26.11 comply with the applicable requirements under this section and submit the fee under
26.12 subdivision 1e.
26.13   Sec. 42. Minnesota Statutes 2024, section 144.1215, is amended by adding a subdivision
26.14 to read:
26.15     Subd. 5. Rulemaking authority. The commissioner shall adopt rules to implement this
26.16 section. Notwithstanding section 14.125, the authority to adopt these rules does not expire.
26.17   Sec. 43. Minnesota Statutes 2024, section 144.122, is amended to read:
26.18     144.122 LICENSE, PERMIT, AND SURVEY FEES.
26.19     (a) The state commissioner of health, by rule, may prescribe procedures and fees for
26.20 filing with the commissioner as prescribed by statute and for the issuance of original and
26.21 renewal permits, licenses, registrations, and certifications issued under authority of the
26.22 commissioner. The expiration dates of the various licenses, permits, registrations, and
26.23 certifications as prescribed by the rules shall be plainly marked thereon. Fees may include
26.24 application and examination fees and a penalty fee for renewal applications submitted after
26.25 the expiration date of the previously issued permit, license, registration, and certification.
26.26 The commissioner may also prescribe, by rule, reduced fees for permits, licenses,
26.27 registrations, and certifications when the application therefor is submitted during the last
26.28 three months of the permit, license, registration, or certification period. Fees proposed to
26.29 be prescribed in the rules shall be first approved by the Department of Management and
26.30 Budget. All fees proposed to be prescribed in rules shall be reasonable. The fees shall be
26.31 in an amount so that the total fees collected by the commissioner will, where practical,
26.32 approximate the cost to the commissioner in administering the program. All fees collected
Article 1 Sec. 43.  26
06/07/25  REVISOR  DTT/LN  25-05697  as introduced
27.1  shall be deposited in the state treasury and credited to the state government special revenue
27.2  fund unless otherwise specifically appropriated by law for specific purposes.
27.3      (b) The commissioner may charge a fee for voluntary certification of medical laboratories
27.4  and environmental laboratories, and for environmental and medical laboratory services
27.5  provided by the department, without complying with paragraph (a) or chapter 14. Fees
27.6  charged for environment and medical laboratory services provided by the department must
27.7  be approximately equal to the costs of providing the services.
27.8      (c) The commissioner may develop a schedule of fees for diagnostic evaluations
27.9  conducted at clinics held by the services for children with disabilities program. All receipts
27.10 generated by the program are annually appropriated to the commissioner for use in the
27.11 maternal and child health program.
27.12     (d) The commissioner shall set license fees for hospitals and nursing homes that are not
27.13 boarding care homes at the following levels:
27.14 The Joint Commission on Accreditation  $7,655 plus $16 per bed $9,524
27.15 of Healthcare Organizations (JCAHO)
27.16 (TJC) and American Osteopathic
27.17 Association (AOA) hospitals
27.18 Non-JCAHO Non-TJC and non-AOA  $5,280 $6,318 plus $250 $317 per bed
27.19 hospitals
27.20 Fees collected per hospital for the  $600 plus $16 per bed
27.21 Minnesota Adverse Health Care Events
27.22 Reporting
27.23 Nursing home  $183 plus $91 per bed until June 30, 2018.
27.24$183 plus $100 per bed between July 1,
27.252018, and June 30, 2020. $183 $238 plus
27.26$105 $142 per bed beginning July 1, 2020.
27.27     The commissioner shall set license fees for outpatient surgical centers, boarding care
27.28 homes, supervised living facilities, assisted living facilities, and assisted living facilities
27.29 with dementia care at the following levels:
27.30 Outpatient surgical centers  $3,712 $1,966
27.31 Fees collected per outpatient surgical  $2,200
27.32 center for the Minnesota Adverse Health
27.33 Care Events Reporting
27.34 Boarding care homes  $183 $220 plus $91 $110 per bed
27.35 Supervised living facilities  $183 $238 plus $91 $118 per bed.
27.36 Assisted living facilities with dementia  $3,000 plus $100 $150 per resident.
27.37 care
27.38 Assisted living facilities  $2,000 plus $75 $125 per resident.
Article 1 Sec. 43.  27
06/07/25  REVISOR  DTT/LN  25-05697  as introduced
28.1  Fees collected under this paragraph are nonrefundable. The fees are nonrefundable even if
28.2  received before July 1, 2017, for licenses or registrations being issued effective July 1, 2017,
28.3  or later.
28.4      (e) Unless prohibited by federal law, the commissioner of health shall charge applicants
28.5  the following fees to cover the cost of any initial certification surveys required to determine
28.6  a provider's eligibility to participate in the Medicare or Medicaid program:
28.7  Prospective payment surveys for hospitals  $  900
28.8  Swing bed surveys for nursing homes  $  1,200
28.9  Psychiatric hospitals  $  1,400
28.10 Rural health facilities  $  1,100
28.11 Portable x-ray providers  $  500
28.12 Home health agencies  $  1,800
28.13 Outpatient therapy agencies  $  800
28.14 End stage renal dialysis providers  $  2,100
28.15 Independent therapists  $  800
28.16 Comprehensive rehabilitation outpatient facilities  $  1,200
28.17 Hospice providers  $  1,700
28.18 Ambulatory surgical providers  $  1,800
28.19 Hospitals  $  4,200
28.20 Other provider categories or additional  Actual surveyor costs: average
28.21 resurveys required to complete initial  surveyor cost x number of hours for
28.22 certification  the survey process.
28.23     These fees shall be submitted at the time of the application for federal certification and
28.24 shall not be refunded. All fees collected after the date that the imposition of fees is not
28.25 prohibited by federal law shall be deposited in the state treasury and credited to the state
28.26 government special revenue fund.
28.27     (f) Notwithstanding section 16A.1283, the commissioner may adjust the fees assessed
28.28 on assisted living facilities and assisted living facilities with dementia care under paragraph
28.29 (d), in a revenue-neutral manner in accordance with the requirements of this paragraph:
28.30     (1) a facility seeking to renew a license shall pay a renewal fee in an amount that is up
28.31 to ten percent lower than the applicable fee in paragraph (d) if residents who receive home
28.32 and community-based waiver services under chapter 256S and section 256B.49 comprise
28.33 more than 50 percent of the facility's capacity in the calendar year prior to the year in which
28.34 the renewal application is submitted; and
Article 1 Sec. 43.  28
06/07/25  REVISOR        DTT/LN  25-05697  as introduced
29.1      (2) a facility seeking to renew a license shall pay a renewal fee in an amount that is up
29.2  to ten percent higher than the applicable fee in paragraph (d) if residents who receive home
29.3  and community-based waiver services under chapter 256S and section 256B.49 comprise
29.4  less than 50 percent of the facility's capacity during the calendar year prior to the year in
29.5  which the renewal application is submitted.
29.6  The commissioner may annually adjust the percentages in clauses (1) and (2), to ensure this
29.7  paragraph is implemented in a revenue-neutral manner. The commissioner shall develop a
29.8  method for determining capacity thresholds in this paragraph in consultation with the
29.9  commissioner of human services and must coordinate the administration of this paragraph
29.10 with the commissioner of human services for purposes of verification.
29.11     (g) The commissioner shall charge hospitals an annual licensing base fee of $1,826 per
29.12 hospital, plus an additional $23 per licensed bed or bassinet fee. Revenue shall be deposited
29.13 to the state government special revenue fund and credited toward trauma hospital designations
29.14 under sections 144.605 and 144.6071.
29.15   Sec. 44. Minnesota Statutes 2024, section 144.1222, subdivision 1a, is amended to read:
29.16     Subd. 1a. Fees. All plans and specifications for public pool and spa construction,
29.17 installation, or alteration or requests for a variance that are submitted to the commissioner
29.18 according to Minnesota Rules, part 4717.3975, shall be accompanied by the appropriate
29.19 fees. All public pool construction plans submitted for review after January 1, 2009, must
29.20 be certified by a professional engineer registered in the state of Minnesota. If the
29.21 commissioner determines, upon review of the plans, that inadequate fees were paid, the
29.22 necessary additional fees shall be paid before plan approval. For purposes of determining
29.23 fees, a project is defined as a proposal to construct or install a public pool, spa, special
29.24 purpose pool, or wading pool and all associated water treatment equipment and drains,
29.25 gutters, decks, water recreation features, spray pads, and those design and safety features
29.26 that are within five feet of any pool or spa. Plans submitted less than 30 days prior to
29.27 construction are subject to an additional late fee equal to 50 percent of the original plan
29.28 review fee. The commissioner shall charge the following fees for plan review and inspection
29.29 of public pools and spas and for requests for variance from the public pool and spa rules:
29.30     (1) each pool, $1,500 $1,600;
29.31     (2) each spa pool, $800 $900;
29.32     (3) each slide, $600 $650;
Article 1 Sec. 44.  29
06/07/25  REVISOR  DTT/LN  25-05697  as introduced
30.1      (4) projects valued at $250,000 or more, the greater of the sum of the fees in clauses (1),
30.2  (2), and (3) or 0.5 percent of the documented estimated project cost to a maximum fee of
30.3  $15,000;
30.4      (5) alterations to an existing pool without changing the size or configuration of the pool,
30.5  $600 $700;
30.6      (6) removal or replacement of pool disinfection equipment only, $100 $200; and
30.7      (7) request for variance from the public pool and spa rules, $500 $550.
30.8    Sec. 45. Minnesota Statutes 2024, section 144.1222, subdivision 2d, is amended to read:
30.9      Subd. 2d. Hot tubs Spa pools on rental houseboats property. (a) For the purposes of
30.10 this subdivision, "spa pool" has the meaning given in Minnesota Rules, part 4717.0250,
30.11 subpart 9.
30.12     (a) (b) Except as provided in paragraph (c), a hot water spa pool intended for seated
30.13 recreational use, including a hot tub or whirlpool, that is located on a houseboat that is rented
30.14 to the public the property of a stand-alone, single-unit rental property, offered for rent by
30.15 the property owner or through a resort, and that is only intended to be used by the occupants
30.16 of the rental property:
30.17     (1) is not a public pool and;
30.18     (2) is exempt from the requirements for public pools under subdivisions 1 to 2c, 4, and
30.19 5 and Minnesota Rules, chapter 4717., except as otherwise provided in this paragraph; and
30.20     (3) may be used by renters so long as:
30.21     (i) the water temperature in the spa pool does not exceed 106 degrees Fahrenheit; and
30.22     (ii) prior to check-in by each new rental party, the resort or property owner tests the
30.23 water in the spa pool for the concentration of chlorine or bromine, pH, and alkalinity, and
30.24 the water in the spa pool meets the requirements for disinfection residual, pH, and alkalinity
30.25 in Minnesota Rules, part 4717.1750, subparts 4, 5, and 6.
30.26     (b) (c) A spa pool intended for seated recreational use, including a hot tub or whirlpool,
30.27 that is located on a houseboat that is rented to the public:
30.28     (1) is not a public pool;
30.29     (2) is exempt from the requirements for public pools under subdivisions 1 to 2c, 4, and
30.30 5 and Minnesota Rules, chapter 4717; and
30.31     (3) is exempt from the requirements under paragraph (b), clause (3).
Article 1 Sec. 45.  30
06/07/25  REVISOR  DTT/LN  25-05697  as introduced
31.1      (d) A political subdivision must not adopt a local law, rule, or ordinance that prohibits
31.2  the operation of, or establishes additional requirements for, a spa pool that meets the criteria
31.3  in paragraph (b) or (c).
31.4      (e) A hot water spa pool under this subdivision must be conspicuously posted with the
31.5  following notice and must be provided to renters upon check in:
31.6"NOTICE
31.7      This spa is exempt from state and local anti-entrapment and sanitary requirements that
31.8  prevent disease transmission waterborne diseases such as Legionnaires' disease, Pseudomonas
31.9  folliculitis (hot tub rash), and chemical burns and is not subject to inspection.
31.10USE AT YOUR OWN RISK
31.11     This notice is required under Minnesota Statutes, section 144.1222, subdivision 2d."
31.12   Sec. 46. [144.1223] REGISTERED SANITARIANS AND REGISTERED
31.13 ENVIRONMENTAL HEALTH SPECIALIST APPLICATION FEES.
31.14     (a) Fees to be submitted with initial or renewal applications for registration as a sanitarian
31.15 or environmental health specialist are as follows:
31.16     (1) initial application fee, $55;
31.17     (2) biennial renewal application fee, $55; and
31.18     (3) penalty for late submission of renewal application, $20, if not renewed by designated
31.19 renewal date.
31.20     (b) Additionally, a $5 technology fee must be paid with the initial registration or
31.21 registration renewal.
31.22   Sec. 47. [144.124] EDUCATION ON RECOGNIZING SIGNS OF PHYSICAL ABUSE
31.23 IN INFANTS.
31.24     Subdivision 1. Education by health care providers. Family practice physicians,
31.25 pediatricians, and other pediatric primary care providers must provide parents and primary
31.26 caregivers of infants up to six months of age with materials on how to recognize the signs
31.27 of physical abuse in infants and how to report suspected physical abuse of infants. These
31.28 materials must be identified and approved by the commissioner of health according to
31.29 subdivision 2 and must be provided to an infant's parents or primary caregivers at the infant's
31.30 first well-baby visit after birth.
Article 1 Sec. 47.  31
06/07/25  REVISOR  DTT/LN  25-05697  as introduced
32.1      Subd. 2. Materials. The commissioner of health, in consultation with the commissioner
32.2  of children, youth, and families, must identify, approve, and make available to pediatric
32.3  primary care providers materials for pediatric primary care providers to use at well-baby
32.4  visits to educate parents and primary caregivers of infants up to six months of age on
32.5  recognizing the signs of physical abuse in infants and how to report suspected physical
32.6  abuse of infants. The commissioner must make these materials available on the Department
32.7  of Health website.
32.8    Sec. 48. Minnesota Statutes 2024, section 144.125, subdivision 1, is amended to read:
32.9      Subdivision 1. Duty to perform testing. (a) It is the duty of (1) the administrative officer
32.10 or other person in charge of each institution caring for infants 28 days or less of age, (2) the
32.11 person required in pursuance of the provisions of section 144.215, to register the birth of a
32.12 child, or (3) the nurse midwife or midwife in attendance at the birth, to arrange to have
32.13 administered to every infant or child in its care tests for heritable and congenital disorders
32.14 according to subdivision 2 and rules prescribed by the state commissioner of health.
32.15     (b) Testing, recording of test results, reporting of test results, and follow-up of infants
32.16 with heritable congenital disorders, including hearing loss detected through the early hearing
32.17 detection and intervention program in section 144.966, shall be performed at the times and
32.18 in the manner prescribed by the commissioner of health.
32.19     (c) The fee to support the newborn screening program, including tests administered
32.20 under this section and section 144.966, shall be $177 $184 per specimen. This fee amount
32.21 shall be deposited in the state treasury and credited to the state government special revenue
32.22 fund.
32.23     (d) The fee to offset the cost of the support services provided under section 144.966,
32.24 subdivision 3a, shall be $15 per specimen. This fee shall be deposited in the state treasury
32.25 and credited to the general fund.
32.26   Sec. 49. Minnesota Statutes 2024, section 144.3831, subdivision 1, is amended to read:
32.27     Subdivision 1. Fee setting. The commissioner of health may assess an annual fee of
32.28 $9.72 $15.22 for every service connection to a public water supply that is owned or operated
32.29 by a home rule charter city, a statutory city, a city of the first class, or a town. The
32.30 commissioner of health may also assess an annual fee for every service connection served
32.31 by a water user district defined in section 110A.02.
Article 1 Sec. 49.  32
06/07/25  REVISOR  DTT/LN  25-05697  as introduced
33.1    Sec. 50. Minnesota Statutes 2024, section 144.55, subdivision 1a, is amended to read:
33.2      Subd. 1a. License fee. The annual license fee for outpatient surgical centers is $1,512
33.3  $1,966.
33.4    Sec. 51. Minnesota Statutes 2024, section 144.554, is amended to read:
33.5      144.554 HEALTH FACILITIES CONSTRUCTION PLAN SUBMITTAL AND
33.6  FEES.
33.7      For hospitals, nursing homes, assisted living facilities, boarding care homes, residential
33.8  hospices, supervised living facilities, freestanding outpatient surgical centers, and end-stage
33.9  renal disease facilities, the commissioner shall collect a fee for the review and approval of
33.10 architectural, mechanical, and electrical plans and specifications submitted before
33.11 construction begins for each project relative to construction of new buildings, additions to
33.12 existing buildings, or remodeling or alterations of existing buildings. All fees collected in
33.13 this section shall be deposited in the state treasury and credited to the state government
33.14 special revenue fund. Fees must be paid at the time of submission of final plans for review
33.15 and are not refundable. The fee is calculated as follows:
33.16      Construction project total estimated cost  Fee
33.17$0 - $10,000  $30 $45
33.18$10,001 - $50,000  $150 $225
33.19$50,001 - $100,000  $300 $450
33.20$100,001 - $150,000  $450 $675
33.21$150,001 - $200,000  $600 $900
33.22$200,001 - $250,000  $750 $1,125
33.23$250,001 - $300,000  $900 $1,350
33.24$300,001 - $350,000  $1,050 $1,575
33.25$350,001 - $400,000  $1,200 $1,800
33.26$400,001 - $450,000  $1,350 $2,025
33.27$450,001 - $500,000  $1,500 $2,250
33.28$500,001 - $550,000  $1,650 $2,475
33.29$550,001 - $600,000  $1,800 $2,700
33.30$600,001 - $650,000  $1,950 $2,925
33.31$650,001 - $700,000  $2,100 $3,150
33.32$700,001 - $750,000  $2,250 $3,375
33.33$750,001 - $800,000  $2,400 $3,600
33.34$800,001 - $850,000  $2,550 $3,825
33.35$850,001 - $900,000  $2,700 $4,050
Article 1 Sec. 51.  33
06/07/25  REVISOR  DTT/LN  25-05697  as introduced
34.1$900,001 - $950,000  $2,850 $4,275
34.2$950,001 - $1,000,000  $3,000 $4,500
34.3$1,000,001 - $1,050,000  $3,150 $4,725
34.4$1,050,001 - $1,100,000  $3,300 $4,950
34.5$1,100,001 - $1,150,000  $3,450 $5,175
34.6$1,150,001 - $1,200,000  $3,600 $5,400
34.7$1,200,001 - $1,250,000  $3,750 $5,625
34.8$1,250,001 - $1,300,000  $3,900 $5,850
34.9$1,300,001 - $1,350,000  $4,050 $6,075
34.10$1,350,001 - $1,400,000  $4,200 $6,300
34.11$1,400,001 - $1,450,000  $4,350 $6,525
34.12$1,450,001 - $1,500,000  $4,500 $6,750
34.13$1,500,001 and over - $2,000,000  $4,800 $7,200
34.14$2,000,001 - $3,000,000  $7,650
34.15$3,000,001 - $4,000,000  $8,100
34.16$4,000,001 - $7,000,000  $8,550
34.17$7,000,001 - $15,000,000  $9,000
34.18$15,000,001 - $50,000,000  $9,450
34.19$50,000,001 and over  $9,900
34.20   Sec. 52. Minnesota Statutes 2024, section 144.562, subdivision 2, is amended to read:
34.21     Subd. 2. Eligibility for license condition. (a) A hospital is not eligible to receive a
34.22 license condition for swing beds unless (1) it either has a licensed bed capacity of less than
34.23 50 beds defined in the federal Medicare regulations, Code of Federal Regulations, title 42,
34.24 section 482.66, or it has a licensed bed capacity of 50 beds or more and has swing beds that
34.25 were approved for Medicare reimbursement before May 1, 1985, or it has a licensed bed
34.26 capacity of less than 65 beds and the available nursing homes within 50 miles have had, in
34.27 the aggregate, an average occupancy rate of 96 percent or higher in the most recent two
34.28 years as documented on the statistical reports to the Department of Health; and (2) it is
34.29 located in a rural area as defined in the federal Medicare regulations, Code of Federal
34.30 Regulations, title 42, section 482.66.
34.31     (b) Except for those critical access hospitals established under section 144.1483, clause
34.32 (9), and section 1820 of the federal Social Security Act, United States Code, title 42, section
34.33 1395i-4, that have an attached nursing home or that owned a nursing home located in the
34.34 same municipality as of May 1, 2005, eligible hospitals are allowed a total number of days
34.35 of swing bed use per year as provided in paragraph (c). Critical access hospitals that have
Article 1 Sec. 52.  34
06/07/25  REVISOR  DTT/LN  25-05697  as introduced
35.1  an attached nursing home or that owned a nursing home located in the same municipality
35.2  as of May 1, 2005, are allowed swing bed use as provided in federal law. A critical access
35.3  hospital described in section 144.5621 is allowed an unlimited number of days of swing
35.4  bed use per year.
35.5      (c) An eligible hospital is allowed a total of 3,000 days of swing bed use in calendar
35.6  year 2020. Beginning in calendar year 2021, and for each subsequent calendar year until
35.7  calendar year 2027, the total number of days of swing bed use per year is increased by 200
35.8  swing bed use days. Beginning in calendar year 2028, an eligible hospital is allowed a total
35.9  of 4,500 days of swing bed use per year.
35.10     (d) Days of swing bed use for medical care that an eligible hospital has determined are
35.11 charity care shall not count toward the applicable limit in paragraph (b) or (c). For purposes
35.12 of this paragraph, "charity care" means care that an eligible hospital provided for free or at
35.13 a discount to persons who cannot afford to pay and for which the eligible hospital did not
35.14 expect payment.
35.15     (e) Days of swing bed use for care of a person who has been denied admission to every
35.16 Medicare-certified skilled nursing facility within 25 miles of the eligible hospital shall not
35.17 count toward the applicable limit in paragraphs (b) and (c). Eligible hospitals must maintain
35.18 documentation that they have contacted each skilled nursing facility within 25 miles to
35.19 determine if any skilled nursing facility beds are available and if the skilled nursing facilities
35.20 are willing to admit the patient. Skilled nursing facilities that are contacted must admit the
35.21 patient or deny admission within 24 hours of being contacted by the eligible hospital. Failure
35.22 to respond within 24 hours is deemed a denial of admission.
35.23     (f) Except for critical access hospitals that have an attached nursing home or that owned
35.24 a nursing home located in the same municipality as of May 1, 2005, the commissioner of
35.25 health may approve swing bed use beyond 2,000 days as long as there are no Medicare
35.26 certified skilled nursing facility beds available within 25 miles of that hospital that are
35.27 willing to admit the patient and the patient agrees to the referral being sent to the skilled
35.28 nursing facility. Critical access hospitals exceeding 2,000 swing bed days must maintain
35.29 documentation that they have contacted skilled nursing facilities within 25 miles to determine
35.30 if any skilled nursing facility beds are available that are willing to admit the patient and the
35.31 patient agrees to the referral being sent to the skilled nursing facility. This paragraph expires
35.32 January 1, 2020.
35.33     (g) After reaching 2,000 days of swing bed use in a year, an eligible hospital to which
35.34 this limit applies may admit six additional patients to swing beds each year without seeking
Article 1 Sec. 52.  35
06/07/25  REVISOR  DTT/LN  25-05697  as introduced
36.1  approval from the commissioner or being in violation of this subdivision. These six swing
36.2  bed admissions are exempt from the limit of 2,000 annual swing bed days for hospitals
36.3  subject to this limit. This paragraph expires January 1, 2020.
36.4      (h) A health care system that is in full compliance with this subdivision may allocate its
36.5  total limit of swing bed days among the hospitals within the system, provided that no hospital
36.6  in the system without an attached nursing home may exceed 2,000 swing bed days per year.
36.7  This paragraph expires January 1, 2020.
36.8      EFFECTIVE DATE. This section is effective January 1, 2026, or upon federal approval,
36.9  whichever is later. The commissioners of health and human services shall inform the revisor
36.10 of statutes when federal approval is obtained.
36.11   Sec. 53. Minnesota Statutes 2024, section 144.562, subdivision 3, is amended to read:
36.12     Subd. 3. Approval of license condition. (a) The commissioner of health shall approve
36.13 a license condition for swing beds if the hospital meets all of the criteria of this subdivision.
36.14     (b) The hospital must meet the eligibility criteria in subdivision 2.
36.15     (c) The hospital must be in compliance with the Medicare conditions of participation
36.16 for swing beds under Code of Federal Regulations, title 42, section 482.66.
36.17     (d) Except as provided in section 144.5621, the hospital must agree, in writing, to limit
36.18 the length of stay of a patient receiving services in a swing bed to not more than 40 days,
36.19 or the duration of Medicare eligibility, unless the commissioner of health approves a greater
36.20 length of stay in an emergency situation. To determine whether an emergency situation
36.21 exists, the commissioner shall require the hospital to provide documentation that continued
36.22 services in the swing bed are required by the patient; that no skilled nursing facility beds
36.23 are available within 25 miles from the patient's home, or in some more remote facility of
36.24 the resident's choice, that can provide the appropriate level of services required by the
36.25 patient; and that other alternative services are not available to meet the needs of the patient.
36.26 If the commissioner approves a greater length of stay, the hospital shall develop a plan
36.27 providing for the discharge of the patient upon the availability of a nursing home bed or
36.28 other services that meet the needs of the patient. Permission to extend a patient's length of
36.29 stay must be requested by the hospital at least ten days prior to the end of the maximum
36.30 length of stay.
36.31     (e) Except as provided in section 144.5621, the hospital must agree, in writing, to limit
36.32 admission to a swing bed only to (1) patients who have been hospitalized and not yet
Article 1 Sec. 53.  36
06/07/25  REVISOR  DTT/LN  25-05697  as introduced
37.1  discharged from the facility, or (2) patients who are transferred directly from an acute care
37.2  hospital.
37.3      (f) The hospital must agree, in writing, to report to the commissioner of health by
37.4  December 1, 1985, and annually thereafter, in a manner required by the commissioner (1)
37.5  the number of patients readmitted to a swing bed within 60 days of a patient's discharge
37.6  from the facility, (2) the hospital's charges for care in a swing bed during the reporting
37.7  period with a description of the care provided for the rate charged, and (3) the number of
37.8  beds used by the hospital for transitional care and similar subacute inpatient care.
37.9      (g) The hospital must agree, in writing, to report statistical data on the utilization of the
37.10 swing beds on forms supplied by the commissioner. The data must include the number of
37.11 swing beds, the number of admissions to and discharges from swing beds, Medicare
37.12 reimbursed patient days, total patient days, and other information required by the
37.13 commissioner to assess the utilization of swing beds.
37.14     EFFECTIVE DATE. This section is effective January 1, 2026, or upon federal approval,
37.15 whichever is later. The commissioners of health and human services shall inform the revisor
37.16 of statutes when federal approval is obtained.
37.17   Sec. 54. [144.5621] SWING BED APPROVAL; EXCEPTIONS.
37.18     Subdivision 1. Swing bed exemption. (a) The conditions and limitations in section
37.19 144.562, paragraphs (d) and (e), do not apply to any hospital located in Cook County that:
37.20     (1) is designated as a critical access hospital under section 144.1483, clause (9), and
37.21 United States Code, title 42, section 1395i-4; and
37.22     (2) has an attached nursing home.
37.23     (b) Any swing bed located in a hospital described in this section may be used to provide
37.24 nursing care without requiring a prior hospital stay.
37.25     (c) The nursing care provided to a patient in a swing bed is a covered medical assistance
37.26 service under section 256B.0625, subdivision 2b.
37.27     Subd. 2. Application of the health care bill of rights. A patient in a swing bed located
37.28 in a hospital described in this section is a resident of a nursing home for the purposes of
37.29 section 144.651.
37.30     Subd. 3. Comprehensive resident assessment. A patient in a swing bed located in a
37.31 hospital described in this section is a resident of a nursing home for the purposes of Minnesota
37.32 Rules, part 4658.0400.
Article 1 Sec. 54.  37
06/07/25  REVISOR  DTT/LN  25-05697  as introduced
38.1      EFFECTIVE DATE. This section is effective January 1, 2026, or upon federal approval,
38.2  whichever is later. The commissioners of health and human services shall inform the revisor
38.3  of statutes when federal approval is obtained.
38.4    Sec. 55. Minnesota Statutes 2024, section 144.563, is amended to read:
38.5      144.563 NURSING SERVICES PROVIDED IN A HOSPITAL; PROHIBITED
38.6  PRACTICES.
38.7      A hospital that has been granted a license condition under section 144.562 or 144.5621
38.8  must not provide to patients not reimbursed by Medicare or medical assistance the types of
38.9  services that would be usually and customarily provided and reimbursed under medical
38.10 assistance or Medicare as services of a skilled nursing facility or intermediate care facility
38.11 for more than 42 days and only for patients who have been hospitalized and no longer require
38.12 an acute level of care. Permission to extend a patient's length of stay may be granted by the
38.13 commissioner if requested by the physician at least ten days prior to the end of the maximum
38.14 length of stay.
38.15     EFFECTIVE DATE. This section is effective January 1, 2026, or upon federal approval,
38.16 whichever is later. The commissioners of health and human services shall inform the revisor
38.17 of statutes when federal approval is obtained.
38.18   Sec. 56. Minnesota Statutes 2024, section 144.608, subdivision 2, is amended to read:
38.19     Subd. 2. Council administration. (a) The council must meet at least twice a year but
38.20 may meet more frequently at the call of the chair, a majority of the council members, or the
38.21 commissioner.
38.22     (b) The terms, compensation, and removal of members of the council are governed by
38.23 section 15.059. The council expires June 30, 2025 2035.
38.24     (c) The council may appoint subcommittees and work groups. Subcommittees shall
38.25 consist of council members. Work groups may include noncouncil members. Noncouncil
38.26 members shall be compensated for work group activities under section 15.059, subdivision
38.27 3, but shall receive expenses only.
38.28   Sec. 57. Minnesota Statutes 2024, section 144.615, subdivision 8, is amended to read:
38.29     Subd. 8. Fees. (a) The biennial license fee for a birth center is $365 $438.
38.30     (b) The temporary license fee is $365 $438.
38.31     (c) Fees shall be collected and deposited according to section 144.122.
Article 1 Sec. 57.  38
06/07/25  REVISOR        DTT/LN  25-05697  as introduced
39.1    Sec. 58. Minnesota Statutes 2024, section 144.966, subdivision 2, as amended by Laws
39.2  2025, chapter 20, section 119, is amended to read:
39.3      Subd. 2. Newborn Hearing Screening Advisory Committee. (a) The commissioner
39.4  of health shall establish a Newborn Hearing Screening Advisory Committee to advise and
39.5  assist the Department of Health; Department of Children, Youth, and Families; and the
39.6  Department of Education in:
39.7      (1) developing protocols and timelines for screening, rescreening, and diagnostic
39.8  audiological assessment and early medical, audiological, and educational intervention
39.9  services for children who are deaf or hard-of-hearing;
39.10     (2) designing protocols for tracking children from birth through age three that may have
39.11 passed newborn screening but are at risk for delayed or late onset of permanent hearing
39.12 loss;
39.13     (3) designing a technical assistance program to support facilities implementing the
39.14 screening program and facilities conducting rescreening and diagnostic audiological
39.15 assessment;
39.16     (4) designing implementation and evaluation of a system of follow-up and tracking; and
39.17     (5) evaluating program outcomes to increase effectiveness and efficiency and ensure
39.18 culturally appropriate services for children with a confirmed hearing loss and their families.
39.19     (b) The commissioner of health shall appoint at least one member from each of the
39.20 following groups with no less than two of the members being deaf or hard-of-hearing:
39.21     (1) a representative from a consumer organization representing culturally deaf persons;
39.22     (2) a parent with a child with hearing loss representing a parent organization;
39.23     (3) a consumer from an organization representing oral communication options;
39.24     (4) a consumer from an organization representing cued speech communication options;
39.25     (5) an audiologist who has experience in evaluation and intervention of infants and
39.26 young children;
39.27     (6) a speech-language pathologist who has experience in evaluation and intervention of
39.28 infants and young children;
39.29     (7) two primary care providers who have experience in the care of infants and young
39.30 children, one of which shall be a pediatrician;
39.31     (8) a representative from the early hearing detection intervention teams;
Article 1 Sec. 58.  39
06/07/25  REVISOR        DTT/LN  25-05697  as introduced
40.1      (9) a representative from the Department of Education resource center for the deaf and
40.2  hard-of-hearing or the representative's designee;
40.3      (10) a representative of the Commission of the Deaf, DeafBlind and Hard of Hearing;
40.4      (11) a representative from the Department of Human Services Deaf, DeafBlind, and
40.5  Hard of Hearing State Services Division;
40.6      (12) one or more of the Part C coordinators from the Department of Education; the
40.7  Department of Health; the Department of Children, Youth, and Families; or the Department
40.8  of Human Services or the department's designees;
40.9      (13) the Department of Health early hearing detection and intervention coordinators;
40.10     (14) two birth hospital representatives from one rural and one urban hospital;
40.11     (15) a pediatric geneticist;
40.12     (16) an otolaryngologist;
40.13     (17) a representative from the Newborn Screening Advisory Committee under this
40.14 subdivision;
40.15     (18) a representative of the Department of Education regional low-incidence facilitators;
40.16     (19) a representative from the deaf mentor program; and
40.17     (20) a representative of the Minnesota State Academy for the Deaf from the Minnesota
40.18 State Academies staff.
40.19 The commissioner must complete the initial appointments required under this subdivision
40.20 by September 1, 2007, and the initial appointments under clauses (19) and (20) by September
40.21 1, 2019.
40.22     (c) The Department of Health member shall chair the first meeting of the committee. At
40.23 the first meeting, the committee shall elect a chair from its membership. The committee
40.24 shall meet at the call of the chair, at least four times a year. The committee shall adopt
40.25 written bylaws to govern its activities. The Department of Health shall provide technical
40.26 and administrative support services as required by the committee. These services shall
40.27 include technical support from individuals qualified to administer infant hearing screening,
40.28 rescreening, and diagnostic audiological assessments.
40.29     Members of the committee shall receive no compensation for their service, but shall be
40.30 reimbursed as provided in section 15.059 for expenses incurred as a result of their duties
40.31 as members of the committee.
Article 1 Sec. 58.  40
06/07/25  REVISOR       DTT/LN  25-05697  as introduced
41.1      (d) By February 15, 2015, and by February 15 of the odd-numbered years after that date,
41.2  the commissioner shall report to the chairs and ranking minority members of the legislative
41.3  committees with jurisdiction over health and data privacy on the activities of the committee
41.4  that have occurred during the past two years.
41.5      (e) This subdivision expires June 30, 2025.
41.6      EFFECTIVE DATE. This section is effective the day following final enactment or
41.7  June 30, 2025, whichever is earlier.
41.8    Sec. 59. Minnesota Statutes 2024, section 144A.43, is amended by adding a subdivision
41.9  to read:
41.10     Subd. 26a. Serious injury. "Serious injury" has the meaning given in section 245.91,
41.11 subdivision 6.
41.12   Sec. 60. Minnesota Statutes 2024, section 144A.474, subdivision 9, is amended to read:
41.13     Subd. 9. Follow-up surveys. For providers that have Level 3 or, Level 4, or Level 5
41.14 violations under subdivision 11, the department shall conduct a follow-up survey within 90
41.15 calendar days of the survey. When conducting a follow-up survey, the surveyor will focus
41.16 on whether the previous violations have been corrected and may also address any new
41.17 violations that are observed while evaluating the corrections that have been made.
41.18   Sec. 61. Minnesota Statutes 2024, section 144A.474, subdivision 11, is amended to read:
41.19     Subd. 11. Fines. (a) Fines and enforcement actions under this subdivision may be assessed
41.20 based on the level and scope of the violations described in paragraph (b) and imposed
41.21 immediately with no opportunity to correct the violation first as follows:
41.22     (1) Level 1, no fines or enforcement;
41.23     (2) Level 2, a fine of $500 per violation, in addition to any of the enforcement
41.24 mechanisms authorized in section 144A.475 for widespread violations;
41.25     (3) Level 3, a fine of $3,000 $1,000 per incident, in addition to any of the enforcement
41.26 mechanisms authorized in section 144A.475;
41.27     (4) Level 4, a fine of $5,000 $3,000 per incident, in addition to any of the enforcement
41.28 mechanisms authorized in section 144A.475;
41.29     (5) Level 5, a fine of $5,000 per violation, in addition to any enforcement mechanism
41.30 authorized in section 144A.475; and
Article 1 Sec. 61.  41
06/07/25  REVISOR  DTT/LN  25-05697  as introduced
42.1      (5) (6) for maltreatment violations for which the licensee was determined to be responsible
42.2  for the maltreatment under section 626.557, subdivision 9c, paragraph (c), a fine of $1,000.
42.3  A fine of $5,000 may be imposed if the commissioner determines the licensee is responsible
42.4  for maltreatment consisting of sexual assault, death, or abuse resulting in serious injury;
42.5  and.
42.6      (6) The fines in clauses (1) to (4) (5) are increased and immediate fine imposition is
42.7  authorized for both surveys and investigations conducted.
42.8      When a fine is assessed against a facility for substantiated maltreatment, the commissioner
42.9  shall not also impose an immediate fine under this chapter for the same circumstance.
42.10     (b) Correction orders for violations are categorized by both level and scope and fines
42.11 shall be assessed as follows:
42.12     (1) level of violation:
42.13     (i) Level 1 is a violation that has no potential to cause more than a will cause only
42.14 minimal impact on the client and does not affect health or safety;
42.15     (ii) Level 2 is a violation that did not harm a client's health or safety but had the potential
42.16 to have harmed a client's health or safety, but was not likely to cause serious injury,
42.17 impairment, or death;
42.18     (iii) Level 3 is a violation that harmed a client's health or safety, not including serious
42.19 injury, impairment, or death, or a violation that has the potential to lead to serious injury,
42.20 impairment, or death or a violation that had the potential to cause more than minimal harm
42.21 to the client; and
42.22     (iv) Level 4 is a violation that results in serious injury, impairment, or death harmed a
42.23 client's health or safety, not including serious injury or death, or a violation that was likely
42.24 to lead to serious injury or death; and
42.25     (v) Level 5 is a violation that results in serious injury or death; and
42.26     (2) scope of violation:
42.27     (i) isolated, when one or a limited number of clients are affected or one or a limited
42.28 number of staff are involved or the situation has occurred only occasionally;
42.29     (ii) pattern, when more than a limited number of clients are affected, more than a limited
42.30 number of staff are involved, or the situation has occurred repeatedly but is not found to be
42.31 pervasive; and
Article 1 Sec. 61.  42
06/07/25  REVISOR  DTT/LN  25-05697  as introduced
43.1      (iii) widespread, when problems are pervasive or represent a systemic failure that has
43.2  affected or has the potential to affect a large portion or all of the clients.
43.3      (c) If the commissioner finds that the applicant or a home care provider has not corrected
43.4  violations by the date specified in the correction order or conditional license resulting from
43.5  a survey or complaint investigation, the commissioner shall provide a notice of
43.6  noncompliance with a correction order by email to the applicant's or provider's last known
43.7  email address. The noncompliance notice must list the violations not corrected.
43.8      (d) For every violation identified by the commissioner, the commissioner shall issue an
43.9  immediate fine pursuant to paragraph (a), clause (6). The license holder must still correct
43.10 the violation in the time specified. The issuance of an immediate fine can occur in addition
43.11 to any enforcement mechanism authorized under section 144A.475. The immediate fine
43.12 may be appealed as allowed under this subdivision.
43.13     (e) The license holder must pay the fines assessed on or before the payment date specified.
43.14 If the license holder fails to fully comply with the order, the commissioner may issue a
43.15 second fine or suspend the license until the license holder complies by paying the fine. A
43.16 timely appeal shall stay payment of the fine until the commissioner issues a final order.
43.17     (f) A license holder shall promptly notify the commissioner in writing when a violation
43.18 specified in the order is corrected. If upon reinspection the commissioner determines that
43.19 a violation has not been corrected as indicated by the order, the commissioner may issue a
43.20 second fine. The commissioner shall notify the license holder by mail to the last known
43.21 address in the licensing record that a second fine has been assessed. The license holder may
43.22 appeal the second fine as provided under this subdivision.
43.23     (g) A home care provider that has been assessed a fine under this subdivision has a right
43.24 to a reconsideration or a hearing under this section and chapter 14.
43.25     (h) When a fine has been assessed, the license holder may not avoid payment by closing,
43.26 selling, or otherwise transferring the licensed program to a third party. In such an event, the
43.27 license holder shall be liable for payment of the fine.
43.28     (i) In addition to any fine imposed under this section, the commissioner may assess a
43.29 penalty amount based on costs related to an investigation that results in a final order assessing
43.30 a fine or other enforcement action authorized by this chapter.
43.31     (j) Fines collected under paragraph (a), clauses (1) to (4), shall be deposited in a dedicated
43.32 special revenue account. On an annual basis, the balance in the special revenue account
Article 1 Sec. 61.  43
06/07/25  REVISOR  DTT/LN  25-05697  as introduced
44.1  shall be appropriated to the commissioner to implement the recommendations of the advisory
44.2  council established in section 144A.4799.
44.3      (k) Fines collected under paragraph (a), clause (5), shall be deposited in a dedicated
44.4  special revenue account and appropriated to the commissioner to provide compensation
44.5  according to subdivision 14 to clients subject to maltreatment. A client may choose to receive
44.6  compensation from this fund, not to exceed $5,000 for each substantiated finding of
44.7  maltreatment, or take civil action. This paragraph expires July 31, 2021.
44.8    Sec. 62. Minnesota Statutes 2024, section 144A.475, subdivision 3, is amended to read:
44.9      Subd. 3. Notice. (a) Prior to any suspension, revocation, or refusal to renew a license,
44.10 the home care provider shall be entitled to notice and a hearing as provided by sections
44.11 14.57 to 14.69. In addition to any other remedy provided by law, the commissioner may,
44.12 without a prior contested case hearing, temporarily suspend a license or prohibit delivery
44.13 of services by a provider for not more than 90 days, or issue a conditional license if the
44.14 commissioner determines that there are level 3 4 violations that do not pose an imminent
44.15 risk of harm to the health or safety of persons in the provider's care, provided:
44.16     (1) advance notice is given to the home care provider;
44.17     (2) after notice, the home care provider fails to correct the problem;
44.18     (3) the commissioner has reason to believe that other administrative remedies are not
44.19 likely to be effective; and
44.20     (4) there is an opportunity for a contested case hearing within the 30 days unless there
44.21 is an extension granted by an administrative law judge pursuant to subdivision 3b.
44.22     (b) If the commissioner determines there are:
44.23     (1) level 4 5 violations; or
44.24     (2) violations that pose an imminent risk of harm to the health or safety of persons in
44.25 the provider's care,
44.26 the commissioner may immediately temporarily suspend a license, prohibit delivery of
44.27 services by a provider, or issue a conditional license without meeting the requirements of
44.28 paragraph (a), clauses (1) to (4).
44.29 For the purposes of this subdivision, "level 3 4" and "level 4 5" have the meanings given
44.30 in section 144A.474, subdivision 11, paragraph (b).
Article 1 Sec. 62.  44
06/07/25  REVISOR        DTT/LN  25-05697  as introduced
45.1    Sec. 63. Minnesota Statutes 2024, section 144A.475, subdivision 3a, is amended to read:
45.2      Subd. 3a. Hearing. Within 15 business days of receipt of the licensee's timely appeal
45.3  of a sanction under this section, other than for a temporary suspension, the commissioner
45.4  shall request assignment of an administrative law judge. The commissioner's request must
45.5  include a proposed date, time, and place of hearing. A hearing must be conducted by an
45.6  administrative law judge pursuant to Minnesota Rules, parts 1400.8505 to 1400.8612, within
45.7  90 calendar days of the request for assignment, unless an extension is requested by either
45.8  party and granted by the administrative law judge for good cause or for purposes of discussing
45.9  settlement. In no case shall one or more extensions be granted for a total of more than 90
45.10 calendar days unless there is a criminal action pending against the licensee. If, while a
45.11 licensee continues to operate pending an appeal of an order for revocation, suspension, or
45.12 refusal to renew a license, the commissioner identifies one or more new violations of law
45.13 that meet the requirements of level 3 4 or 4 5 violations as defined in section 144A.474,
45.14 subdivision 11, paragraph (b), the commissioner shall act immediately to temporarily suspend
45.15 the license under the provisions in subdivision 3.
45.16   Sec. 64. Minnesota Statutes 2024, section 144A.475, subdivision 3b, is amended to read:
45.17     Subd. 3b. Expedited hearing. (a) Within five business days of receipt of the license
45.18 holder's timely appeal of a temporary suspension or issuance of a conditional license, the
45.19 commissioner shall request assignment of an administrative law judge. The request must
45.20 include a proposed date, time, and place of a hearing. A hearing must be conducted by an
45.21 administrative law judge pursuant to Minnesota Rules, parts 1400.8505 to 1400.8612, within
45.22 30 calendar days of the request for assignment, unless an extension is requested by either
45.23 party and granted by the administrative law judge for good cause. The commissioner shall
45.24 issue a notice of hearing by certified mail or personal service at least ten business days
45.25 before the hearing. Certified mail to the last known address is sufficient. The scope of the
45.26 hearing shall be limited solely to the issue of whether the temporary suspension or issuance
45.27 of a conditional license should remain in effect and whether there is sufficient evidence to
45.28 conclude that the licensee's actions or failure to comply with applicable laws are level 3 4
45.29 or 4 5 violations as defined in section 144A.474, subdivision 11, paragraph (b), or that there
45.30 were violations that posed an imminent risk of harm to the health and safety of persons in
45.31 the provider's care.
45.32     (b) The administrative law judge shall issue findings of fact, conclusions, and a
45.33 recommendation within ten business days from the date of hearing. The parties shall have
45.34 ten calendar days to submit exceptions to the administrative law judge's report. The record
Article 1 Sec. 64.  45
06/07/25  REVISOR        DTT/LN  25-05697  as introduced
46.1  shall close at the end of the ten-day period for submission of exceptions. The commissioner's
46.2  final order shall be issued within ten business days from the close of the record. When an
46.3  appeal of a temporary immediate suspension or conditional license is withdrawn or dismissed,
46.4  the commissioner shall issue a final order affirming the temporary immediate suspension
46.5  or conditional license within ten calendar days of the commissioner's receipt of the
46.6  withdrawal or dismissal. The license holder is prohibited from operation during the temporary
46.7  suspension period.
46.8      (c) When the final order under paragraph (b) affirms an immediate suspension, and a
46.9  final licensing sanction is issued under subdivisions 1 and 2 and the licensee appeals that
46.10 sanction, the licensee is prohibited from operation pending a final commissioner's order
46.11 after the contested case hearing conducted under chapter 14.
46.12     (d) A licensee whose license is temporarily suspended must comply with the requirements
46.13 for notification and transfer of clients in subdivision 5. These requirements remain if an
46.14 appeal is requested.
46.15   Sec. 65. Minnesota Statutes 2024, section 144A.475, subdivision 3c, is amended to read:
46.16     Subd. 3c. Immediate temporary suspension. (a) In addition to any other remedies
46.17 provided by law, the commissioner may, without a prior contested case hearing, immediately
46.18 temporarily suspend a license or prohibit delivery of services by a provider for not more
46.19 than 90 days, or issue a conditional license, if the commissioner determines that there are:
46.20     (1) level 4 5 violations; or
46.21     (2) violations that pose an imminent risk of harm to the health or safety of persons in
46.22 the provider's care.
46.23     (b) For purposes of this subdivision, "level 4 5" has the meaning given in section
46.24 144A.474, subdivision 11, paragraph (b).
46.25     (c) A notice stating the reasons for the immediate temporary suspension or conditional
46.26 license and informing the license holder of the right to an expedited hearing under subdivision
46.27 3b must be delivered by personal service to the address shown on the application or the last
46.28 known address of the license holder. The license holder may appeal an order immediately
46.29 temporarily suspending a license or issuing a conditional license. The appeal must be made
46.30 in writing by certified mail or personal service. If mailed, the appeal must be postmarked
46.31 and sent to the commissioner within five calendar days after the license holder receives
46.32 notice. If an appeal is made by personal service, it must be received by the commissioner
46.33 within five calendar days after the license holder received the order.
Article 1 Sec. 65.  46
06/07/25  REVISOR  DTT/LN  25-05697  as introduced
47.1      (d) A license holder whose license is immediately temporarily suspended must comply
47.2  with the requirements for notification and transfer of clients in subdivision 5. These
47.3  requirements remain if an appeal is requested.
47.4    Sec. 66. Minnesota Statutes 2024, section 144A.71, subdivision 2, is amended to read:
47.5      Subd. 2. Application information and fee. The commissioner shall establish forms and
47.6  procedures for processing each supplemental nursing services agency registration application.
47.7  An application for a supplemental nursing services agency registration must include at least
47.8  the following:
47.9      (1) the names and addresses of all owners and controlling persons of the supplemental
47.10 nursing services agency;
47.11     (2) if the owner is a corporation, copies of its articles of incorporation and current bylaws,
47.12 together with the names and addresses of its officers and directors;
47.13     (3) if the owner is a limited liability company, copies of its articles of organization and
47.14 operating agreement, together with the names and addresses of its officers and directors;
47.15     (4) documentation that the supplemental nursing services agency has medical malpractice
47.16 insurance to insure against the loss, damage, or expense of a claim arising out of the death
47.17 or injury of any person as the result of negligence or malpractice in the provision of health
47.18 care services by the supplemental nursing services agency or by any employee of the agency;
47.19     (5) documentation that the supplemental nursing services agency has an employee
47.20 dishonesty bond in the amount of $10,000;
47.21     (6) documentation that the supplemental nursing services agency has insurance coverage
47.22 for workers' compensation for all nurses, nursing assistants, nurse aides, and orderlies
47.23 provided or procured by the agency;
47.24     (7) documentation that the supplemental nursing services agency filed with the
47.25 commissioner of revenue: (i) the name and address of the bank, savings bank, or savings
47.26 association in which the supplemental nursing services agency deposits all employee income
47.27 tax withholdings; and (ii) the name and address of any nurse, nursing assistant, nurse aide,
47.28 or orderly whose income is derived from placement by the agency, if the agency purports
47.29 the income is not subject to withholding;
47.30     (8) any other relevant information that the commissioner determines is necessary to
47.31 properly evaluate an application for registration;
Article 1 Sec. 66.  47
06/07/25  REVISOR        DTT/LN  25-05697  as introduced
48.1      (9) a policy and procedure that describes how the supplemental nursing services agency's
48.2  records will be immediately available at all times to the commissioner and facility; and
48.3      (10) a nonrefundable registration fee of $2,035 $2,442.
48.4      If a supplemental nursing services agency fails to provide the items in this subdivision
48.5  to the department, the commissioner shall immediately suspend or refuse to issue the
48.6  supplemental nursing services agency registration. The supplemental nursing services agency
48.7  may appeal the commissioner's findings according to section 144A.475, subdivisions 3a
48.8  and 7, except that the hearing must be conducted by an administrative law judge within 60
48.9  calendar days of the request for hearing assignment.
48.10   Sec. 67. Minnesota Statutes 2024, section 144A.753, subdivision 1, is amended to read:
48.11     Subdivision 1. License required; application. (a) A hospice provider may not operate
48.12 in the state without a valid license issued by the commissioner.
48.13     (b) Within ten days after receiving an application for a license, the commissioner shall
48.14 acknowledge receipt of the application in writing. The acknowledgment must indicate
48.15 whether the application appears to be complete or whether additional information is required
48.16 before the application is considered complete. Within 90 days after receiving a complete
48.17 application, the commissioner shall either grant or deny the license. If an applicant is not
48.18 granted or denied a license within 90 days after submitting a complete application, the
48.19 license must be deemed granted. An applicant whose license has been deemed granted must
48.20 provide written notice to the commissioner before providing hospice care.
48.21     (c) Each application for a hospice provider license, or for a renewal of a license, shall
48.22 be accompanied by a fee as follows:
48.23     (1) for revenues no more than $25,000, $125 $150;
48.24     (2) for revenues greater than $25,000 and no more than $100,000, $312.50 $375;
48.25     (3) for revenues greater than $100,000 and no more than $250,000, $625 $750;
48.26     (4) for revenues greater than $250,000 and no more than $350,000, $937.50 $1,125;
48.27     (5) for revenues greater than $350,000 and no more than $450,000, $1,250 $1,500;
48.28     (6) for revenues greater than $450,000 and no more than $550,000, $1,562.50 $1,875;
48.29     (7) for revenues greater than $550,000 and no more than $650,000, $1,875 $2,250;
48.30     (8) for revenues greater than $650,000 and no more than $750,000, $2,187.50 $2,625;
48.31     (9) for revenues greater then $750,000 and no more than $850,000, $2,500 $3,000;
Article 1 Sec. 67.  48
06/07/25  REVISOR        DTT/LN  25-05697  as introduced
49.1      (10) for revenues greater than $850,000 and no more than $950,000, $2,812.50 $3,375;
49.2      (11) for revenues greater than $950,000 and no more than $1,100,000, $3,125 $3,750;
49.3      (12) for revenues greater than $1,100,000 and no more than $1,275,000, $3,750 $4,500;
49.4      (13) for revenues greater than $1,275,000 and no more than $1,500,000, $4,375 $5,250;
49.5  and
49.6      (14) for revenues greater than $1,500,000, $5,000 $6,000.
49.7    Sec. 68. Minnesota Statutes 2024, section 144G.20, subdivision 3, is amended to read:
49.8      Subd. 3. Immediate temporary suspension. (a) In addition to any other remedies
49.9  provided by law, the commissioner may, without a prior contested case hearing, immediately
49.10 temporarily suspend a license or prohibit delivery of housing or services by a facility for
49.11 not more than 90 calendar days or issue a conditional license, if the commissioner determines
49.12 that there are:
49.13     (1) Level 4 5 violations; or
49.14     (2) violations that pose an imminent risk of harm to the health or safety of residents.
49.15     (b) For purposes of this subdivision, "Level 4 5" has the meaning given in section
49.16 144G.31.
49.17     (c) A notice stating the reasons for the immediate temporary suspension or conditional
49.18 license and informing the licensee of the right to an expedited hearing under subdivision
49.19 17 must be delivered by personal service to the address shown on the application or the last
49.20 known address of the licensee. The licensee may appeal an order immediately temporarily
49.21 suspending a license or issuing a conditional license. The appeal must be made in writing
49.22 by certified mail or personal service. If mailed, the appeal must be postmarked and sent to
49.23 the commissioner within five calendar days after the licensee receives notice. If an appeal
49.24 is made by personal service, it must be received by the commissioner within five calendar
49.25 days after the licensee received the order.
49.26     (d) A licensee whose license is immediately temporarily suspended must comply with
49.27 the requirements for notification and transfer of residents in subdivision 15. The requirements
49.28 in subdivision 9 remain if an appeal is requested.
49.29   Sec. 69. Minnesota Statutes 2024, section 144G.20, subdivision 13, is amended to read:
49.30     Subd. 13. Notice to facility. (a) Prior to any suspension, revocation, or refusal to renew
49.31 a license, the facility shall be entitled to notice and a hearing as provided by sections 14.57
Article 1 Sec. 69.  49
06/07/25  REVISOR  DTT/LN  25-05697  as introduced
50.1  to 14.69. The hearing must commence within 60 calendar days after the proceedings are
50.2  initiated. In addition to any other remedy provided by law, the commissioner may, without
50.3  a prior contested case hearing, temporarily suspend a license or prohibit delivery of services
50.4  by a provider for not more than 90 calendar days, or issue a conditional license if the
50.5  commissioner determines that there are Level 3 4 violations that do not pose an imminent
50.6  risk of harm to the health or safety of the facility residents, provided:
50.7      (1) advance notice is given to the facility;
50.8      (2) after notice, the facility fails to correct the problem;
50.9      (3) the commissioner has reason to believe that other administrative remedies are not
50.10 likely to be effective; and
50.11     (4) there is an opportunity for a contested case hearing within 30 calendar days unless
50.12 there is an extension granted by an administrative law judge.
50.13     (b) If the commissioner determines there are Level 4 5 violations or violations that pose
50.14 an imminent risk of harm to the health or safety of the facility residents, the commissioner
50.15 may immediately temporarily suspend a license, prohibit delivery of services by a facility,
50.16 or issue a conditional license without meeting the requirements of paragraph (a), clauses
50.17 (1) to (4).
50.18 For the purposes of this subdivision, "Level 3 4" and "Level 4 5" have the meanings given
50.19 in section 144G.31.
50.20   Sec. 70. Minnesota Statutes 2024, section 144G.20, subdivision 16, is amended to read:
50.21     Subd. 16. Hearing. Within 15 business days of receipt of the licensee's timely appeal
50.22 of a sanction under this section, other than for a temporary suspension, the commissioner
50.23 shall request assignment of an administrative law judge. The commissioner's request must
50.24 include a proposed date, time, and place of hearing. A hearing must be conducted by an
50.25 administrative law judge pursuant to Minnesota Rules, parts 1400.8505 to 1400.8612, within
50.26 90 calendar days of the request for assignment, unless an extension is requested by either
50.27 party and granted by the administrative law judge for good cause or for purposes of discussing
50.28 settlement. In no case shall one or more extensions be granted for a total of more than 90
50.29 calendar days unless there is a criminal action pending against the licensee. If, while a
50.30 licensee continues to operate pending an appeal of an order for revocation, suspension, or
50.31 refusal to renew a license, the commissioner identifies one or more new violations of law
50.32 that meet the requirements of Level 3 4 or Level 4 5 violations as defined in section 144G.31,
50.33 the commissioner shall act immediately to temporarily suspend the license.
Article 1 Sec. 70.  50
06/07/25  REVISOR        DTT/LN  25-05697  as introduced
51.1    Sec. 71. Minnesota Statutes 2024, section 144G.20, subdivision 17, is amended to read:
51.2      Subd. 17. Expedited hearing. (a) Within five business days of receipt of the licensee's
51.3  timely appeal of a temporary suspension or issuance of a conditional license, the
51.4  commissioner shall request assignment of an administrative law judge. The request must
51.5  include a proposed date, time, and place of a hearing. A hearing must be conducted by an
51.6  administrative law judge pursuant to Minnesota Rules, parts 1400.8505 to 1400.8612, within
51.7  30 calendar days of the request for assignment, unless an extension is requested by either
51.8  party and granted by the administrative law judge for good cause. The commissioner shall
51.9  issue a notice of hearing by certified mail or personal service at least ten business days
51.10 before the hearing. Certified mail to the last known address is sufficient. The scope of the
51.11 hearing shall be limited solely to the issue of whether the temporary suspension or issuance
51.12 of a conditional license should remain in effect and whether there is sufficient evidence to
51.13 conclude that the licensee's actions or failure to comply with applicable laws are Level 3 4
51.14 or Level 4 5 violations as defined in section 144G.31, or that there were violations that
51.15 posed an imminent risk of harm to the resident's health and safety.
51.16     (b) The administrative law judge shall issue findings of fact, conclusions, and a
51.17 recommendation within ten business days from the date of hearing. The parties shall have
51.18 ten calendar days to submit exceptions to the administrative law judge's report. The record
51.19 shall close at the end of the ten-day period for submission of exceptions. The commissioner's
51.20 final order shall be issued within ten business days from the close of the record. When an
51.21 appeal of a temporary immediate suspension or conditional license is withdrawn or dismissed,
51.22 the commissioner shall issue a final order affirming the temporary immediate suspension
51.23 or conditional license within ten calendar days of the commissioner's receipt of the
51.24 withdrawal or dismissal. The licensee is prohibited from operation during the temporary
51.25 suspension period.
51.26     (c) When the final order under paragraph (b) affirms an immediate suspension, and a
51.27 final licensing sanction is issued under subdivisions 1 and 2 and the licensee appeals that
51.28 sanction, the licensee is prohibited from operation pending a final commissioner's order
51.29 after the contested case hearing conducted under chapter 14.
51.30     (d) A licensee whose license is temporarily suspended must comply with the requirements
51.31 for notification and transfer of residents under subdivision 15. These requirements remain
51.32 if an appeal is requested.
Article 1 Sec. 71.  51
06/07/25  REVISOR  DTT/LN  25-05697  as introduced
52.1    Sec. 72. Minnesota Statutes 2024, section 144G.30, subdivision 7, is amended to read:
52.2      Subd. 7. Required follow-up surveys. For assisted living facilities that have Level 3
52.3  or, Level 4, or Level 5 violations under section 144G.31, the commissioner shall conduct
52.4  a follow-up survey within 90 calendar days of the survey. When conducting a follow-up
52.5  survey, the surveyor shall focus on whether the previous violations have been corrected and
52.6  may also address any new violations that are observed while evaluating the corrections that
52.7  have been made.
52.8    Sec. 73. Minnesota Statutes 2024, section 144G.31, subdivision 2, is amended to read:
52.9      Subd. 2. Levels of violations. Correction orders for violations are categorized by level
52.10 as follows:
52.11     (1) Level 1 is a violation that has no potential to cause more than a minimal impact on
52.12 the resident will cause only minimal impact on the resident and does not affect health or
52.13 safety;
52.14     (2) Level 2 is a violation that did not harm a resident's health or safety but had the
52.15 potential to have harmed a resident's health or safety, but was not likely to cause serious
52.16 injury, impairment, or death;
52.17     (3) Level 3 is a violation that harmed a resident's health or safety, not including serious
52.18 injury, impairment, or death, or a violation that has the potential to lead to serious injury,
52.19 impairment, or death or a violation that had the potential to cause more than minimal harm
52.20 to the resident; and
52.21     (4) Level 4 is a violation that results in serious injury, impairment, or death. harmed a
52.22 resident's health or safety, not including serious injury or death, or a violation that was likely
52.23 to lead to serious injury or death; and
52.24     (5) Level 5 is a violation that results in serious injury or death.
52.25   Sec. 74. Minnesota Statutes 2024, section 144G.31, subdivision 4, is amended to read:
52.26     Subd. 4. Fine amounts. (a) Fines and enforcement actions under this subdivision may
52.27 be assessed based on the level and scope of the violations described in subdivisions 2 and
52.28 3 as follows and may be imposed immediately with no opportunity to correct the violation
52.29 prior to imposition:
52.30     (1) Level 1, no fines or enforcement;
Article 1 Sec. 74.  52
06/07/25  REVISOR  DTT/LN  25-05697  as introduced
53.1      (2) Level 2, a fine of $500 per violation, in addition to any enforcement mechanism
53.2  authorized in section 144G.20 for widespread violations;
53.3      (3) Level 3, a fine of $3,000 $1,000 per violation, in addition to any enforcement
53.4  mechanism authorized in section 144G.20;
53.5      (4) Level 4, a fine of $5,000 $3,000 per violation, in addition to any enforcement
53.6  mechanism authorized in section 144G.20; and
53.7      (5) Level 5, a fine of $5,000 per violation, in addition to any enforcement mechanism
53.8  authorized in section 144G.20; and
53.9      (5) (6) for maltreatment violations for which the licensee was determined to be responsible
53.10 for the maltreatment under section 626.557, subdivision 9c, paragraph (c), a fine of $1,000
53.11 per incident. A fine of $5,000 per incident may be imposed if the commissioner determines
53.12 the licensee is responsible for maltreatment consisting of sexual assault, death, or abuse
53.13 resulting in serious injury.
53.14     (b) When a fine is assessed against a facility for substantiated maltreatment, the
53.15 commissioner shall not also impose an immediate fine under this chapter for the same
53.16 circumstance.
53.17   Sec. 75. Minnesota Statutes 2024, section 144G.31, subdivision 5, is amended to read:
53.18     Subd. 5. Immediate fine; payment. (a) For every Level 3 or, Level 4, or Level 5
53.19 violation, the commissioner may issue an immediate fine. The licensee must still correct
53.20 the violation in the time specified. The issuance of an immediate fine may occur in addition
53.21 to any enforcement mechanism authorized under section 144G.20. The immediate fine may
53.22 be appealed as allowed under this chapter.
53.23     (b) The licensee must pay the fines assessed on or before the payment date specified. If
53.24 the licensee fails to fully comply with the order, the commissioner may issue a second fine
53.25 or suspend the license until the licensee complies by paying the fine. A timely appeal shall
53.26 stay payment of the fine until the commissioner issues a final order.
53.27     (c) A licensee shall promptly notify the commissioner in writing when a violation
53.28 specified in the order is corrected. If upon reinspection the commissioner determines that
53.29 a violation has not been corrected as indicated by the order, the commissioner may issue
53.30 an additional fine. The commissioner shall notify the licensee by mail to the last known
53.31 address in the licensing record that a second fine has been assessed. The licensee may appeal
53.32 the second fine as provided under this subdivision.
Article 1 Sec. 75.  53
06/07/25  REVISOR        DTT/LN  25-05697  as introduced
54.1      (d) A facility that has been assessed a fine under this section has a right to a
54.2  reconsideration or hearing under this chapter and chapter 14.
54.3    Sec. 76. Minnesota Statutes 2024, section 144G.45, subdivision 6, is amended to read:
54.4      Subd. 6. New construction; plans. (a) For all new licensure and construction beginning
54.5  on or after August 1, 2021, the following must be provided to the commissioner:
54.6      (1) architectural and engineering plans and specifications for new construction must be
54.7  prepared and signed by architects and engineers who are registered in Minnesota. Final
54.8  working drawings and specifications for proposed construction must be submitted to the
54.9  commissioner for review and approval;
54.10     (2) final architectural plans and specifications must include elevations and sections
54.11 through the building showing types of construction, and must indicate dimensions and
54.12 assignments of rooms and areas, room finishes, door types and hardware, elevations and
54.13 details of nurses' work areas, utility rooms, toilet and bathing areas, and large-scale layouts
54.14 of dietary and laundry areas. Plans must show the location of fixed equipment and sections
54.15 and details of elevators, chutes, and other conveying systems. Fire walls and smoke partitions
54.16 must be indicated. The roof plan must show all mechanical installations. The site plan must
54.17 indicate the proposed and existing buildings, topography, roadways, walks and utility service
54.18 lines; and
54.19     (3) final mechanical and electrical plans and specifications must address the complete
54.20 layout and type of all installations, systems, and equipment to be provided. Heating plans
54.21 must include heating elements, piping, thermostatic controls, pumps, tanks, heat exchangers,
54.22 boilers, breeching, and accessories. Ventilation plans must include room air quantities,
54.23 ducts, fire and smoke dampers, exhaust fans, humidifiers, and air handling units. Plumbing
54.24 plans must include the fixtures and equipment fixture schedule; water supply and circulating
54.25 piping, pumps, tanks, riser diagrams, and building drains; the size, location, and elevation
54.26 of water and sewer services; and the building fire protection systems. Electrical plans must
54.27 include fixtures and equipment, receptacles, switches, power outlets, circuits, power and
54.28 light panels, transformers, and service feeders. Plans must show location of nurse call signals,
54.29 cable lines, fire alarm stations, and fire detectors and emergency lighting.
54.30     (b) Unless construction is begun within one year after approval of the final working
54.31 drawing and specifications, the drawings must be resubmitted for review and approval.
54.32     (c) The commissioner must be notified within 30 days before completion of construction
54.33 so that the commissioner can make arrangements for a final inspection by the commissioner.
Article 1 Sec. 76.  54
06/07/25  REVISOR        DTT/LN  25-05697  as introduced
55.1      (d) At least one set of complete life safety plans, including changes resulting from
55.2  remodeling or alterations, must be kept on file in the facility.
55.3      (e) For new construction beginning on or after July 1, 2025, the licensee must comply
55.4  with section 144.554 to submit applicable construction plans and fees to the commissioner.
55.5    Sec. 77. Minnesota Statutes 2024, section 145.8811, is amended to read:
55.6      145.8811 MATERNAL AND CHILD HEALTH ADVISORY TASK FORCE
55.7  COMMITTEE.
55.8      Subdivision 1. Composition of task force committee. The commissioner shall establish
55.9  and appoint a Maternal and Child Health Advisory Task Force Committee consisting of 15
55.10 members who will provide equal representation from:
55.11     (1) professionals with expertise in maternal and child health services;
55.12     (2) representatives of community health boards as defined in section 145A.02, subdivision
55.13 5; and
55.14     (3) consumer representatives interested in the health of mothers and children.
55.15     No members shall be employees of the Minnesota Department of Health. Section 15.059
55.16 governs the Maternal and Child Health Advisory Task Force Committee. Notwithstanding
55.17 section 15.059, the Maternal and Child Health Advisory Task Force Committee does not
55.18 expire.
55.19     Subd. 2. Duties. The advisory task force committee shall meet on a regular basis to
55.20 perform the following duties:
55.21     (1) review and report on the health care needs of mothers and children throughout the
55.22 state of Minnesota;
55.23     (2) review and report on the type, frequency, and impact of maternal and child health
55.24 care services provided to mothers and children under existing maternal and child health
55.25 care programs, including programs administered by the commissioner of health;
55.26     (3) establish, review, and report to the commissioner a list of program guidelines and
55.27 criteria which the advisory task force committee considers essential to providing an effective
55.28 maternal and child health care program to low-income populations and high-risk persons
55.29 and fulfilling the purposes defined in section 145.88;
55.30     (4) make recommendations to the commissioner for the use of other federal and state
55.31 funds available to meet maternal and child health needs;
Article 1 Sec. 77.  55
06/07/25  REVISOR  DTT/LN  25-05697  as introduced
56.1      (5) make recommendations to the commissioner of health on priorities for funding the
56.2  following maternal and child health services:
56.3      (i) prenatal, delivery, and postpartum care;
56.4      (ii) comprehensive health care for children, especially from birth through five years of
56.5  age;
56.6      (iii) adolescent health services;
56.7      (iv) family planning services;
56.8      (v) preventive dental care;
56.9      (vi) special services for chronically ill and disabled children; and
56.10     (vii) any other services that promote the health of mothers and children; and
56.11     (6) establish in consultation with the commissioner statewide outcomes that will improve
56.12 the health status of mothers and children.
56.13   Sec. 78. [145.9231] EPILEPSY AND RELATED SEIZURE DISORDERS; DATA
56.14 COLLECTION AND STATE COORDINATION PLAN.
56.15     Subdivision 1. Data collection. The commissioner of health must collect, analyze, and
56.16 report data on epilepsy and related seizure disorders in Minnesota. The data must include
56.17 number of diagnoses, clinical outcomes, mortality rates, and related population health data
56.18 for each calendar year. Deidentified data must be made publicly available.
56.19     Subd. 2. State coordination plan. The commissioner of health must use the data on
56.20 epilepsy and seizure disorders to inform statewide efforts and build coordinated systems
56.21 and partnerships to support community-led and culturally responsive strategies to ensure
56.22 that Minnesotans at risk for or living with epilepsy and seizure disorders and their caregivers
56.23 have equitable access to opportunities and resources to support their well-being and quality
56.24 of life. The commissioner of health must use the data to identify areas of need and
56.25 recommend strategies to address gaps.
56.26   Sec. 79. Minnesota Statutes 2024, section 145.9269, subdivision 2, is amended to read:
56.27     Subd. 2. Allocation of subsidies. The commissioner of health shall distribute subsidies
56.28 to federally qualified health centers operating in Minnesota to continue, expand, and improve
56.29 federally qualified health center services to low-income populations. The commissioner
56.30 shall distribute the funds appropriated under this section to federally qualified health centers
56.31 operating in Minnesota as of January 1, 2007. The amount of each subsidy shall be in
Article 1 Sec. 79.  56
06/07/25  REVISOR  DTT/LN  25-05697  as introduced
57.1  proportion to each federally qualified health center's amount of discounts granted to patients
57.2  during the most recent calendar year as reported on the federal Uniform Data System report
57.3  in conformance with the Bureau of Primary Health Care Program Expectations Policy
57.4  Information Notice 98-23, except that each eligible federally qualified health center shall
57.5  receive at least two five percent but no more than 30 percent of the total amount of money
57.6  available under this section.
57.7    Sec. 80. Minnesota Statutes 2024, section 157.16, subdivision 2, is amended to read:
57.8      Subd. 2. License renewal. Initial and renewal licenses for all food and beverage service
57.9  establishments, youth camps, hotels, motels, lodging establishments, public pools, and
57.10 resorts shall be issued on an annual basis. Any person who operates a place of business after
57.11 the expiration date of a license or without having submitted an application and paid the fee
57.12 shall be deemed to have violated the provisions of this chapter and shall be subject to
57.13 enforcement action, as provided in the Health Enforcement Consolidation Act, sections
57.14 144.989 to 144.993. In addition, a penalty of $60 $100 shall be added to the total of the
57.15 license fee for any food and beverage service establishment operating without a license as
57.16 a mobile food unit, a seasonal temporary or seasonal permanent food stand, or a special
57.17 event food stand, and a penalty of $120 $200 shall be added to the total of the license fee
57.18 for all restaurants, food carts, hotels, motels, lodging establishments, youth camps, public
57.19 pools, and resorts operating without a license for a period of up to 30 days. A late fee of
57.20 $360 $450 shall be added to the license fee for establishments operating more than 30 days
57.21 without a license.
57.22   Sec. 81. Minnesota Statutes 2024, section 157.16, subdivision 2a, is amended to read:
57.23     Subd. 2a. Food manager certification. An applicant for certification or certification
57.24 renewal as a food manager must submit to the commissioner a $35 $45 nonrefundable
57.25 certification fee payable to the Department of Health. The commissioner shall issue a
57.26 duplicate certificate to replace a lost, destroyed, or mutilated certificate if the applicant
57.27 submits a completed application on a form provided by the commissioner for a duplicate
57.28 certificate and pays $20 $25 to the department for the cost of duplication. In addition, a $5
57.29 technology fee must be paid with the initial certification, certification renewal, or duplicate
57.30 certificate application.
57.31   Sec. 82. Minnesota Statutes 2024, section 157.16, subdivision 3, is amended to read:
57.32     Subd. 3. Establishment fees; definitions. (a) The following fees are required for food
57.33 and beverage service establishments, youth camps, hotels, motels, lodging establishments,
Article 1 Sec. 82.  57
06/07/25  REVISOR  DTT/LN  25-05697  as introduced
58.1  public pools, and resorts licensed under this chapter. Food and beverage service
58.2  establishments must pay the highest applicable fee under paragraph (d), clause (1), (2), (3),
58.3  or (4). The license fee for new operators previously licensed under this chapter for the same
58.4  calendar year is one-half of the appropriate annual license fee, plus any penalty that may
58.5  be required. The license fee for operators opening on or after October 1 is one-half of the
58.6  appropriate annual license fee, plus any penalty that may be required.
58.7      (b) All food and beverage service establishments, except special event food stands, and
58.8  all hotels, motels, lodging establishments, public pools, and resorts shall pay an annual base
58.9  fee of $165 $300.
58.10     (c) A special event food stand shall pay a flat fee of $55 $75 annually. "Special event
58.11 food stand" means a fee category where food is prepared or served in conjunction with
58.12 celebrations, county fairs, or special events from a special event food stand as defined in
58.13 section 157.15.
58.14     (d) In addition to the base fee in paragraph (b), each food and beverage service
58.15 establishment, other than a special event food stand and a school concession stand, and each
58.16 hotel, motel, lodging establishment, public pool, and resort shall pay an additional annual
58.17 fee for each fee category, additional food service, or required additional inspection specified
58.18 in this paragraph:
58.19     (1) Category 1 establishment, $110 $185. "Category 1 establishment" means a fee
58.20 category that provides one or more of the following items or is one of the listed
58.21 establishments or facilities:
58.22     (i) serves prepackaged food that is served in the package;
58.23     (ii) serves a continental breakfast such as rolls, coffee, juice, milk, and cold cereal;
58.24     (iii) serves soft drinks, coffee, or nonalcoholic beverages;
58.25     (iv) provides cleaning for eating, drinking, or cooking utensils, when the only food
58.26 served is prepared off site;
58.27     (v) a food establishment where the method of food preparation meets the definition of
58.28 a low-risk establishment in section 157.20; or
58.29     (vi) operates as a child care facility licensed under section 142B.05 and Minnesota Rules,
58.30 chapter 9503.
58.31     (2) Category 2 establishment, $245 $430. "Category 2 establishment" means an
58.32 establishment that is not a Category 1 establishment and is either:
Article 1 Sec. 82.  58
06/07/25  REVISOR       DTT/LN  25-05697  as introduced
59.1      (i) a food establishment where the method of food preparation meets the definition of a
59.2  medium-risk establishment in section 157.20; or
59.3      (ii) an elementary or secondary school as defined in section 120A.05.
59.4      (3) Category 3 establishment, $385 $670. "Category 3 establishment" means an
59.5  establishment that is not a Category 1 or Category 2 establishment and is either:
59.6      (i) a food establishment where the method of food preparation meets the definition of a
59.7  high-risk establishment in section 157.20; or
59.8      (ii) an establishment where 500 or more meals are prepared per day and served at one
59.9  or more separate locations.
59.10     (4) Other food and beverage service, including food carts, mobile food units, seasonal
59.11 temporary food stands, and seasonal permanent food stands, $85 $150.
59.12     (5) Lodging per sleeping accommodation unit, $11 $15, including hotels, motels, lodging
59.13 establishments, and resorts, up to a maximum of $1,100 $1,500. "Lodging per sleeping
59.14 accommodation unit" means a fee category including the number of guest rooms, cottages,
59.15 or other rental units of a hotel, motel, lodging establishment, or resort; or the number of
59.16 beds in a dormitory.
59.17     (6) First public pool, $355 $455; each additional public pool, $200 $300. "Public pool"
59.18 means a fee category that has the meaning given in section 144.1222, subdivision 4.
59.19     (7) First spa, $200 $300; each additional spa, $110 $200. "Spa pool" means a fee category
59.20 that has the meaning given in Minnesota Rules, part 4717.0250, subpart 9.
59.21     (8) Private sewer or water, $60 $85. "Individual private water" means a fee category
59.22 with a water supply other than a community public water supply as defined in Minnesota
59.23 Rules, chapter 4720. "Individual private sewer" means a fee category with an individual
59.24 sewage treatment system which uses subsurface treatment and disposal.
59.25     (9) Additional food service, $175 $250. "Additional food service" means a location at
59.26 a food service establishment, other than the primary food preparation and service area, used
59.27 to prepare or serve beverages or food to the public. Additional food service does not apply
59.28 to school concession stands.
59.29     (10) Additional inspection fee, $250 $350. "Additional inspection fee" means a fee to
59.30 conduct the second inspection each year for elementary and secondary education facility
59.31 school lunch programs when required by the Richard B. Russell National School Lunch
59.32 Act.
Article 1 Sec. 82.  59
06/07/25  REVISOR  DTT/LN  25-05697  as introduced
60.1      (11) HACCP verification, $175 $225. "HACCP verification" means an annual fee
60.2  category for a business that performs one or more specialized process that requires an
60.3  HACCP plan as required in chapter 31 and Minnesota Rules, chapter 4626.
60.4      (e) A fee for review of construction plans must accompany the initial license application
60.5  for restaurants, hotels, motels, lodging establishments, resorts, seasonal food stands, and
60.6  mobile food units. Plans submitted less than 30 days prior to construction are subject to an
60.7  additional late fee equal to 50 percent of the original plan review fee. A fee for review of
60.8  an HACCP plan for specialized processing must be submitted and approved prior to preparing
60.9  and serving the specialized processed food for human consumption. The fees for construction
60.10 plan reviews and HACCP plan reviews are as follows:
60.11 Service Area  Type  Fee
60.12$400
60.13 Food  category 1 establishment  $550
60.14$450
60.15category 2 establishment  $750
60.16$500
60.17category 3 food establishment  $800
60.18$250
60.19additional food service  $400
60.20$500
60.21HACCP Plan Review  $600
60.22$250
60.23 Transient food service  food cart  $500
60.24$250
60.25seasonal permanent food stand  $500
60.26$250
60.27seasonal temporary food stand  $500
60.28$350
60.29mobile food unit  $700
60.30$375
60.31 Lodging  less than 25 rooms  $450
60.32$400
60.3325 to less than 100 rooms  $500
60.34$500
60.35100 rooms or more  $600
60.36$350
60.37less than five cabins  $400
60.38$400
60.39five to less than ten cabins  $450
60.40$450
60.41ten cabins or more  $500
Article 1 Sec. 82.  60
06/07/25  REVISOR  DTT/LN  25-05697  as introduced
61.1      (f) When existing food and beverage service establishments, hotels, motels, lodging
61.2  establishments, resorts, seasonal food stands, and mobile food units are extensively
61.3  remodeled, a fee must be submitted with the remodeling plans. The fee for this construction
61.4  plan review is as follows:
61.5  Service Area  Type  Fee
61.6$300
61.7  Food  category 1 establishment  $450
61.8$350
61.9category 2 establishment  $500
61.10$400
61.11category 3 establishment  $550
61.12$250
61.13additional food service  $400
61.14$250
61.15 Transient food service  food cart  $400
61.16$250
61.17seasonal permanent food stand  $400
61.18$250
61.19seasonal temporary food stand  $400
61.20$250
61.21mobile food unit  $400
61.22$250
61.23 Lodging  less than 25 rooms  $300
61.24$300
61.2525 to less than 100 rooms  $350
61.26$450
61.27100 rooms or more  $500
61.28$250
61.29less than five cabins  $300
61.30$350
61.31five to less than ten cabins  $400
61.32$400
61.33ten cabins or more  $450
61.34     (g) Special event food stands are not required to submit construction or remodeling plans
61.35 for review.
61.36     (h) Youth camps shall pay an annual single fee for food and lodging as follows:
61.37     (1) camps with up to 99 campers, $325 $375;
61.38     (2) camps with 100 to 199 campers, $550 $600; and
61.39     (3) camps with 200 or more campers, $750 $800.
Article 1 Sec. 82.  61
06/07/25  REVISOR        DTT/LN  25-05697  as introduced
62.1      (i) A youth camp which pays fees under paragraph (d) is not required to pay fees under
62.2  paragraph (h).
62.3    Sec. 83. Minnesota Statutes 2024, section 157.16, subdivision 3a, is amended to read:
62.4      Subd. 3a. Statewide hospitality fee. Every person, firm, or corporation that operates a
62.5  licensed boarding establishment, food and beverage service establishment, seasonal temporary
62.6  or permanent food stand, special event food stand, mobile food unit, food cart, resort, hotel,
62.7  motel, or lodging establishment in Minnesota must submit to the commissioner a $40 $50
62.8  annual statewide hospitality fee for each licensed activity. The fee for establishments licensed
62.9  by the Department of Health is required at the same time the licensure fee is due. For
62.10 establishments licensed by local governments, the fee is due by July 1 of each year.
62.11   Sec. 84. Minnesota Statutes 2024, section 157.16, is amended by adding a subdivision to
62.12 read:
62.13     Subd. 3b. Technology fee. Every food and beverage service establishment, youth camp,
62.14 hotel, motel, lodging establishment, public pool, and resort licensed under this chapter must
62.15 pay a $5 technology fee for each licensed activity for the initial license and with each
62.16 renewal.
62.17   Sec. 85. Minnesota Statutes 2024, section 256B.0625, subdivision 2, is amended to read:
62.18     Subd. 2. Skilled and intermediate nursing care. (a) Medical assistance covers skilled
62.19 nursing home services and services of intermediate care facilities, including training and
62.20 habilitation services, as defined in section 252.41, subdivision 3, for persons with
62.21 developmental disabilities who are residing in intermediate care facilities for persons with
62.22 developmental disabilities. Medical assistance must not be used to pay the costs of nursing
62.23 care provided to a patient in a swing bed as defined in section 144.562, unless (1) the facility
62.24 in which the swing bed is located is eligible as a sole community provider, as defined in
62.25 Code of Federal Regulations, title 42, section 412.92, or the facility is a public hospital
62.26 owned by a governmental entity with 15 or fewer licensed acute care beds; (2) the Centers
62.27 for Medicare and Medicaid Services approves the necessary state plan amendments; (3) the
62.28 patient was screened as provided by law; (4) the patient no longer requires acute care
62.29 services; and (5) no nursing home beds are available within 25 miles of the facility. The
62.30 commissioner shall exempt a facility from compliance with the sole community provider
62.31 requirement in clause (1) if, as of January 1, 2004, the facility had an agreement with the
62.32 commissioner to provide medical assistance swing bed services.
Article 1 Sec. 85.  62
06/07/25  REVISOR  DTT/LN  25-05697  as introduced
63.1      (b) Medical assistance also covers up to ten days of nursing care provided to a patient
63.2  in a swing bed if: (1) the patient's physician, advanced practice registered nurse, or physician
63.3  assistant certifies that the patient has a terminal illness or condition that is likely to result
63.4  in death within 30 days and that moving the patient would not be in the best interests of the
63.5  patient and patient's family; (2) no open nursing home beds are available within 25 miles
63.6  of the facility; and (3) no open beds are available in any Medicare hospice program within
63.7  50 miles of the facility. The daily medical assistance payment for nursing care for the patient
63.8  in the swing bed is the statewide average medical assistance skilled nursing care per diem
63.9  as computed annually by the commissioner on July 1 of each year.
63.10     EFFECTIVE DATE. This section is effective January 1, 2026, or upon federal approval,
63.11 whichever is later. The commissioners of health and human services shall inform the revisor
63.12 of statutes when federal approval is obtained.
63.13   Sec. 86. Minnesota Statutes 2024, section 256B.0625, is amended by adding a subdivision
63.14 to read:
63.15     Subd. 2b. Nursing care provided to a patient in a swing bed. (a) Medical assistance
63.16 must not be used to pay the costs of nursing care provided to a patient in a swing bed as
63.17 defined in section 144.562, unless:
63.18     (1) the facility in which the swing bed is located is eligible as a sole community provider,
63.19 as defined in Code of Federal Regulations, title 42, section 412.92, or the facility is a public
63.20 hospital owned by a governmental entity with 25 or fewer licensed acute care beds;
63.21     (2) the Centers for Medicare and Medicaid Services approves the necessary state plan
63.22 amendments;
63.23     (3) the patient was screened as provided by law;
63.24     (4) the patient no longer requires acute care services; and
63.25     (5) no nursing home beds are available within 25 miles of the facility.
63.26     (b) The commissioner shall exempt a facility from compliance with the sole community
63.27 provider requirement in paragraph (a), clause (1), if, as of January 1, 2004, the facility had
63.28 an agreement with the commissioner to provide medical assistance swing bed services.
63.29     (c) Medical assistance also covers up to ten days of nursing care provided to a patient
63.30 in a swing bed if:
63.31     (1) the patient's physician, advanced practice registered nurse, or physician assistant
63.32 certifies that the patient has a terminal illness or condition that is likely to result in death
Article 1 Sec. 86.  63
06/07/25  REVISOR        DTT/LN  25-05697  as introduced
64.1  within 30 days and that moving the patient would not be in the best interests of the patient
64.2  and patient's family;
64.3      (2) no open nursing home beds are available within 25 miles of the facility; and
64.4      (3) no open beds are available in any Medicare hospice program within 50 miles of the
64.5  facility.
64.6      (d) The commissioner shall exempt any facility described under section 144.5621 from
64.7  compliance with the requirements of paragraph (a), clauses (3) and (5), and paragraph (c),
64.8  and medical assistance covers an unlimited number of days of nursing care provided to a
64.9  patient in a swing bed at a facility described under section 144.5621.
64.10     (e) The daily medical assistance payment for nursing care for the patient in the swing
64.11 bed is the statewide average medical assistance skilled nursing care per diem as computed
64.12 annually by the commissioner on July 1 of each year.
64.13     EFFECTIVE DATE. This section is effective January 1, 2026, or upon federal approval,
64.14 whichever is later. The commissioners of health and human services shall inform the revisor
64.15 of statutes when federal approval is obtained.
64.16   Sec. 87. Minnesota Statutes 2024, section 256B.692, subdivision 2, is amended to read:
64.17     Subd. 2. Duties of commissioner of health. (a) Notwithstanding chapters 62D and 62N,
64.18 a county that elects to purchase medical assistance in return for a fixed sum without regard
64.19 to the frequency or extent of services furnished to any particular enrollee is not required to
64.20 obtain a certificate of authority under chapter 62D or 62N. The county board of
64.21 commissioners is the governing body of a county-based purchasing program. In a multicounty
64.22 arrangement, the governing body is a joint powers board established under section 471.59.
64.23     (b) A county that elects to purchase medical assistance services under this section must
64.24 satisfy the commissioner of health that the requirements for assurance of consumer protection,
64.25 provider protection, and fiscal solvency of chapter 62D, applicable to health maintenance
64.26 organizations will be met according to the following schedule:
64.27     (1) for a county-based purchasing plan approved on or before June 30, 2008, the plan
64.28 must have in reserve:
64.29     (i) at least 50 percent of the minimum amount required under chapter 62D as of January
64.30 1, 2010;
64.31     (ii) at least 75 percent of the minimum amount required under chapter 62D as of January
64.32 1, 2011;
Article 1 Sec. 87.  64
06/07/25  REVISOR  DTT/LN  25-05697  as introduced
65.1      (iii) at least 87.5 percent of the minimum amount required under chapter 62D as of
65.2  January 1, 2012; and
65.3      (iv) at least 100 percent of the minimum amount required under chapter 62D as of January
65.4  1, 2013; and
65.5      (2) for a county-based purchasing plan first approved after June 30, 2008, the plan must
65.6  have in reserve:
65.7      (i) at least 50 percent of the minimum amount required under chapter 62D at the time
65.8  the plan begins enrolling enrollees;
65.9      (ii) at least 75 percent of the minimum amount required under chapter 62D after the first
65.10 full calendar year;
65.11     (iii) at least 87.5 percent of the minimum amount required under chapter 62D after the
65.12 second full calendar year; and
65.13     (iv) at least 100 percent of the minimum amount required under chapter 62D after the
65.14 third full calendar year.
65.15     (c) Until a plan is required to have reserves equaling at least 100 percent of the minimum
65.16 amount required under chapter 62D, the plan may demonstrate its ability to cover any losses
65.17 by satisfying the requirements of chapter 62N. A county-based purchasing plan must also
65.18 assure the commissioner of health that the requirements of sections 62J.041; 62J.48; 62J.71
65.19 to 62J.73; all applicable provisions of chapter 62Q, including sections 62Q.075; 62Q.1055;
65.20 62Q.106; 62Q.12; 62Q.135; 62Q.14; 62Q.19; 62Q.23, paragraph (c); 62Q.43; 62Q.47;
65.21 62Q.50; 62Q.52 to 62Q.56; 62Q.58; 62Q.68 to 62Q.72; and 72A.201 will be met.
65.22     (d) All enforcement and rulemaking powers available under chapters 62D, 62J, 62N,
65.23 and 62Q are hereby granted to the commissioner of health with respect to counties that
65.24 purchase medical assistance services under this section.
65.25     (e) The commissioner, in consultation with county government, shall develop
65.26 administrative and financial reporting requirements for county-based purchasing programs
65.27 relating to sections 62D.041, 62D.042, 62D.045, 62D.08, 62N.28, 62N.29, and 62N.31,
65.28 and other sections as necessary, that are specific to county administrative, accounting, and
65.29 reporting systems and consistent with other statutory requirements of counties.
65.30     (f) The commissioner shall collect from a county-based purchasing plan under this
65.31 section the following fees:
Article 1 Sec. 87.  65
06/07/25  REVISOR        DTT/LN  25-05697  as introduced
66.1      (1) fees attributable to the costs of audits and other examinations of plan financial
66.2  operations. These fees are subject to the provisions of Minnesota Rules, part 4685.2800,
66.3  subpart 1, item F; and
66.4      (2) an annual fee of $21,500 $30,000, to be paid by June 15 of each calendar year.
66.5  All fees collected under this paragraph shall be deposited in the state government special
66.6  revenue fund.
66.7    Sec. 88. Minnesota Statutes 2024, section 256R.01, is amended by adding a subdivision
66.8  to read:
66.9      Subd. 1a. Payment rates for nursing care provided to a patient in a swing
66.10 bed. Payment rates paid to any hospital for nursing care provided to a patient in a swing
66.11 bed must be those rates established pursuant section 256B.0625, subdivision 2b.
66.12     EFFECTIVE DATE. This section is effective January 1, 2026, or upon federal approval,
66.13 whichever is later. The commissioners of health and human services shall inform the revisor
66.14 of statutes when federal approval is obtained.
66.15   Sec. 89. Minnesota Statutes 2024, section 326.72, subdivision 1, is amended to read:
66.16     Subdivision 1. When license required. A person within the state intending to directly
66.17 perform or cause to be performed through subcontracting or similar delegation any
66.18 asbestos-related work either for financial gain or with respect to the person's own property
66.19 shall first apply for and obtain a license from the commissioner. The license shall be in
66.20 writing, be dated when issued, contain an expiration date, be signed by the commissioner,
66.21 and give the name and address of the person to whom it is issued.
66.22     The domiciled owner of a single family residence is not required to hold a license or
66.23 pay a project permit fee to conduct asbestos-related work in the domiciled residence.
66.24     Any person performing any asbestos-related work within the state must be licensed by
66.25 the commissioner, whether directly performing asbestos work or causing it to be performed
66.26 through subcontracting or similar delegation. A domiciled owner of a single-family residence
66.27 is not required to hold a license or pay a project permit fee to conduct asbestos-related work
66.28 in the domiciled residence.
66.29   Sec. 90. Minnesota Statutes 2024, section 326.75, subdivision 3, is amended to read:
66.30     Subd. 3. Permit fee. Five calendar days before beginning asbestos-related work, a person
66.31 shall pay a project permit fee to the commissioner equal to two three percent of the total
Article 1 Sec. 90.  66
06/07/25  REVISOR        DTT/LN  25-05697  as introduced
67.1  costs of the asbestos-related work. For asbestos-related work performed in single or
67.2  multifamily residences, of greater than ten but less than 260 linear feet of asbestos-containing
67.3  material on pipes, or greater than six but less than 160 square feet of asbestos-containing
67.4  material on other facility components, a person shall pay a project permit fee of $35 to the
67.5  commissioner.
67.6    Sec. 91. Minnesota Statutes 2024, section 326.75, subdivision 3a, is amended to read:
67.7      Subd. 3a. Asbestos-related training course permit fee. The commissioner shall establish
67.8  by rule a permit fee to be paid by A training course provider shall pay the commissioner a
67.9  fee of $500 on application for a training course permit or and $250 for the renewal of a
67.10 permit of each asbestos-related training course required for certification or registration.
67.11   Sec. 92. Minnesota Statutes 2024, section 327.15, subdivision 2, is amended to read:
67.12     Subd. 2. License renewal. Initial and renewal licenses for all manufactured home parks
67.13 and recreational camping areas shall be issued annually and shall have an expiration date
67.14 included on the license. Any person who operates a manufactured home park or recreational
67.15 camping area after the expiration date of a license or without having submitted an application
67.16 and paid the fee shall be deemed to have violated the provisions of this chapter and shall
67.17 be subject to enforcement action, as provided in the Health Enforcement Consolidation Act,
67.18 sections 144.989 to 144.993. In addition, a penalty of $120 $200 shall be added to the total
67.19 of the license fee for any manufactured home park or recreational camping area operating
67.20 without a license for a period of up to 30 days. A late fee of $360 $450 shall be added to
67.21 the license fee for any manufactured home park or recreational camping area operating
67.22 more than 30 days without a license.
67.23   Sec. 93. Minnesota Statutes 2024, section 327.15, subdivision 3, is amended to read:
67.24     Subd. 3. Fees, manufactured home parks and recreational camping areas. (a) The
67.25 following fees are required for manufactured home parks and recreational camping areas
67.26 licensed under this chapter. Fees collected under this section shall be deposited in the state
67.27 government special revenue fund. Recreational camping areas and manufactured home
67.28 parks shall pay the highest applicable base fee under paragraph (b). The license fee for new
67.29 operators of a manufactured home park or recreational camping area previously licensed
67.30 under this chapter for the same calendar year is one-half of the appropriate annual license
67.31 fee, plus any penalty that may be required. The license fee for operators opening on or after
67.32 October 1 is one-half of the appropriate annual license fee, plus any penalty that may be
67.33 required.
Article 1 Sec. 93.  67
06/07/25  REVISOR  DTT/LN  25-05697  as introduced
68.1      (b) All manufactured home parks and recreational camping areas shall pay the following
68.2  annual base fee:
68.3      (1) a manufactured home park, $165 $280; and
68.4      (2) a recreational camping area with:
68.5      (i) 24 or less sites, $55 $100;
68.6      (ii) 25 to 99 sites, $230 $410; and
68.7      (iii) 100 or more sites, $330 $610.
68.8  In addition to the base fee, manufactured home parks and recreational camping areas shall
68.9  pay $5 $8 for each licensed site. This paragraph does not apply to special event recreational
68.10 camping areas. Operators of a manufactured home park or a recreational camping area also
68.11 licensed under section 157.16 for the same location shall pay only one base fee, whichever
68.12 is the highest of the base fees found in this section or section 157.16.
68.13     (c) In addition to the fee in paragraph (b), each manufactured home park or recreational
68.14 camping area shall pay an additional annual fee for each fee category specified in this
68.15 paragraph:
68.16     (1) Manufactured home parks and recreational camping areas with public swimming
68.17 pools and spas shall pay the appropriate fees specified in section 157.16.
68.18     (2) Individual private sewer or water, $60 $85. "Individual private water" means a fee
68.19 category with a water supply other than a community public water supply as defined in
68.20 Minnesota Rules, chapter 4720. "Individual private sewer" means a fee category with a
68.21 subsurface sewage treatment system which uses subsurface treatment and disposal.
68.22     (d) The following fees must accompany a plan review application for initial construction
68.23 of a manufactured home park or recreational camping area:
68.24     (1) for initial construction of less than 25 sites, $375 $400;
68.25     (2) for initial construction of 25 to 99 sites, $400 $425; and
68.26     (3) for initial construction of 100 or more sites, $500 $525.
68.27     (e) The following fees must accompany a plan review application when an existing
68.28 manufactured home park or recreational camping area is expanded:
68.29     (1) for expansion of less than 25 sites, $250 $300;
68.30     (2) for expansion of 25 to 99 sites, $300 $350; and
Article 1 Sec. 93.  68
06/07/25  REVISOR  DTT/LN  25-05697  as introduced
69.1      (3) for expansion of 100 or more sites, $450 $500.
69.2      (f) Plan review applications submitted less than 30 days prior to construction are subject
69.3  to an additional late fee equal to 50 percent of the original plan review fee.
69.4    Sec. 94. Minnesota Statutes 2024, section 327.15, subdivision 4, is amended to read:
69.5      Subd. 4. Fees, special event recreational camping areas. (a) The following fees are
69.6  required for special event recreational camping areas licensed under this chapter.
69.7      (b) All special event recreational camping areas shall pay an annual fee of $150 $250
69.8  plus $1 $4 for each licensed site.
69.9      (c) A special event recreational camping area shall pay a late fee of $360 $450 for failing
69.10 to obtain a license prior to operating.
69.11     (d) The following fees must accompany a plan review application for initial construction
69.12 of a special event recreational camping area:
69.13     (1) for initial construction of less than 25 special event recreational camping sites, $375
69.14 $475;
69.15     (2) for initial construction of 25 to 99 sites, $400 $500; and
69.16     (3) for initial construction of 100 or more sites, $500 $600.
69.17     (e) The following fees must accompany a plan review application for expansion of a
69.18 special event recreational camping area:
69.19     (1) for expansion of less than 25 sites, $250 $300;
69.20     (2) for expansion of 25 to 99 sites, $300 $350; and
69.21     (3) for expansion of 100 or more sites, $450 $500.
69.22     (f) Plan review applications submitted less than 30 days prior to construction are subject
69.23 to an additional late fee equal to 50 percent of the original plan review fee.
69.24   Sec. 95. Minnesota Statutes 2024, section 327.15, is amended by adding a subdivision to
69.25 read:
69.26     Subd. 5. Technology fee. All manufactured home parks, recreational camping areas,
69.27 and special event camping areas must pay a $5 technology fee at initial licensing and upon
69.28 each renewal.
Article 1 Sec. 95.  69
06/07/25  REVISOR  DTT/LN  25-05697  as introduced
70.1    Sec. 96. SPOKEN LANGUAGE HEALTH CARE INTERPRETER WORK GROUP.
70.2      Subdivision 1. Definitions. (a) For purposes of this section, the following terms have
70.3  the meanings given.
70.4      (b) "Commissioner" means the commissioner of health.
70.5      (c) "Common languages" means the 15 most common languages without regard to dialect
70.6  in Minnesota.
70.7      (d) "Registered interpreter" means a spoken language interpreter who is listed on the
70.8  Department of Health's spoken language health care interpreter roster.
70.9      (e) "Work group" means the spoken language health care interpreter work group
70.10 established in this section.
70.11     Subd. 2. Composition. The commissioner, after receiving work group candidate
70.12 applications, must appoint 15 members to the work group consisting of the following
70.13 members:
70.14     (1) three members who are interpreters listed on the Department of Health's spoken
70.15 language health care interpreter roster and who are Minnesota residents. Of these members:
70.16     (i) each must be an interpreter for a different language;
70.17     (ii) at least one must have a national certification credential; and
70.18     (iii) at least one must have been listed on the roster as an interpreter in a language other
70.19 than the common languages and must have completed a nationally recognized training
70.20 program for health care interpreters that is, at a minimum, 40 hours in length;
70.21     (2) three members representing limited English proficiency (LEP) individuals. Of these
70.22 members, two must represent LEP individuals who are proficient in a common language
70.23 other than English and one must represent LEP individuals who are proficient in a language
70.24 that is not one of the common languages;
70.25     (3) one member representing a health plan company;
70.26     (4) one member who is not an interpreter and who is representing a Minnesota health
70.27 system;
70.28     (5) two members representing interpreter agencies, including one member representing
70.29 agencies whose main office is located outside the seven-county metropolitan area and one
70.30 member representing agencies whose main office is located within the seven-county
70.31 metropolitan area;
Article 1 Sec. 96.  70
06/07/25  REVISOR  DTT/LN  25-05697  as introduced
71.1      (6) one member representing the Department of Health;
71.2      (7) one member representing the Department of Human Services;
71.3      (8) one member representing an interpreter training program or postsecondary educational
71.4  institution program providing interpreter courses or skills assessment;
71.5      (9) one member who is affiliated with a Minnesota-based or Minnesota chapter of a
71.6  national or international organization representing interpreters; and
71.7      (10) one member who is a licensed health care provider.
71.8      Subd. 3. Duties. The work group must compile a list of recommendations to support
71.9  and improve access to the critical health care interpreting services provided across the state,
71.10 including but not limited to:
71.11     (1) changing requirements for registered and certified interpreters to reflect changing
71.12 needs of the Minnesota health care community and emerging national standards of training,
71.13 competency, and testing;
71.14     (2) addressing barriers for interpreters to gain access to the roster, including barriers for
71.15 interpreters of languages other than common languages and interpreters in rural areas;
71.16     (3) reimbursing spoken language health care interpreting;
71.17     (4) identifying gaps in interpreter services in rural areas and recommending ways to
71.18 address interpreter training and funding needs;
71.19     (5) providing training, certification, and continuing education programs;
71.20     (6) convening a meeting of public and private sector representatives of the spoken
71.21 language health care interpreter community to identify ongoing sources of financial assistance
71.22 to aid individual interpreters in meeting interpreter training and testing requirements for the
71.23 registry;
71.24     (7) conducting surveys of people receiving and providing interpreter services to
71.25 understand changing needs and consumer quality of care; and
71.26     (8) suggesting changes in requirements and qualifications on telehealth or remote
71.27 interpreting.
71.28     Subd. 4. Compensation; expense reimbursement. Compensation shall be offered to
71.29 work group members not being compensated for their participation in work group activities
71.30 as part of their existing job duties. Work group members shall be compensated and
Article 1 Sec. 96.  71
06/07/25  REVISOR        DTT/LN  25-05697  as introduced
72.1  reimbursed for expenses for work group activities under Minnesota Statutes, section 15.059,
72.2  subdivision 3.
72.3      Subd. 5. Administrative support; meeting space, meeting facilitation. The
72.4  commissioner must provide meeting space and administrative support for the work group.
72.5  The commissioner may contract with a neutral independent consultant to provide this
72.6  administrative support and to facilitate and lead the meetings of the work group.
72.7      Subd. 6. Deadline for appointments. The commissioner must appoint members to the
72.8  work group by August 15, 2025.
72.9      Subd. 7. Expiration. This section expires on November 2, 2026, or upon submission
72.10 of the report required under subdivision 9, whichever is earlier.
72.11     Subd. 8. Initial spoken language health care interpreter work group meetings. The
72.12 commissioner shall convene the first meeting of the work group by October 1, 2025. Prior
72.13 to the first meeting, work group members must receive results from previously conducted
72.14 surveys and gather evidence-based research on interpreter services in Minnesota. During
72.15 the first meetings, work group members may consult with subject matter experts, including
72.16 but not limited to signed language interpreting experts, academic experts with knowledge
72.17 of interpreting research, and academic health experts to address specific gaps in spoken
72.18 language health care interpreting. The work group shall provide a minimum of two
72.19 opportunities for public comment. These opportunities shall be announced with at least four
72.20 weeks' notice, with publicity in the five most common languages in Minnesota. Interpreters
72.21 for those same languages shall be provided during the public comment opportunities.
72.22     Subd. 9. Report. By November 1, 2026, the commissioner must provide the chairs and
72.23 ranking minority members of the legislative committees with jurisdiction over health care
72.24 interpreter services with recommendations, including draft legislation and any statutory
72.25 changes needed to implement the recommendations, to improve and support access to health
72.26 care interpreting services statewide.
72.27   Sec. 97. REPORT ON FACILITY FEES.
72.28     Subdivision 1. Definitions. (a) For purposes of this section, the following terms have
72.29 the meanings given.
72.30     (b) "Facility fee" means any separate charge or billing by a provider-based clinic in
72.31 addition to a professional fee for physicians' services that is intended to cover building,
72.32 electronic medical records systems, billing, and other administrative and operational
72.33 expenses.
Article 1 Sec. 97.  72
06/07/25  REVISOR  DTT/LN  25-05697  as introduced
73.1      (c) "Provider-based clinic" means the site of an off-campus clinic or provider office,
73.2  located at least 250 yards from the main hospital buildings or as determined by the Centers
73.3  for Medicare and Medicaid Services, that is owned by a hospital licensed under Minnesota
73.4  Statutes, chapter 144, or a health system that operates one or more hospitals licensed under
73.5  Minnesota Statutes, chapter 144, and is primarily engaged in providing diagnostic and
73.6  therapeutic care, including medical history, physical examinations, assessment of health
73.7  status, and treatment monitoring. Provider-based clinic does not include clinics that are
73.8  exclusively providing laboratory, x-ray, testing, therapy, pharmacy, or educational services
73.9  and does not include facilities designated as rural health clinics.
73.10     Subd. 2. Reporting. (a) By January 15, 2027, hospitals licensed under Minnesota Statutes,
73.11 chapter 144, and health systems operating one or more hospitals licensed under Minnesota
73.12 Statutes, chapter 144, must submit a report to the commissioner of health identifying facility
73.13 fees charged, billed, and collected during the preceding calendar year. The commissioner
73.14 must publish the information reported on a publicly accessible website. The report shall be
73.15 in the format prescribed by the commissioner of health.
73.16     (b) The report under this subdivision must include the following information for each
73.17 facility owned or operated by the hospital or health system providing services for which a
73.18 facility fee is charged, billed, or collected:
73.19     (1) the name and full address of each facility;
73.20     (2) the number of patient visits at each facility; and
73.21     (3) the number, total amount, and range of allowable facility fees paid at each facility
73.22 by Medicare, medical assistance, MinnesotaCare, and private insurance.
73.23     (c) The report under this subdivision must include the following information for the
73.24 entire hospital or health system:
73.25     (1) the total amount charged and billed for facility fees;
73.26     (2) the total amount collected from facility fees;
73.27     (3) the top ten procedures or services provided by the hospital or health system that
73.28 generated the greatest amount of facility fee gross revenue, the volume of each of these ten
73.29 procedures or services and the gross and net revenue totals for each procedure or service,
73.30 and the total net amount of revenue received by the hospital or health system derived from
73.31 facility fees;
73.32     (4) the top ten procedures or services, based on patient volume, provided by the hospital
73.33 or health system for which facility fees are charged, billed, or collected, based on patient
Article 1 Sec. 97.  73
06/07/25  REVISOR       DTT/LN  25-05697  as introduced
74.1  volume, including the gross and net revenue totals received for each such procedure or
74.2  service; and
74.3      (5) any other information related to facility fees that the commissioner of health may
74.4  require.
74.5      Subd. 3. Enforcement. The commissioner of health may, pursuant to the procedures in
74.6  Minnesota Statutes, sections 144.99 and 144.991, impose an administrative penalty on a
74.7  hospital or health system for failure to comply with subdivision 2. The penalty must not
74.8  exceed $1,000 per occurrence.
74.9    Sec. 98. RULEMAKING.
74.10     The Department of Health must adopt rules using the expedited process under Minnesota
74.11 Statutes, section 14.389, to amend certain parts in Minnesota Rules, chapter 4695, to conform
74.12 with the changes made in this act.
74.13   Sec. 99. REPEALER.
74.14     (a) Minnesota Statutes 2024, section 103I.550, is repealed.
74.15     (b) Minnesota Rules, part 4695.2900, is repealed.
74.16ARTICLE 2
74.17DEPARTMENT OF HEALTH POLICY
74.18   Section 1. Minnesota Statutes 2024, section 62J.461, subdivision 3, is amended to read:
74.19     Subd. 3. Reporting by covered entities to the commissioner. (a) Each 340B covered
74.20 entity shall report to the commissioner by April 1 of each year the following information
74.21 for transactions conducted by the 340B covered entity or on its behalf, and related to its
74.22 participation in the federal 340B program for the previous calendar year:
74.23     (1) the aggregated acquisition cost for prescription drugs obtained under the 340B
74.24 program;
74.25     (2) the aggregated payment amount received for drugs obtained under the 340B program
74.26 and dispensed or administered to patients;:
74.27     (i) that are net of the contracted price for insurance claims payments; and
74.28     (ii) that reflect the portion of payment received from grants, cash, or other payment types
74.29 that relate to the dispensing or administering of drugs obtained under the 340B program;
Article 2 Section 1.  74
06/07/25  REVISOR  DTT/LN  25-05697  as introduced
75.1      (3) the number of pricing units dispensed or administered for prescription drugs described
75.2  in clause (2); and
75.3      (4) the aggregated payments made:
75.4      (i) to contract pharmacies to dispense drugs obtained under the 340B program;
75.5      (ii) to any other entity that is not the covered entity and is not a contract pharmacy for
75.6  managing any aspect of the covered entity's 340B program; and
75.7      (iii) for all other internal, direct expenses related to administering the 340B program
75.8  with a detailed description of the direct costs included.
75.9  The information under clauses (2) and (3) must be reported by payer type, including but
75.10 not limited to commercial insurance, medical assistance, MinnesotaCare, and Medicare, in
75.11 the form and manner prescribed by the commissioner.
75.12     (b) For covered entities that are hospitals, the information required under paragraph (a),
75.13 clauses (1) to (3), must also be reported at the national drug code level for the 50 most
75.14 frequently dispensed or administered drugs by the facility under the 340B program.
75.15     (c) Data submitted to the commissioner under paragraphs (a) and (b) are classified as
75.16 nonpublic data, as defined in section 13.02, subdivision 9.
75.17   Sec. 2. Minnesota Statutes 2024, section 62J.461, subdivision 4, is amended to read:
75.18     Subd. 4. Enforcement and exceptions. (a) Any health care covered entity subject to
75.19 reporting under this section that fails to provide data in the form and manner prescribed by
75.20 the commissioner is subject to the levy of a fine paid to the commissioner of up to $500 for
75.21 each day the data are past due. Any fine levied against the entity under this subdivision is
75.22 subject to the contested case and judicial review provisions of sections 14.57 and to 14.69.
75.23     (b) The commissioner may grant an entity an extension of or exemption from the reporting
75.24 obligations under this subdivision section, upon a showing of good cause by the entity.
75.25   Sec. 3. Minnesota Statutes 2024, section 62J.461, subdivision 5, is amended to read:
75.26     Subd. 5. Reports to the legislature. By November 15, 2024, and by November 15 of
75.27 each year thereafter, the commissioner shall submit to the chairs and ranking minority
75.28 members of the legislative committees with jurisdiction over health care finance and policy,
75.29 a report that aggregates the data submitted under subdivision 3, paragraphs (a) and (b). The
75.30 following information must be included in the report For all 340B entities whose net 340B
75.31 revenue constitutes a significant share, as determined by the commissioner, of all net 340B
Article 2 Sec. 3.  75
06/07/25  REVISOR  DTT/LN  25-05697  as introduced
76.1  revenue across all 340B covered entities in Minnesota, the following information must also
76.2  be included in the report:
76.3(1) the information submitted under subdivision 2; and
76.4(2) for each 340B entity identified in subdivision 2, that entity's 340B net revenue as
76.5  calculated using the data submitted under subdivision 3, paragraph (a), with net revenue
76.6  being subdivision 3, paragraph (a), clause (2), less the sum of subdivision 3, paragraph (a),
76.7  clauses (1) and (4).
76.8  For all other entities, the data in the report must be aggregated to the entity type or groupings
76.9  of entity types in a manner that prevents the identification of an individual entity and any
76.10 entity's specific data value reported for an individual data element.
76.11   Sec. 4. Minnesota Statutes 2024, section 62J.51, subdivision 19a, is amended to read:
76.12Subd. 19a. Uniform explanation of benefits document. "Uniform explanation of
76.13 benefits document" means either the document associated with and explaining the details
76.14 of a group purchaser's claim adjudication for services rendered or its electronic equivalent
76.15 under section 62J.581, which is sent to a patient.
76.16   Sec. 5. Minnesota Statutes 2024, section 62J.581, is amended to read:
76.1762J.581 STANDARDS FOR MINNESOTA UNIFORM HEALTH CARE
76.18 REIMBURSEMENT DOCUMENTS.
76.19Subdivision 1. Minnesota uniform remittance advice. All group purchasers shall
76.20 provide a uniform claim payment/advice transaction to health care providers when a claim
76.21 is adjudicated. The uniform claim payment/advice transaction shall comply with section
76.22 62J.536, subdivision 1, paragraph (b), and rules adopted under section 62J.536, subdivision
76.23 2.
76.24Subd. 2. Minnesota uniform explanation of benefits document. (a) All group
76.25 purchasers shall provide a uniform explanation of benefits document to health care patients
76.26 when an explanation of benefits document is provided as otherwise required or permitted
76.27 by law. The uniform explanation of benefits document shall comply with the standards
76.28 prescribed in this section.
76.29(b) Notwithstanding paragraph (a), this section does not apply to group purchasers not
76.30 included as covered entities under United States Code, title 42, sections 1320d to 1320d-8,
76.31 as amended from time to time, and the regulations promulgated under those sections.
Article 2 Sec. 5.  76
06/07/25  REVISOR  DTT/LN  25-05697  as introduced
77.1Subd. 3. Scope. For purposes of sections 62J.50 to 62J.61, the uniform claim
77.2  payment/advice transaction and uniform explanation of benefits document format specified
77.3  in subdivision 4 shall apply to all health care services delivered by a health care provider
77.4  or health care provider organization in Minnesota, regardless of the location of the payer.
77.5  Health care services not paid on an individual claims basis, such as capitated payments, are
77.6  not included in this section. A health plan company is excluded from the requirements in
77.7  subdivisions 1 and subdivision 2 if they comply with section 62A.01, subdivisions 2 and
77.8  3.
77.9Subd. 4. Specifications. (a) The uniform explanation of benefits document shall be
77.10 provided by use of a paper document conforming to the specifications in this section or its
77.11 electronic equivalent under paragraph (b).
77.12(b) Group purchasers may make the uniform explanation of benefits available in a version
77.13 that can be accessed by health care patients electronically if:
77.14(1) the group purchaser making the uniform explanation of benefits available
77.15 electronically provides health care patients the ability to choose whether to receive paper,
77.16 electronic, or both paper and electronic versions of their uniform explanation of benefits;
77.17(2) the group purchaser provides clear, readily accessible information and instructions
77.18 for the patient to communicate their choice; and
77.19(3) health care patients not responding to the opportunity to make a choice will receive
77.20 at a minimum a paper uniform explanation of benefits.
77.21(c) The commissioner, after consulting with the Administrative Uniformity Committee,
77.22 shall specify the data elements and definitions for the paper uniform explanation of benefits
77.23 document. The commissioner and the Administrative Uniformity Committee must consult
77.24 with the Minnesota Dental Association and Delta Dental Plan of Minnesota before requiring
77.25 under this section the use of a paper document for the uniform explanation of benefits
77.26 document or the uniform claim payment/advice transaction for dental care services. Any
77.27 electronic version of the uniform explanation of benefits must use the same data elements
77.28 and definitions as the paper uniform explanation of benefits.
77.29Subd. 5. Effective date. The requirements in subdivisions 1 and 2 are effective June 30,
77.30 2007. The requirements in subdivisions 1 and 2 apply regardless of when the health care
77.31 service was provided to the patient.
Article 2 Sec. 5.  77
06/07/25  REVISOR  DTT/LN  25-05697  as introduced
78.1    Sec. 6. Minnesota Statutes 2024, section 62J.84, subdivision 2, is amended to read:
78.2Subd. 2. Definitions. (a) For purposes of this section, the terms defined in this subdivision
78.3  have the meanings given.
78.4(b) "Biosimilar" means a drug that is produced or distributed pursuant to a biologics
78.5  license application approved under United States Code, title 42, section 262(K)(3).
78.6(c) "Brand name drug" means a drug that is produced or distributed pursuant to:
78.7(1) a new drug application approved under United States Code, title 21, section 355(c),
78.8  except for a generic drug as defined under Code of Federal Regulations, title 42, section
78.9  447.502; or
78.10(2) a biologics license application approved under United States Code, title 42, section
78.11 262(a)(c).
78.12(d) "Commissioner" means the commissioner of health.
78.13(e) "Generic drug" means a drug that is marketed or distributed pursuant to:
78.14(1) an abbreviated new drug application approved under United States Code, title 21,
78.15 section 355(j);
78.16(2) an authorized generic as defined under Code of Federal Regulations, title 42, section
78.17 447.502; or
78.18(3) a drug that entered the market the year before 1962 and was not originally marketed
78.19 under a new drug application.
78.20(f) "Manufacturer" means a drug manufacturer licensed under section 151.252.
78.21(g) "New prescription drug" or "new drug" means a prescription drug approved for
78.22 marketing by the United States Food and Drug Administration (FDA) for which no previous
78.23 wholesale acquisition cost has been established for comparison.
78.24(h) "Patient assistance program" means a program that a manufacturer offers to the public
78.25 in which a consumer may reduce the consumer's out-of-pocket costs for prescription drugs
78.26 by using coupons, discount cards, prepaid gift cards, manufacturer debit cards, or by other
78.27 means.
78.28(i) "Prescription drug" or "drug" has the meaning provided in section 151.441, subdivision
78.29 8.
78.30(j) "Price" means the wholesale acquisition cost as defined in United States Code, title
78.31 42, section 1395w-3a(c)(6)(B).
Article 2 Sec. 6.  78
06/07/25  REVISOR  DTT/LN  25-05697  as introduced
79.1      (k) "30-day supply" means the total daily dosage units of a prescription drug
79.2  recommended by the prescribing label approved by the FDA for 30 days. If the
79.3  FDA-approved prescribing label includes more than one recommended daily dosage, the
79.4  30-day supply is based on the maximum recommended daily dosage on the FDA-approved
79.5  prescribing label.
79.6      (l) "Course of treatment" means the total dosage of a single prescription for a prescription
79.7  drug recommended by the FDA-approved prescribing label. If the FDA-approved prescribing
79.8  label includes more than one recommended dosage for a single course of treatment, the
79.9  course of treatment is the maximum recommended dosage on the FDA-approved prescribing
79.10 label.
79.11     (m) "Drug product family" means a group of one or more prescription drugs that share
79.12 a unique generic drug description or nontrade name and dosage form.
79.13     (n) "Individual salable unit" means the smallest container of product introduced into
79.14 commerce by the manufacturer or repackager that is intended by the manufacturer or
79.15 repackager for individual sale to a dispenser.
79.16     (o) (n) "National drug code" means the three-segment code maintained by the federal
79.17 Food and Drug Administration that includes a labeler code, a product code, and a package
79.18 code for a drug product and that has been converted to an 11-digit format consisting of five
79.19 digits in the first segment, four digits in the second segment, and two digits in the third
79.20 segment. A three-segment code shall be considered converted to an 11-digit format when,
79.21 as necessary, at least one "0" has been added to the front of each segment containing less
79.22 than the specified number of digits such that each segment contains the specified number
79.23 of digits.
79.24     (p) (o) "Pharmacy" or "pharmacy provider" means a community/outpatient pharmacy
79.25 as defined in Minnesota Rules, part 6800.0100, subpart 2, that is also licensed as a pharmacy
79.26 by the Board of Pharmacy under section 151.19.
79.27     (q) (p) "Pharmacy benefit manager" or "PBM" means an entity licensed to act as a
79.28 pharmacy benefit manager under section 62W.03.
79.29     (r) (q) "Pricing unit" means the smallest dispensable amount of a prescription drug
79.30 product that could be dispensed or administered.
79.31     (s) (r) "Rebate" means a discount, chargeback, or other price concession that affects the
79.32 price of a prescription drug product, regardless of whether conferred through regular
79.33 aggregate payments, on a claim-by-claim basis at the point of sale, as part of retrospective
Article 2 Sec. 6.  79
06/07/25  REVISOR  DTT/LN  25-05697  as introduced
80.1  financial reconciliations, including reconciliations that also reflect other contractual
80.2  arrangements, or by any other method. "Rebate" does not mean a bona fide service fee as
80.3  defined in Code of Federal Regulations, title 42, section 447.502.
80.4      (t) (s) "Reporting entity" means any manufacturer, pharmacy, pharmacy benefit manager,
80.5  wholesale drug distributor, or any other entity required to submit data under this section.
80.6      (u) (t) "Wholesale drug distributor" or "wholesaler" means an entity that:
80.7      (1) is licensed to act as a wholesale drug distributor under section 151.47; and.
80.8      (2) distributes prescription drugs, for which it is not the manufacturer, to persons or
80.9  entities, or both, other than a consumer or patient in the state.
80.10   Sec. 7. Minnesota Statutes 2024, section 62J.84, subdivision 3, is amended to read:
80.11     Subd. 3. Prescription drug price increases reporting. (a) Beginning January 1, 2022,
80.12 a drug manufacturer must submit to the commissioner the information described in paragraph
80.13 (b) for each prescription drug for which the price was $100 or greater for a 30-day supply
80.14 or for a course of treatment lasting less than 30 days and:
80.15     (1) for brand name drugs where there is an increase of ten percent or greater in the price
80.16 over the previous 12-month period or an increase of 16 percent or greater in the price over
80.17 the previous 24-month period; and
80.18     (2) for generic or biosimilar drugs where there is an increase of 50 percent or greater in
80.19 the price over the previous 12-month period.
80.20     (b) For each of the drugs described in paragraph (a), the manufacturer shall submit to
80.21 the commissioner no later than 60 days after the price increase goes into effect, in the form
80.22 and manner prescribed by the commissioner, the following information, if applicable:
80.23     (1) the description and price of the drug and the net increase, expressed as a percentage,
80.24 with the following listed separately:
80.25     (i) the national drug code;
80.26     (ii) the product name;
80.27     (iii) the dosage form;
80.28     (iv) the strength; and
80.29     (v) the package size;
80.30     (2) the factors that contributed to the price increase;
Article 2 Sec. 7.  80
06/07/25  REVISOR  DTT/LN  25-05697  as introduced
81.1      (3) the name of any generic version of the prescription drug available on the market;
81.2      (4) the year the prescription drug was introduced for sale in the United States;
81.3      (4) (5) the introductory price of the prescription drug when it was introduced for sale in
81.4  the United States and the price of the drug on the last day of each of the five calendar years
81.5  preceding the price increase;
81.6      (5) (6) the direct costs incurred during the previous 12-month period by the manufacturer
81.7  that are associated with the prescription drug, listed separately:
81.8      (i) to manufacture the prescription drug;
81.9      (ii) to market the prescription drug, including advertising costs; and
81.10     (iii) to distribute the prescription drug;
81.11     (7) the number of units of the prescription drug sold during the previous 12-month period;
81.12     (6) (8) the total sales revenue for the prescription drug during the previous 12-month
81.13 period;
81.14     (9) the total rebate payable amount accrued for the prescription drug during the previous
81.15 12-month period;
81.16     (7) (10) the manufacturer's net profit attributable to the prescription drug during the
81.17 previous 12-month period;
81.18     (8) (11) the total amount of financial assistance the manufacturer has provided through
81.19 patient prescription assistance programs during the previous 12-month period, if applicable;
81.20     (9) (12) any agreement between a manufacturer and another entity contingent upon any
81.21 delay in offering to market a generic version of the prescription drug;
81.22     (10) (13) the patent expiration date of the prescription drug if it is under patent;
81.23     (11) (14) the name and location of the company that manufactured the drug;
81.24     (12) (15) if a brand name prescription drug, the highest price paid for the prescription
81.25 drug during the previous calendar year in the ten countries, excluding the United States,
81.26 that charged the highest single price for the prescription drug; and
81.27     (13) (16) if the prescription drug was acquired by the manufacturer during the previous
81.28 12-month period, all of the following information:
81.29     (i) price at acquisition;
81.30     (ii) price in the calendar year prior to acquisition;
Article 2 Sec. 7.  81
06/07/25  REVISOR  DTT/LN  25-05697  as introduced
82.1      (iii) name of the company from which the drug was acquired;
82.2      (iv) date of acquisition; and
82.3      (v) acquisition price.
82.4      (c) The manufacturer may submit any documentation necessary to support the information
82.5  reported under this subdivision.
82.6    Sec. 8. Minnesota Statutes 2024, section 62J.84, subdivision 6, is amended to read:
82.7      Subd. 6. Public posting of prescription drug price information. (a) The commissioner
82.8  shall post on the department's website, or may contract with a private entity or consortium
82.9  that satisfies the standards of section 62U.04, subdivision 6, to meet this requirement, the
82.10 following information:
82.11     (1) a list of the prescription drugs reported under subdivisions 3, 4, and 11 to 14 and the
82.12 manufacturers of those prescription drugs; and
82.13     (2) a list of reporting entities that reported prescription drug price information under
82.14 subdivisions 3, 4, and 11 to 14; and
82.15     (2) (3) information reported to the commissioner under subdivisions 3, 4, and 11 to 14,
82.16 aggregated on a per-drug basis in a manner that does not allow the identification of a reporting
82.17 entity that is not the manufacturer of the drug.
82.18     (b) The information must be published in an easy-to-read format and in a manner that
82.19 identifies the information that is disclosed on a per-drug basis and must not be aggregated
82.20 in a manner that prevents the identification of the prescription drug.
82.21     (c) The commissioner shall not post to the department's website or a private entity
82.22 contracting with the commissioner shall not post any information described in this section
82.23 if the information is not public data under section 13.02, subdivision 8a; or is trade secret
82.24 information under section 13.37, subdivision 1, paragraph (b); or is trade secret information
82.25 pursuant to the Defend Trade Secrets Act of 2016, United States Code, title 18, section
82.26 1836, as amended. If a reporting entity believes information should be withheld from public
82.27 disclosure pursuant to this paragraph, the reporting entity must clearly and specifically
82.28 identify that information and describe the legal basis in writing when the reporting entity
82.29 submits the information under this section. If the commissioner disagrees with the reporting
82.30 entity's request to withhold information from public disclosure, the commissioner shall
82.31 provide the reporting entity written notice that the information will be publicly posted 30
82.32 days after the date of the notice.
Article 2 Sec. 8.  82
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83.1      (d) If the commissioner withholds any information from public disclosure pursuant to
83.2  this subdivision, the commissioner shall post to the department's website a report describing
83.3  the nature of the information and the commissioner's basis for withholding the information
83.4  from disclosure.
83.5      (e) To the extent the information required to be posted under this subdivision is collected
83.6  and made available to the public by another state, by the University of Minnesota, or through
83.7  an online drug pricing reference and analytical tool, the commissioner may reference the
83.8  availability of this drug price data from another source including, within existing
83.9  appropriations, creating the ability of the public to access the data from the source for
83.10 purposes of meeting the reporting requirements of this subdivision.
83.11   Sec. 9. Minnesota Statutes 2024, section 62J.84, subdivision 10, is amended to read:
83.12     Subd. 10. Notice of prescription drugs of substantial public interest. (a) No later than
83.13 January 31, 2024, and quarterly thereafter, the commissioner shall produce and post on the
83.14 department's website a list of prescription drugs that the commissioner determines to represent
83.15 a substantial public interest and for which the commissioner intends to request data under
83.16 subdivisions 11 to 14, subject to paragraph (c). The commissioner shall base its inclusion
83.17 of prescription drugs on any information the commissioner determines is relevant to providing
83.18 greater consumer awareness of the factors contributing to the cost of prescription drugs in
83.19 the state, and the commissioner shall consider drug product families that include prescription
83.20 drugs:
83.21     (1) that triggered reporting under subdivision 3 or 4 during the previous calendar quarter;
83.22     (2) for which average claims paid amounts exceeded 125 percent of the price as of the
83.23 claim incurred date during the most recent calendar quarter for which claims paid amounts
83.24 are available; or
83.25     (3) that are identified by members of the public during a public comment process.
83.26     (b) Not sooner than 30 days after publicly posting the list of prescription drugs under
83.27 paragraph (a), the department shall notify, via email, reporting entities registered with the
83.28 department of:
83.29     (1) the requirement to report under subdivisions 11 to 14.; and
83.30     (2) the reporting period for which data must be provided.
83.31     (c) The commissioner must not designate more than 500 prescription drugs as having a
83.32 substantial public interest in any one notice.
Article 2 Sec. 9.  83
06/07/25  REVISOR  DTT/LN  25-05697  as introduced
84.1      (d) Notwithstanding subdivision 16, the commissioner is exempt from chapter 14,
84.2  including section 14.386, in implementing this subdivision.
84.3      EFFECTIVE DATE. This section is effective the day following final enactment.
84.4    Sec. 10. Minnesota Statutes 2024, section 62J.84, subdivision 11, is amended to read:
84.5      Subd. 11. Manufacturer prescription drug substantial public interest reporting. (a)
84.6  Beginning January 1, 2024, a manufacturer must submit to the commissioner the information
84.7  described in paragraph (b) for any prescription drug:
84.8      (1) included in a notification to report issued to the manufacturer by the department
84.9  under subdivision 10;
84.10     (2) which the manufacturer manufactures or repackages;
84.11     (3) for which the manufacturer sets the wholesale acquisition cost; and
84.12     (4) for which the manufacturer has not submitted data under subdivision 3 during the
84.13 120-day period prior to the date of the notification to report.
84.14     (b) For each of the drugs described in paragraph (a), the manufacturer shall submit to
84.15 the commissioner no later than 60 days after the date of the notification to report, in the
84.16 form and manner prescribed by the commissioner, the following information, if applicable:
84.17     (1) a description of the drug with the following listed separately:
84.18     (i) the national drug code;
84.19     (ii) the product name;
84.20     (iii) the dosage form;
84.21     (iv) the strength; and
84.22     (v) the package size;
84.23     (2) the price of the drug product on the later of:
84.24     (i) the day one year prior to the date of the notification to report;
84.25     (ii) the introduced to market date; or
84.26     (iii) the acquisition date;
84.27     (3) the price of the drug product on the date of the notification to report;
84.28     (4) the year the prescription drug was introduced for sale in the United States;
Article 2 Sec. 10.  84
06/07/25  REVISOR  DTT/LN  25-05697  as introduced
85.1      (4) (5) the introductory price of the prescription drug when it was introduced for sale in
85.2  the United States and the price of the drug on the last day of each of the five calendar years
85.3  preceding the date of the notification to report;
85.4      (5) (6) the direct costs incurred during the 12-month period prior to the date of reporting
85.5  period specified in the notification to report by the manufacturers that are associated with
85.6  the prescription drug, listed separately:
85.7      (i) to manufacture the prescription drug;
85.8      (ii) to market the prescription drug, including advertising costs; and
85.9      (iii) to distribute the prescription drug;
85.10     (6) (7) the number of units of the prescription drug sold during the 12-month period
85.11 prior to the date of reporting period specified in the notification to report;
85.12     (7) (8) the total sales revenue for the prescription drug during the 12-month period prior
85.13 to the date of reporting period specified in the notification to report;
85.14     (8) (9) the total rebate payable amount accrued for the prescription drug during the
85.15 12-month period prior to the date of reporting period specified in the notification to report;
85.16     (9) (10) the manufacturer's net profit attributable to the prescription drug during the
85.17 12-month period prior to the date of reporting period specified in the notification to report;
85.18     (10) (11) the total amount of financial assistance the manufacturer has provided through
85.19 patient prescription assistance programs during the 12-month period prior to the date of
85.20 reporting period specified in the notification to report, if applicable;
85.21     (11) (12) any agreement between a manufacturer and another entity contingent upon
85.22 any delay in offering to market a generic version of the prescription drug;
85.23     (12) (13) the patent expiration date of the prescription drug if the prescription drug is
85.24 under patent;
85.25     (13) (14) the name and location of the company that manufactured the drug;
85.26     (14) (15) if the prescription drug is a brand name prescription drug, the ten countries
85.27 other than the United States that paid the highest prices for the prescription drug during the
85.28 previous calendar year and their prices; and
85.29     (15) (16) if the prescription drug was acquired by the manufacturer within a 12-month
85.30 period prior to the date of the reporting period specified in the notification to report, all of
85.31 the following information:
Article 2 Sec. 10.  85
06/07/25  REVISOR  DTT/LN  25-05697  as introduced
86.1      (i) the price at acquisition;
86.2      (ii) the price in the calendar year prior to acquisition;
86.3      (iii) the name of the company from which the drug was acquired;
86.4      (iv) the date of acquisition; and
86.5      (v) the acquisition price.
86.6      (c) The manufacturer may submit any documentation necessary to support the information
86.7  reported under this subdivision.
86.8    Sec. 11. Minnesota Statutes 2024, section 62J.84, subdivision 12, is amended to read:
86.9      Subd. 12. Pharmacy prescription drug substantial public interest reporting. (a)
86.10 Beginning January 1, 2024, a pharmacy must submit to the commissioner the information
86.11 described in paragraph (b) for any prescription drug:
86.12     (1) included in a notification to report issued to the pharmacy by the department under
86.13 subdivision 10.; and
86.14     (2) that the pharmacy dispensed in Minnesota or mailed to a Minnesota address.
86.15     (b) For each of the drugs described in paragraph (a), the pharmacy shall submit to the
86.16 commissioner no later than 60 days after the date of the notification to report, in the form
86.17 and manner prescribed by the commissioner, the following information, if applicable:
86.18     (1) a description of the drug with the following listed separately:
86.19     (i) the national drug code;
86.20     (ii) the product name;
86.21     (iii) the dosage form;
86.22     (iv) the strength; and
86.23     (v) the package size;
86.24     (2) the number of units of the drug acquired during the 12-month period prior to the date
86.25 of reporting period specified in the notification to report;
86.26     (3) the total spent before rebates by the pharmacy to acquire the drug during the 12-month
86.27 period prior to the date of reporting period specified in the notification to report;
86.28     (4) the total rebate receivable amount accrued by the pharmacy for the drug during the
86.29 12-month period prior to the date of reporting period specified in the notification to report;
Article 2 Sec. 11.  86
06/07/25  REVISOR        DTT/LN  25-05697  as introduced
87.1      (5) the number of pricing units of the drug dispensed by the pharmacy during the
87.2  12-month period prior to the date of reporting period specified in the notification to report;
87.3      (6) the total payment receivable by the pharmacy for dispensing the drug including
87.4  ingredient cost, dispensing fee, and administrative fees during the 12-month period prior
87.5  to the date of reporting period specified in the notification to report;
87.6      (7) the total rebate payable amount accrued by the pharmacy for the drug during the
87.7  12-month period prior to the date of reporting period specified in the notification to report;
87.8  and
87.9      (8) the average cash price paid by consumers per pricing unit for prescriptions dispensed
87.10 where no claim was submitted to a health care service plan or health insurer during the
87.11 12-month period prior to the date of reporting period specified in the notification to report.
87.12     (c) The pharmacy may submit any documentation necessary to support the information
87.13 reported under this subdivision.
87.14     (d) The commissioner may grant extensions, exemptions, or both to compliance with
87.15 the requirements of paragraphs (a) and (b) by small or independent pharmacies, if compliance
87.16 with paragraphs (a) and (b) would represent a hardship or undue burden to the pharmacy.
87.17 The commissioner may establish procedures for small or independent pharmacies to request
87.18 extensions or exemptions under this paragraph.
87.19   Sec. 12. Minnesota Statutes 2024, section 62J.84, subdivision 13, is amended to read:
87.20     Subd. 13. PBM prescription drug substantial public interest reporting. (a) Beginning
87.21 January 1, 2024, a PBM must submit to the commissioner the information described in
87.22 paragraph (b) for any prescription drug:
87.23     (1) included in a notification to report issued to the PBM by the department under
87.24 subdivision 10.; and
87.25     (2) for which the PBM fulfilled pharmacy benefit management duties for Minnesota
87.26 residents.
87.27     (b) For each of the drugs described in paragraph (a), the PBM shall submit to the
87.28 commissioner no later than 60 days after the date of the notification to report, in the form
87.29 and manner prescribed by the commissioner, the following information, if applicable:
87.30     (1) a description of the drug with the following listed separately:
87.31     (i) the national drug code;
Article 2 Sec. 12.  87
06/07/25  REVISOR        DTT/LN  25-05697  as introduced
88.1      (ii) the product name;
88.2      (iii) the dosage form;
88.3      (iv) the strength; and
88.4      (v) the package size;
88.5      (2) the number of pricing units of the drug product filled for which the PBM administered
88.6  claims during the 12-month period prior to the date of reporting period specified in the
88.7  notification to report;
88.8      (3) the total reimbursement amount accrued and payable to pharmacies for pricing units
88.9  of the drug product filled for which the PBM administered claims during the 12-month
88.10 period prior to the date of reporting period specified in the notification to report;
88.11     (4) the total reimbursement or administrative fee amount, or both, accrued and receivable
88.12 from payers for pricing units of the drug product filled for which the PBM administered
88.13 claims during the 12-month period prior to the date of reporting period specified in the
88.14 notification to report;
88.15     (5) the total administrative fee amount accrued and receivable from payers for pricing
88.16 units of the drug product filled during the reporting period specified in the notification to
88.17 report;
88.18     (5) (6) the total rebate receivable amount accrued by the PBM for the drug product
88.19 during the 12-month period prior to the date of reporting period specified in the notification
88.20 to report; and
88.21     (6) (7) the total rebate payable amount accrued by the PBM for the drug product during
88.22 the 12-month period prior to the date of reporting period specified in the notification to
88.23 report.
88.24     (c) The PBM may submit any documentation necessary to support the information
88.25 reported under this subdivision.
88.26   Sec. 13. Minnesota Statutes 2024, section 62J.84, subdivision 14, is amended to read:
88.27     Subd. 14. Wholesale drug distributor prescription drug substantial public interest
88.28 reporting. (a) Beginning January 1, 2024, a wholesale drug distributor that distributes
88.29 prescription drugs, for which it is not the manufacturer, to persons or entities, or both, other
88.30 than a consumer or patient in the state, must submit to the commissioner the information
88.31 described in paragraph (b) for any prescription drug:
Article 2 Sec. 13.  88
06/07/25  REVISOR        DTT/LN  25-05697  as introduced
89.1      (1) included in a notification to report issued to the wholesale drug distributor by the
89.2  department under subdivision 10.; and
89.3      (2) that the wholesale drug distributor distributed within or into Minnesota.
89.4      (b) For each of the drugs described in paragraph (a), the wholesale drug distributor shall
89.5  submit to the commissioner no later than 60 days after the date of the notification to report,
89.6  in the form and manner prescribed by the commissioner, the following information, if
89.7  applicable:
89.8      (1) a description of the drug with the following listed separately:
89.9      (i) the national drug code;
89.10     (ii) the product name;
89.11     (iii) the dosage form;
89.12     (iv) the strength; and
89.13     (v) the package size;
89.14     (2) the number of units of the drug product acquired by the wholesale drug distributor
89.15 during the 12-month period prior to the date of reporting period specified in the notification
89.16 to report;
89.17     (3) the total spent before rebates by the wholesale drug distributor to acquire the drug
89.18 product during the 12-month period prior to the date of reporting period specified in the
89.19 notification to report;
89.20     (4) the total rebate receivable amount accrued by the wholesale drug distributor for the
89.21 drug product during the 12-month period prior to the date of reporting period specified in
89.22 the notification to report;
89.23     (5) the number of units of the drug product sold by the wholesale drug distributor during
89.24 the 12-month period prior to the date of reporting period specified in the notification to
89.25 report;
89.26     (6) gross revenue from sales in the United States generated by the wholesale drug
89.27 distributor for this the drug product during the 12-month period prior to the date of reporting
89.28 period specified in the notification to report; and
89.29     (7) total rebate payable amount accrued by the wholesale drug distributor for the drug
89.30 product during the 12-month period prior to the date of reporting period specified in the
89.31 notification to report.
Article 2 Sec. 13.  89
06/07/25  REVISOR  DTT/LN  25-05697  as introduced
90.1      (c) The wholesale drug distributor may submit any documentation necessary to support
90.2  the information reported under this subdivision.
90.3    Sec. 14. Minnesota Statutes 2024, section 62J.84, subdivision 15, is amended to read:
90.4      Subd. 15. Registration requirements. Beginning January 1, 2024, A reporting entity
90.5  subject to this chapter shall register, or update existing registration information, with the
90.6  department in a form and manner prescribed by the commissioner by January 30 each year.
90.7      EFFECTIVE DATE. This section is effective January 1, 2026.
90.8    Sec. 15. Minnesota Statutes 2024, section 62K.10, subdivision 2, is amended to read:
90.9      Subd. 2. Primary care; mental health services; general hospital services Time and
90.10 distance standards. The maximum travel distance or time shall be the lesser of 30 miles
90.11 or 30 minutes to the nearest provider of each of the following services: primary care services,
90.12 mental health services, and general hospital services Health carriers must meet the time and
90.13 distance standards under Code of Federal Regulations, title 45, section 155.1050.
90.14   Sec. 16. Minnesota Statutes 2024, section 62K.10, subdivision 5, is amended to read:
90.15     Subd. 5. Waiver. (a) A health carrier may apply to the commissioner of health for a
90.16 waiver of the requirements in subdivision 2 or 3 if it is unable to meet the statutory
90.17 requirements. A waiver application must be submitted on a form provided by the
90.18 commissioner, must be accompanied by an application fee of $500 for each application to
90.19 waive the requirements in subdivision 2 or 3 for one or more provider types per county, and
90.20 must:
90.21     (1) demonstrate with specific data that the requirement of subdivision 2 or 3 is not
90.22 feasible in a particular service area or part of a service area; and
90.23     (2) include specific information as to the steps that were and will be taken to address
90.24 the network inadequacy, and, for steps that will be taken prospectively to address network
90.25 inadequacy, the time frame within which those steps will be taken.
90.26     (b) The commissioner shall establish guidelines for evaluating waiver applications,
90.27 standards governing approval or denial of a waiver application, and standards for steps that
90.28 health carriers must take to address the network inadequacy and allow the health carrier to
90.29 meet network adequacy requirements within a reasonable time period. The commissioner
90.30 shall review each waiver application using these guidelines and standards and shall approve
90.31 a waiver application only if:
Article 2 Sec. 16.  90
06/07/25  REVISOR  DTT/LN  25-05697  as introduced
91.1      (1) the standards for approval established by the commissioner are satisfied; and
91.2      (2) the steps that were and will be taken to address the network inadequacy and the time
91.3  frame for taking these steps satisfy the standards established by the commissioner.
91.4      (c) If, in its waiver application, a health carrier demonstrates to the commissioner that
91.5  there are no providers of a specific type or specialty in a county, the commissioner may
91.6  approve a waiver in which the health carrier is allowed to address network inadequacy in
91.7  that county by providing for patient access to providers of that type or specialty via telehealth,
91.8  as defined in section 62A.673, subdivision 2.
91.9      (d) The waiver shall automatically expire after one year. Upon or prior to expiration of
91.10 a waiver, a health carrier unable to meet the requirements in subdivision 2 or 3 must submit
91.11 a new waiver application under paragraph (a) and must also submit evidence of steps the
91.12 carrier took to address the network inadequacy. When the commissioner reviews a waiver
91.13 application for a network adequacy requirement which has been waived for the carrier for
91.14 the most recent one-year period, the commissioner shall also examine the steps the carrier
91.15 took during that one-year period to address network inadequacy, and shall only approve a
91.16 subsequent waiver application that satisfies the requirements in paragraph (b), demonstrates
91.17 that the carrier took the steps it proposed to address network inadequacy, and explains why
91.18 the carrier continues to be unable to satisfy the requirements in subdivision 2 or 3.
91.19     (e) Application fees collected under this subdivision shall be deposited in the state
91.20 government special revenue fund in the state treasury.
91.21   Sec. 17. Minnesota Statutes 2024, section 62K.10, subdivision 6, is amended to read:
91.22     Subd. 6. Referral centers. Subdivisions Subdivision 2 and 3 shall not apply if an enrollee
91.23 is referred to a referral center for health care services. A referral center is a medical facility
91.24 that provides highly specialized medical care, including but not limited to organ transplants.
91.25 A health carrier or preferred provider organization may consider the volume of services
91.26 provided annually, case mix, and severity adjusted mortality and morbidity rates in
91.27 designating a referral center.
91.28   Sec. 18. Minnesota Statutes 2024, section 103I.005, subdivision 17b, is amended to read:
91.29     Subd. 17b. Temporary boring. "Temporary boring" means an excavation that is 15
91.30 feet or more in depth, is sealed within 72 hours of the time of construction, and is drilled,
91.31 cored, washed, driven, dug, jetted, or otherwise constructed to:
Article 2 Sec. 18.  91
06/07/25  REVISOR        DTT/LN  25-05697  as introduced
92.1      (1) conduct physical, chemical, or biological testing of groundwater, including
92.2  groundwater quality monitoring;
92.3      (2) monitor or measure physical, chemical, radiological, or biological parameters of
92.4  earth materials or earth fluids, including hydraulic conductivity, bearing capacity, or
92.5  resistance;
92.6      (3) measure groundwater levels, including use of a piezometer; and or
92.7      (4) determine groundwater flow direction or velocity.
92.8    Sec. 19. Minnesota Statutes 2024, section 103I.101, subdivision 2, is amended to read:
92.9      Subd. 2. Duties. The commissioner shall:
92.10     (1) regulate the drilling, construction, modification, repair, and sealing of wells and
92.11 borings;
92.12     (2) examine and license:
92.13     (i) well contractors;
92.14     (ii) persons constructing, repairing, and sealing bored geothermal heat exchangers;
92.15     (iii) persons modifying or repairing well casings above the pitless unit or adaptor, well
92.16 screens, well diameters, and installing well pumps or pumping equipment;
92.17     (iv) persons constructing, repairing, and sealing dewatering wells;
92.18     (v) persons sealing wells or borings; and
92.19     (vi) persons excavating or drilling holes for the installation of elevator borings; and
92.20     (vii) persons installing, removing, or maintaining groundwater thermal exchange devices
92.21 and submerged closed loop heat exchangers;
92.22     (3) examine and license environmental well contractors;
92.23     (4) license explorers engaged in exploratory boring and examine individuals who
92.24 supervise or oversee exploratory boring;
92.25     (5) after consultation with the commissioner of natural resources and the Pollution
92.26 Control Agency, establish standards for the design, location, construction, repair, and sealing
92.27 of wells and borings within the state; and
92.28     (6) issue permits for wells, groundwater thermal devices, bored geothermal heat
92.29 exchangers, installation of submerged closed loop heat exchanger systems, and elevator
92.30 borings.
Article 2 Sec. 19.  92
06/07/25  REVISOR  DTT/LN  25-05697  as introduced
93.1    Sec. 20. Minnesota Statutes 2024, section 103I.101, subdivision 5, is amended to read:
93.2      Subd. 5. Commissioner to adopt rules. The commissioner shall adopt rules including:
93.3      (1) issuance of licenses for:
93.4      (i) qualified well contractors;
93.5      (ii) persons constructing, repairing, and sealing dewatering wells;
93.6      (iii) persons sealing wells or borings;
93.7      (iv) persons installing, modifying, or repairing well casings, well screens, well diameters,
93.8  and well pumps or pumping equipment;
93.9      (v) persons constructing, repairing, and sealing bored geothermal heat exchangers;
93.10     (vi) persons constructing, repairing, and sealing elevator borings; and
93.11     (vii) persons constructing, repairing, and sealing environmental wells; and
93.12     (viii) persons installing, removing, or maintaining groundwater thermal exchange devices
93.13 and submerged closed loop heat exchangers;
93.14     (2) establishment of conditions for examination and review of applications for license
93.15 and certification;
93.16     (3) establishment of conditions for revocation and suspension of license and certification;
93.17     (4) establishment of minimum standards for design, location, construction, repair, and
93.18 sealing of wells and borings to implement the purpose and intent of this chapter;
93.19     (5) establishment of a system for reporting on wells and borings drilled and sealed;
93.20     (6) establishment of standards for the construction, maintenance, sealing, and water
93.21 quality monitoring of wells in areas of known or suspected contamination;
93.22     (7) establishment of wellhead protection measures for wells serving public water supplies;
93.23     (8) establishment of procedures to coordinate collection of well and boring data with
93.24 other state and local governmental agencies;
93.25     (9) establishment of criteria and procedures for submission of well and boring logs,
93.26 formation samples or well or boring cuttings, water samples, or other special information
93.27 required for and water resource mapping; and
93.28     (10) establishment of minimum standards for design, location, construction, maintenance,
93.29 repair, sealing, safety, and resource conservation related to borings, including exploratory
93.30 borings as defined in section 103I.005, subdivision 9.
Article 2 Sec. 20.  93
06/07/25  REVISOR        DTT/LN  25-05697  as introduced
94.1    Sec. 21. Minnesota Statutes 2024, section 103I.101, is amended by adding a subdivision
94.2  to read:
94.3      Subd. 7. Inspection. At a minimum, the commissioner of health shall inspect at least
94.4  25 percent of well construction notifications each year under this section.
94.5    Sec. 22. Minnesota Statutes 2024, section 138.912, subdivision 1, is amended to read:
94.6      Subdivision 1. Establishment. The healthy eating, here at home program is established
94.7  to provide incentives for low-income Minnesotans to use federal Supplemental Nutrition
94.8  Assistance Program (SNAP) or SUN bucks (Summer EBT) benefits for healthy purchases
94.9  at Minnesota-based farmers' markets, mobile markets, and direct-farmer sales, including
94.10 community-supported agriculture shares.
94.11   Sec. 23. Minnesota Statutes 2024, section 138.912, subdivision 2, is amended to read:
94.12     Subd. 2. Definitions. (a) The definitions in this subdivision apply to this section.
94.13     (b) "Healthy eating, here at home" means a program administered by the Minnesota
94.14 Humanities Center Department of Health to provide incentives for low-income Minnesotans
94.15 to use SNAP or SUN bucks (Summer EBT) benefits for healthy purchases at Minnesota-based
94.16 farmers' markets.
94.17     (c) "Healthy purchases" means SNAP-eligible foods.
94.18     (d) "Minnesota-based farmers' market" means a physical market as defined in section
94.19 28A.151, subdivision 1, paragraph (b), and also includes mobile markets and direct-farmer
94.20 sales, including through a community-supported agriculture model.
94.21     (e) "Voucher" means a physical or electronic credit.
94.22     (f) "Eligible household" means an individual or family that is determined to be a recipient
94.23 of SNAP or SUN bucks (Summer EBT).
94.24   Sec. 24. Minnesota Statutes 2024, section 138.912, subdivision 3, is amended to read:
94.25     Subd. 3. Grants. The Minnesota Humanities Center commissioner shall allocate grant
94.26 funds to nonprofit organizations that work with Minnesota-based farmers' markets to provide
94.27 up to $10 vouchers to SNAP or SUN bucks (Summer EBT) participants who use electronic
94.28 benefits transfer (EBT) cards for healthy purchases. Funds may also be provided for vouchers
94.29 distributed through nonprofit organizations engaged in healthy cooking and food education
94.30 outreach to eligible households for use at farmers' markets. Funds appropriated under this
94.31 section may not be used for healthy cooking classes or food education outreach. When
Article 2 Sec. 24.  94
06/07/25  REVISOR        DTT/LN  25-05697  as introduced
95.1  awarding grants, the Minnesota Humanities Center commissioner must consider how the
95.2  nonprofit organizations will achieve geographic balance, including specific efforts to reach
95.3  eligible households across the state, and the organizations' capacity to manage the
95.4  programming and outreach.
95.5    Sec. 25. Minnesota Statutes 2024, section 138.912, subdivision 4, is amended to read:
95.6      Subd. 4. Household eligibility; participation. To be eligible for a healthy eating, here
95.7  at home voucher, an eligible household must meet the Minnesota SNAP or SUN bucks
95.8  (Summer EBT) eligibility requirements under section 142F.10.
95.9    Sec. 26. Minnesota Statutes 2024, section 138.912, subdivision 6, is amended to read:
95.10     Subd. 6. Program reporting. The nonprofit organizations that receive grant funds must
95.11 report annually to the Minnesota Humanities Center commissioner with information regarding
95.12 the operation of the program, including the number of vouchers issued and the number of
95.13 people served. To the extent practicable, the nonprofit organizations must report on the
95.14 usage of the vouchers and evaluate the program's effectiveness.
95.15   Sec. 27. Minnesota Statutes 2024, section 144.50, is amended by adding a subdivision to
95.16 read:
95.17     Subd. 8. Controlling person. (a) "Controlling person" includes the following individuals,
95.18 if applicable, as deemed appropriate by the hospital:
95.19     (1) any officer of the organization;
95.20     (2) any hospital administrator; and
95.21     (3) any managerial official.
95.22     (b) Controlling person does not include:
95.23     (1) a bank, savings bank, trust company, savings association, credit union, industrial
95.24 loan and thrift company, investment banking firm, or insurance company, unless the entity
95.25 directly or through a subsidiary operates a hospital;
95.26     (2) government and government-sponsored entities such as the United States Department
95.27 of Housing and Urban Development, Ginnie Mae, Fannie Mae, Freddie Mac, and the
95.28 Minnesota Housing Finance Agency which provide loans, financing, and insurance products
95.29 for housing sites;
Article 2 Sec. 27.  95
06/07/25  REVISOR  DTT/LN  25-05697  as introduced
96.1      (3) an individual who is a state or federal official, a state or federal employee, or a
96.2  member or employee of the governing body of a political subdivision of the state or federal
96.3  government that operates one or more hospitals, unless the individual is also an officer,
96.4  owner, or managerial official of the hospital; receives any remuneration from a hospital; or
96.5  is a controlling person not otherwise excluded in this subdivision;
96.6      (4) a natural person who is a member of a tax-exempt organization under section 290.05,
96.7  subdivision 2, unless the individual is also a controlling person not otherwise excluded in
96.8  this subdivision; and
96.9      (5) a natural person who owns less than five percent of the outstanding common shares
96.10 of a corporation:
96.11     (i) whose securities are exempt by virtue of section 80A.45, clause (6); or
96.12     (ii) whose transactions are exempt by virtue of section 80A.46, clause (7).
96.13   Sec. 28. Minnesota Statutes 2024, section 144.555, subdivision 1a, is amended to read:
96.14     Subd. 1a. Notice of closing, curtailing operations, relocating services, or ceasing to
96.15 offer certain services; hospitals. (a) The controlling persons of a hospital licensed under
96.16 sections 144.50 to 144.56 or a hospital campus must notify the commissioner of health, the
96.17 public, and others at least 182 days before the hospital or hospital campus voluntarily plans
96.18 to implement one of the scheduled actions listed in paragraph (b), unless the controlling
96.19 persons can demonstrate to the commissioner that meeting the advanced notice requirement
96.20 is not feasible and the commissioner approves a shorter advanced notice.
96.21     (b) The following scheduled actions require advanced notice under paragraph (a):
96.22     (1) ceasing operations;
96.23     (2) curtailing operations to the extent that emergency department services or patients
96.24 receiving inpatient health services must be relocated;
96.25     (3) relocating the provision of inpatient health services or emergency department services
96.26 to another hospital or another hospital campus; or
96.27     (4) ceasing to offer inpatient maternity care and inpatient newborn care services, inpatient
96.28 intensive care unit services, inpatient mental health services, or inpatient substance use
96.29 disorder treatment services.
96.30     (c) A notice required under this subdivision must comply with the requirements in
96.31 subdivision 1d.
Article 2 Sec. 28.  96
06/07/25  REVISOR  DTT/LN  25-05697  as introduced
97.1      (d) The commissioner shall cooperate with the controlling persons and advise them
97.2  about relocating the patients.
97.3      (e) For purposes of this subdivision, "inpatient" means services that are provided to a
97.4  person who has been admitted to a hospital for bed occupancy.
97.5    Sec. 29. Minnesota Statutes 2024, section 144.555, subdivision 1b, is amended to read:
97.6      Subd. 1b. Public hearing. Within 30 days after receiving notice under subdivision 1a,
97.7  the commissioner shall conduct a public hearing on the scheduled cessation of operations,
97.8  curtailment of operations, relocation of health services, or cessation in offering health
97.9  services. The commissioner must provide adequate public notice of the hearing in a time
97.10 and manner determined by the commissioner. The commissioner must ensure that video
97.11 conferencing technology is used at the public hearing to allow members of the public to
97.12 view and participate in the hearing. The controlling persons of the hospital or hospital
97.13 campus must participate in the public hearing. The public hearing must be held at a location
97.14 that is within ten miles of the hospital or hospital campus or with the commissioner's approval
97.15 as close as is practicable, that can accommodate the hearing's anticipated public attendance,
97.16 and that is provided or arranged by the hospital or hospital campus. Video conferencing
97.17 technology must be used to allow members of the public to view and participate in the
97.18 hearing. The public hearing must include:
97.19     (1) an explanation by the controlling persons of the reasons for ceasing or curtailing
97.20 operations, relocating health services, or ceasing to offer any of the listed health services;
97.21     (2) a description of the actions that controlling persons will take to ensure that residents
97.22 in the hospital's or campus's service area have continued access to the health services being
97.23 eliminated, curtailed, or relocated;
97.24     (3) an opportunity for at least one hour of public testimony on the scheduled cessation
97.25 or curtailment of operations, relocation of health services, or cessation in offering any of
97.26 the listed health services, and on the hospital's or campus's plan to ensure continued access
97.27 to those health services being eliminated, curtailed, or relocated; and
97.28     (4) an opportunity for the controlling persons to respond to questions from interested
97.29 persons.
Article 2 Sec. 29.  97
06/07/25  REVISOR        DTT/LN  25-05697  as introduced
98.1    Sec. 30. [144.6584] INFORMED CONSENT REQUIRED FOR SENSITIVE
98.2  EXAMINATIONS.
98.3      Subdivision 1. Definition. For purposes of this section, "sensitive examination" means
98.4  a pelvic, breast, urogenital, or rectal examination.
98.5      Subd. 2. Informed consent required; exceptions. A health professional, or a student
98.6  or resident participating in a course of instruction, clinical training, or a residency program
98.7  for a health profession, must not perform a sensitive examination on an anesthetized or
98.8  unconscious patient unless:
98.9      (1) the patient or the patient's legally authorized representative provided prior written,
98.10 informed consent to the sensitive examination for preventive, diagnostic, or treatment
98.11 purposes;
98.12     (2) the patient or the patient's legally authorized representative provided prior written,
98.13 informed consent to the sensitive examination being performed solely for educational or
98.14 training purposes;
98.15     (3) the patient or the patient's legally authorized representative provided prior written,
98.16 informed consent to a surgical procedure or diagnostic examination and the sensitive
98.17 examination is related to that surgical procedure or diagnostic examination and is medically
98.18 necessary;
98.19     (4) the patient is unconscious and incapable of providing informed consent and the
98.20 sensitive examination is medically necessary for diagnostic or treatment purposes; or
98.21     (5) the sensitive examination is performed by a health professional qualified to perform
98.22 the examination and is performed for purposes of collecting evidence or documenting
98.23 injuries.
98.24     Subd. 3. Ground for disciplinary action. A person who violates this section is subject
98.25 to disciplinary action by the health-related licensing board regulating the person.
98.26   Sec. 31. Minnesota Statutes 2024, section 145.987, subdivision 1, is amended to read:
98.27     Subdivision 1. Establishment; composition of advisory council. The health equity
98.28 advisory and leadership (HEAL) council consists of 18 members appointed by the
98.29 commissioner of health, including but not limited to members who will provide representation
98.30 from the following groups:
98.31     (1) African American and African heritage communities;
98.32     (2) Asian American and Pacific Islander communities;
Article 2 Sec. 31.  98
06/07/25  REVISOR  DTT/LN  25-05697  as introduced
99.1      (3) Latina/o/x communities;
99.2      (4) American Indian communities and Tribal governments and nations;
99.3      (5) disability communities;
99.4      (6) lesbian, gay, bisexual, transgender, and queer (LGBTQ) communities; and
99.5      (7) representatives who reside outside the seven-county metropolitan area.
99.6    Sec. 32. Minnesota Statutes 2024, section 145.987, subdivision 2, is amended to read:
99.7      Subd. 2. Organization and meetings. (a) Terms, compensation, and removal of members
99.8  of the advisory council shall be as provided in section 15.059, subdivisions 2 to 4, except
99.9  that terms for advisory council members shall be for two years. Members may be reappointed
99.10 to serve up to two additional terms. Notwithstanding section 15.059, subdivision 6, the
99.11 advisory council shall not expire. The commissioner shall recommend appointments to
99.12 replace members vacating their positions in a timely manner, no more than three months
99.13 after the advisory council reviews panel recommendations.
99.14     (b) The commissioner must convene meetings at least quarterly and must provide meeting
99.15 space and administrative support to the advisory council. Subcommittees may be convened
99.16 as necessary. Advisory council meetings are subject to the Open Meeting Law under chapter
99.17 13D.
99.18   Sec. 33. [148.781] CENTRAL SERVICE TECHNICIAN.
99.19     Subdivision 1. Application. This section applies to persons who perform the functions
99.20 of a central service technician in a health care facility.
99.21     Subd. 2. Definitions. For purposes of this section, the following terms have the meanings
99.22 given:
99.23     (1) "central service technician" means a person who decontaminates, inspects, assembles,
99.24 packages, and sterilizes reusable medical instruments or devices used by a health care
99.25 facility;
99.26     (2) "health care facility" means a hospital or ambulatory surgical center; and
99.27     (3) "health care practitioner" means an individual regulated by a health-related licensing
99.28 board as defined in section 214.01, subdivision 2, or by the commissioner of health under
99.29 sections 148.511 to 148.5198, to the extent the individual provides services in a health care
99.30 facility and the tasks of a central service technician are within the individual's scope of
Article 2 Sec. 33.  99
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
100.1  practice. Health care practitioner includes an intern, resident, or fellow who performs or
100.2  assists with surgery.
100.3      Subd. 3. Requirements for central service technician. (a) A health care facility shall
100.4  employ or otherwise retain the services of a central service technician only if the central
100.5  service technician:
100.6      (1) has successfully passed a nationally accredited examination for central service
100.7  technicians and holds and maintains one of the following credentials administered by a
100.8  nationally accredited central service technician credentialing organization: a certified
100.9  registered central service technician credential, a certified endoscope reprocessor credential,
100.10 a certified sterile processing and distribution technician credential, or a certified flexible
100.11 endoscope reprocessor credential; or
100.12     (2) provides evidence that the person was employed by or was retained as a central
100.13 service technician by a health care facility on or before December 31, 2027.
100.14     (b) A central service technician who does not meet the requirements of paragraph (a),
100.15 clause (1), shall have 24 months from the date of hire to obtain a certified registered central
100.16 service technician credential, a certified endoscope reprocessor credential, a certified sterile
100.17 processing and distribution technician credential, or a certified flexible endoscope reprocessor
100.18 credential.
100.19     (c) A person who qualifies to operate as a central service technician in a health care
100.20 facility under paragraph (a) must annually complete ten hours of continuing education
100.21 credits to remain qualified to operate as a central service technician. The continuing education
100.22 required under this paragraph must be related to the functions of a central service technician.
100.23     (d) Nothing in this subdivision shall prohibit the following persons from performing the
100.24 tasks or functions of a central service technician:
100.25     (1) a health care practitioner;
100.26     (2) a person who holds or maintains a registration, certification, or license by a nationally
100.27 accredited credentialing organization to perform health care services; or
100.28     (3) a student or intern performing the functions of a central service technician under the
100.29 direct supervision of a health care practitioner as part of the student's or intern's training or
100.30 internship.
100.31     (e) A health care facility shall, upon the written request of a central service technician,
100.32 verify in writing the central service technician's dates of employment or the contract period
100.33 during which the central service technician provided services to the health care facility.
  Article 2 Sec. 33.  100
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
101.1      EFFECTIVE DATE. This section is effective 180 days after final enactment.
101.2    Sec. 34. TRANSFER OF PROGRAM.
101.3      The healthy eating, here at home program is transferred from the Minnesota Humanities
101.4  Center to the Department of Health on July 1, 2025. The provisions of Minnesota Statutes,
101.5  section 15.039, apply to this transfer.
101.6    Sec. 35. REVISOR INSTRUCTION.
101.7      The revisor of statutes shall renumber Minnesota Statutes, section 138.912, as section
101.8  144.0554. The revisor shall make any cross-reference changes necessary resulting from the
101.9  renumbering of the healthy eating, here at home program.
101.10   Sec. 36. REPEALER.
101.11     Minnesota Statutes 2024, section 62K.10, subdivision 3, is repealed.
101.12ARTICLE 3
101.13HEALTH LICENSING BOARDS
101.14   Section 1. Minnesota Statutes 2024, section 144.99, subdivision 1, is amended to read:
101.15     Subdivision 1. Remedies available. The provisions of chapters 103I and 157 and sections
101.16 115.71 to 115.77; 144.12, subdivision 1, paragraphs (1), (2), (5), (6), (10), (12), (13), (14),
101.17 and (15); 144.1201 to 144.1204; 144.121; 144.1215; 144.1222; 144.35; 144.381 to 144.385;
101.18 144.411 to 144.417; 144.495; 144.71 to 144.74; 144.9501 to 144.9512; 144.97 to 144.98;
101.19 144.992; 147.037, subdivision 1b, paragraph (d); 326.70 to 326.785; 327.10 to 327.131;
101.20 and 327.14 to 327.28 and all rules, orders, stipulation agreements, settlements, compliance
101.21 agreements, licenses, registrations, certificates, and permits adopted or issued by the
101.22 department or under any other law now in force or later enacted for the preservation of
101.23 public health may, in addition to provisions in other statutes, be enforced under this section.
101.24     EFFECTIVE DATE. This section is effective January 1, 2026.
101.25   Sec. 2. Minnesota Statutes 2024, section 144A.43, subdivision 15, is amended to read:
101.26     Subd. 15. Occupational therapist. "Occupational therapist" means a person who is
101.27 licensed under sections 148.6401 to 148.6449 has the meaning given in section 148.6402,
101.28 subdivision 14.
  Article 3 Sec. 2.  101
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
102.1    Sec. 3. Minnesota Statutes 2024, section 144G.08, subdivision 45, is amended to read:
102.2      Subd. 45. Occupational therapist. "Occupational therapist" means a person who is
102.3  licensed under sections 148.6401 to 148.6449 has the meaning given in section 148.6402,
102.4  subdivision 14.
102.5    Sec. 4. Minnesota Statutes 2024, section 147.01, subdivision 7, is amended to read:
102.6      Subd. 7. Physician application and license fees. (a) The board may charge the following
102.7  nonrefundable application and license fees processed pursuant to sections 147.02, 147.03,
102.8  147.037, 147.0375, and 147.38:
102.9      (1) physician application fee, $200;
102.10     (2) physician annual registration renewal fee, $192;
102.11     (3) physician endorsement to other states, $40;
102.12     (4) physician emeritus license, $50;
102.13     (5) physician late fee, $60;
102.14     (6) nonrenewable 24-month limited license, $392;
102.15     (7) initial physician license for limited license holder, $192;
102.16     (6) (8) duplicate license fee, $20;
102.17     (7) (9) certification letter fee, $25;
102.18     (8) (10) education or training program approval fee, $100;
102.19     (9) (11) report creation and generation fee, $60 per hour;
102.20     (10) (12) examination administration fee (half day), $50;
102.21     (11) (13) examination administration fee (full day), $80;
102.22     (12) (14) fees developed by the Interstate Commission for determining physician
102.23 qualification to register and participate in the interstate medical licensure compact, as
102.24 established in rules authorized in and pursuant to section 147.38, not to exceed $1,000; and
102.25     (13) (15) verification fee, $25.
102.26     (b) The board may prorate the initial annual license fee. All licensees are required to
102.27 pay the full fee upon license renewal. The revenue generated from the fee must be deposited
102.28 in an account in the state government special revenue fund.
  Article 3 Sec. 4.  102
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
103.1    Sec. 5. Minnesota Statutes 2024, section 147.037, is amended by adding a subdivision to
103.2  read:
103.3      Subd. 1b. Limited license. (a) A limited license under this subdivision is valid for one
103.4  24-month period and is not renewable or eligible for reapplication. The board may issue a
103.5  limited license, valid for 24 months, to any person who satisfies the requirements of
103.6  subdivision 1, paragraphs (a) to (c) and (e) to (g), and who:
103.7      (1) pursuant to a license or other authorization to practice, has practiced medicine, as
103.8  defined in section 147.081, subdivision 3, clauses (2) to (4), for at least 60 months in the
103.9  previous 12 years outside of the United States;
103.10     (2) submits sufficient evidence of an offer to practice within the context of a collaborative
103.11 agreement within a hospital or clinical setting where the limited license holder and physicians
103.12 work together to provide patient care;
103.13     (3) provides services in a designated rural area or underserved urban community as
103.14 defined in section 144.1501; and
103.15     (4) submits two letters of recommendation in support of a limited license, which must
103.16 include one letter from a physician with whom the applicant previously worked and one
103.17 letter from an administrator of the hospital or clinical setting in which the applicant previously
103.18 worked. The letters of recommendation must attest to the applicant's good medical standing.
103.19 The board may accept alternative forms of proof that demonstrate good medical standing
103.20 where there are extenuating circumstances that prevent an applicant from providing letters.
103.21     (b) For purposes of this subdivision, a person has satisfied the requirements of subdivision
103.22 1, paragraph (e), if the person has passed steps or levels one and two of the USMLE or the
103.23 COMLEX-USA with passing scores as recommended by the USMLE program or National
103.24 Board of Osteopathic Medical Examiners within three attempts.
103.25     (c) A person issued a limited license under this subdivision must not be required to
103.26 present evidence satisfactory to the board of the completion of one year of graduate clinical
103.27 medical training in a program accredited by a national accrediting organization approved
103.28 by the board.
103.29     (d) An employer of a limited license holder must pay the limited license holder at least
103.30 an amount equivalent to a medical resident in a comparable field. The employer must carry
103.31 medical malpractice insurance covering a limited license holder for the duration of the
103.32 employment. The commissioner of health may issue a correction order under section 144.99,
103.33 subdivision 3, requiring an employer to comply with this paragraph. An employer must not
  Article 3 Sec. 5.  103
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
104.1  retaliate against or discipline an employee for raising a complaint or pursuing enforcement
104.2  relating to this paragraph.
104.3      (e) The board may issue a full and unrestricted license to practice medicine to a person
104.4  who holds a limited license issued pursuant to paragraph (a) and who has:
104.5      (1) held the limited license for two years and is in good standing to practice medicine
104.6  in this state;
104.7      (2) practiced for a minimum of 1,692 hours per year for each of the previous two years;
104.8      (3) submitted a letter of recommendation in support of a full and unrestricted license
104.9  containing all attestations required under paragraph (i) from any physician who participated
104.10 in the collaborative agreement;
104.11     (4) passed steps or levels one, two, and three of the USMLE or COMLEX-USA with
104.12 passing scores as recommended by the USMLE program or National Board of Osteopathic
104.13 Medical Examiners within three attempts; and
104.14     (5) completed 20 hours of continuing medical education.
104.15     (f) A limited license holder must submit to the board, every six months or upon request,
104.16 a statement certifying whether the person is still employed as a physician in this state and
104.17 whether the person has been subjected to professional discipline as a result of the person's
104.18 practice. The board may suspend or revoke a limited license if a majority of the board
104.19 determines that the limited license holder is no longer employed as a physician in this state
104.20 by an employer. The limited license holder must be granted an opportunity to be heard prior
104.21 to the board's determination. Upon request by the limited license holder, the limited license
104.22 holder may have 90 days to regain employment. A limited license holder may change
104.23 employers during the duration of the limited license if the limited license holder has another
104.24 offer of employment. In the event that a change of employment occurs, the limited license
104.25 holder must still work the number of hours required under paragraph (e), clause (2), to be
104.26 eligible for a full and unrestricted license to practice medicine.
104.27     (g) In addition to any other remedy provided by law, the board may, without a hearing,
104.28 temporarily suspend the license of a limited license holder if the board finds that the limited
104.29 license holder has violated a statute or rule that the board is empowered to enforce and
104.30 continued practice by the limited license holder would create a serious risk of harm to the
104.31 public. The suspension takes effect upon written notice to the limited license holder,
104.32 specifying the statute or rule violated. The suspension remains in effect until the board
104.33 issues a final order in the matter after a hearing. At the time it issues the suspension notice,
  Article 3 Sec. 5.  104
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
105.1  the board shall schedule a disciplinary hearing to be held pursuant to the Administrative
105.2  Procedure Act. The limited license holder shall be provided with at least 20 days' notice of
105.3  any hearing held pursuant to this subdivision. The hearing shall be scheduled to begin no
105.4  later than 30 days after the issuance of the suspension order.
105.5      (h) For purposes of this subdivision, "collaborative agreement" means a mutually agreed
105.6  upon plan for the overall working relationship and collaborative arrangement between a
105.7  holder of a limited license and one or more physicians licensed under this chapter that
105.8  designates the scope of services that can be provided to manage the care of patients. The
105.9  limited license holder and one of the collaborating physicians must have experience in
105.10 providing care to patients with the same or similar medical conditions. Under the
105.11 collaborative agreement, the limited license holder must shadow the collaborating physician
105.12 for four weeks, after which time the limited license holder must staff all patient encounters
105.13 with the collaborating physician for an additional four weeks. After eight weeks, the
105.14 collaborating physician has discretion to allow the limited license holder to see patients
105.15 independently and may, at the discretion of the collaborating physician, require the limited
105.16 license holder to present patients. However, the limited license holder must be supervised
105.17 by the collaborating physician for a minimum of two hours per week. A limited license
105.18 holder may practice medicine without a collaborating physician physically present, but the
105.19 limited license holder and collaborating physicians must be able to easily contact each other
105.20 by radio, telephone, or other telecommunication device while the limited license holder
105.21 practices medicine. The limited license holder must have one-on-one practice reviews with
105.22 each collaborating physician, provided in person or through eye-to-eye electronic media
105.23 while maintaining visual contact, for at least two hours per week.
105.24     (i) At least one collaborating physician must submit a letter to the board, after the limited
105.25 license holder has practiced under the license for 12 months, attesting to the following:
105.26     (1) the limited license holder has a basic understanding of federal and state laws regarding
105.27 the provision of health care, including but not limited to:
105.28     (i) medical licensing obligations and standards; and
105.29     (ii) the Health Insurance Portability and Accountability Act, Public Law 104-191;
105.30     (2) the limited license holder has a basic understanding of documentation standards;
105.31     (3) the limited license holder has a thorough understanding of which medications are
105.32 available and unavailable in the United States;
  Article 3 Sec. 5.  105
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
106.1      (4) the limited license holder has a thorough understanding of American medical standards
106.2  of care;
106.3      (5) the limited license holder has demonstrated mastery of each of the following:
106.4      (i) gathering a history and performing a physical exam;
106.5      (ii) developing and prioritizing a differential diagnosis following a clinical encounter
106.6  and selecting a working diagnosis;
106.7      (iii) recommending and interpreting common diagnostic and screening tests;
106.8      (iv) entering and discussing orders and prescriptions;
106.9      (v) providing an oral presentation of a clinical encounter;
106.10     (vi) giving a patient handover to transition care responsibly;
106.11     (vii) recognizing a patient requiring urgent care and initiating an evaluation; and
106.12     (viii) obtaining informed consent for tests, procedures, and treatments; and
106.13     (6) the limited license holder is providing appropriate medical care.
106.14     (j) The board must not grant a license under this section unless the applicant possesses
106.15 federal immigration status that allows the applicant to practice as a physician in the United
106.16 States.
106.17     EFFECTIVE DATE. This section is effective January 1, 2026.
106.18   Sec. 6. Minnesota Statutes 2024, section 147D.03, subdivision 1, is amended to read:
106.19     Subdivision 1. General. Within the meaning of sections 147D.01 to 147D.27, a person
106.20 who shall publicly profess to be a traditional midwife and who, for a fee, shall assist or
106.21 attend to a woman in pregnancy, childbirth outside a hospital, and postpartum, shall be
106.22 regarded as practicing traditional midwifery. A certified midwife licensed by the Board of
106.23 Nursing under chapter 148G is not subject to the provisions of this chapter.
106.24   Sec. 7. Minnesota Statutes 2024, section 148.108, subdivision 1, is amended to read:
106.25     Subdivision 1. Fees. In addition to the fees established in Minnesota Rules, chapter
106.26 2500, The board is authorized to charge the fees in this section.
  Article 3 Sec. 7.  106
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107.1    Sec. 8. Minnesota Statutes 2024, section 148.108, is amended by adding a subdivision to
107.2  read:
107.3      Subd. 5. Chiropractic license fees. Fees for chiropractic licensure are the following
107.4  amounts but may be adjusted lower by board action:
107.5      (1) initial application for licensure fee, $300;
107.6      (2) annual renewal of an active license fee, $250;
107.7      (3) annual renewal of an inactive license fee, 75 percent of the current active license
107.8  renewal fee under clause (2);
107.9      (4) late renewal penalty fee, $150 per month late; and
107.10     (5) application for reinstatement of a voluntarily retired or inactive license fee, $187.50.
107.11   Sec. 9. Minnesota Statutes 2024, section 148.108, is amended by adding a subdivision to
107.12 read:
107.13     Subd. 6. Acupuncture registration fees. Fees for acupuncture registration are the
107.14 following amounts but may be adjusted lower by board action:
107.15     (1) initial application acupuncture registration fee, $200;
107.16     (2) annual renewal of active acupuncture registration fee, $100;
107.17     (3) annual renewal of inactive acupuncture registration fee, 75 percent of the current
107.18 active acupuncture registration renewal fee under clause (2); and
107.19     (4) reinstatement of nonrenewed acupuncture registration fee, $200.
107.20   Sec. 10. Minnesota Statutes 2024, section 148.108, is amended by adding a subdivision
107.21 to read:
107.22     Subd. 7. Independent examiner registration fees. Fees for independent examiner
107.23 registration are the following amounts but may be adjusted lower by board action:
107.24     (1) initial application independent examiner registration fee, $200;
107.25     (2) annual renewal of independent examiner registration fee, $100; and
107.26     (3) reinstatement of nonrenewed independent examiner registration fee, $200.
  Article 3 Sec. 10.  107
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108.1    Sec. 11. Minnesota Statutes 2024, section 148.108, is amended by adding a subdivision
108.2  to read:
108.3      Subd. 8. Animal chiropractic registration fees. Fees for animal chiropractic registration
108.4  are the following amounts but may be adjusted lower by board action:
108.5      (1) initial application animal chiropractic registration fee, $200;
108.6      (2) annual renewal of active animal chiropractic registration fee, $100;
108.7      (3) annual renewal of inactive animal chiropractic registration fee, 75 percent of the
108.8  current active animal chiropractic renewal fee under clause (2); and
108.9      (4) reinstatement of nonrenewed animal chiropractic registration fee, $200.
108.10   Sec. 12. Minnesota Statutes 2024, section 148.108, is amended by adding a subdivision
108.11 to read:
108.12     Subd. 9. Graduate preceptorship registration fee. The application fee for graduate
108.13 preceptorship registration is $250, but may be adjusted lower by board action.
108.14   Sec. 13. Minnesota Statutes 2024, section 148.108, is amended by adding a subdivision
108.15 to read:
108.16     Subd. 10. Professional firm registration fees. In addition to fees authorized under
108.17 chapter 319B, the late renewal penalty fee for professional firm registration is $5 per month
108.18 late.
108.19   Sec. 14. Minnesota Statutes 2024, section 148.108, is amended by adding a subdivision
108.20 to read:
108.21     Subd. 11. Miscellaneous fees. Fees under this subdivision are the following amounts
108.22 but may be adjusted lower by board action:
108.23     (1) annual continuing education sponsorship fee, $600;
108.24     (2) individual continuing education seminar sponsorship fee, $200;
108.25     (3) mailing list request fee, $200;
108.26     (4) license verification fee, $20;
108.27     (5) duplicate certificate fee, $20; and
108.28     (6) document copies fee, $0.25 per side of document page.
  Article 3 Sec. 14.  108
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
109.1    Sec. 15. Minnesota Statutes 2024, section 148.191, subdivision 2, is amended to read:
109.2Subd. 2. Powers. (a) The board is authorized to adopt and, from time to time, revise
109.3  rules not inconsistent with the law, as may be necessary to enable it to carry into effect the
109.4  provisions of sections 148.171 to 148.285 and chapter 148G. The board shall prescribe by
109.5  rule curricula and standards for schools and courses preparing persons for licensure under
109.6  sections 148.171 to 148.285 and 148G.12. It shall conduct or provide for surveys of such
109.7  schools and courses at such times as it may deem necessary. It shall approve such schools
109.8  and courses as meet the requirements of sections 148.171 to 148.285 or section 148G.12,
109.9  and board rules. It shall examine, license, and renew the license of duly qualified applicants.
109.10 It shall hold examinations at least once in each year at such time and place as it may
109.11 determine. It shall by rule adopt, evaluate, and periodically revise, as necessary, requirements
109.12 for licensure and for registration and renewal of registration as defined in section 148.231
109.13 and chapter 148G. It shall maintain a record of all persons licensed by the board to practice
109.14 advanced practice, professional, or practical nursing, or certified as a midwife. It shall cause
109.15 the prosecution of all persons violating sections 148.171 to 148.285 or chapter 148G, and
109.16 have power to incur such necessary expense therefor. It shall register public health nurses
109.17 who meet educational and other requirements established by the board by rule, including
109.18 payment of a fee. It shall have power to issue subpoenas, and to compel the attendance of
109.19 witnesses and the production of all necessary documents and other evidentiary material.
109.20 Any board member may administer oaths to witnesses, or take their affirmation. It shall
109.21 keep a record of all its proceedings.
109.22(b) The board shall have access to hospital, nursing home, and other medical records of
109.23 a patient cared for by a nurse or certified midwife under review. If the board does not have
109.24 a written consent from a patient permitting access to the patient's records, the nurse, certified
109.25 midwife, or facility shall delete any data in the record that identifies the patient before
109.26 providing it to the board. The board shall have access to such other records as reasonably
109.27 requested by the board to assist the board in its investigation. Nothing herein may be
109.28 construed to allow access to any records protected by section 145.64. The board shall
109.29 maintain any records obtained pursuant to this paragraph as investigative data under chapter
109.30 13.
109.31(c) The board may accept and expend grants or gifts of money or in-kind services from
109.32 a person, a public or private entity, or any other source for purposes consistent with the
109.33 board's role and within the scope of its statutory authority.
109.34(d) The board may accept registration fees for meetings and conferences conducted for
109.35 the purposes of board activities that are within the scope of its authority.
  Article 3 Sec. 15.  109
  06/07/25  REVISOR       DTT/LN  25-05697  as introduced
110.1    Sec. 16. Minnesota Statutes 2024, section 148.241, is amended to read:
110.2      148.241 EXPENSES.
110.3      Subdivision 1. Appropriation. The expenses of administering sections 148.171 to
110.4  148.285 and chapter 148G shall be paid from the appropriation made to the Minnesota
110.5  Board of Nursing.
110.6      Subd. 2. Expenditure. All amounts appropriated to the board shall be held subject to
110.7  the order of the board to be used only for the purpose of meeting necessary expenses incurred
110.8  in the performance of the purposes of sections 148.171 to 148.285 and chapter 148G, and
110.9  the duties imposed thereby as well as the promotion of nursing or certified midwifery
110.10 education and standards of nursing or certified midwifery care in this state.
110.11   Sec. 17. Minnesota Statutes 2024, section 148.512, subdivision 17a, is amended to read:
110.12     Subd. 17a. Speech-language pathology assistant. "Speech-language pathology assistant"
110.13 means a person who meets the qualifications under section 148.5181 and provides
110.14 speech-language pathology services under the supervision of a licensed speech-language
110.15 pathologist under sections 122A.183 and 122A.184 or in accordance with section 148.5192.
110.16   Sec. 18. Minnesota Statutes 2024, section 148.5192, subdivision 3, is amended to read:
110.17     Subd. 3. Supervision requirements. (a) A supervising speech-language pathologist
110.18 shall authorize and accept full responsibility for the performance, practice, and activity of
110.19 a speech-language pathology assistant. The amount and type of supervision required must
110.20 be based on the skills and experience of the speech-language pathology assistant. A minimum
110.21 of one hour every 30 days of consultative supervision time must be documented for each
110.22 speech-language pathology assistant.
110.23     (b) A supervising speech-language pathologist must:
110.24     (1) be licensed under sections 122A.183, 122A.184, or 148.511 to 148.5198;
110.25     (2) hold a certificate of clinical competence from the American Speech-Language-Hearing
110.26 Association or its equivalent as approved by the commissioner; and
110.27     (3) have completed at least ten hours of continuing education in supervision.
110.28     (c) Once every 60 days, the supervising speech-language pathologist must treat or cotreat
110.29 with the speech-language pathology assistant each client on the speech-language pathology
110.30 assistant's caseload.
  Article 3 Sec. 18.  110
  06/07/25  REVISOR        DTT/LN  25-05697  as introduced
111.1      (d) For purposes of this section, "direct supervision" means observation and guidance
111.2  by the supervising speech-language pathologist during the performance of a delegated duty
111.3  that occurs either on-site and in-view or through the use of real-time, two-way interactive
111.4  audio and visual communication. The supervision requirements described in this section
111.5  are minimum requirements. Additional supervision requirements may be imposed at the
111.6  discretion of the supervising speech-language pathologist.
111.7      (e) A supervising speech-language pathologist must be available to communicate with
111.8  a speech-language pathology assistant at any time the assistant is in direct contact with a
111.9  client.
111.10     (f) A supervising speech-language pathologist must document activities performed by
111.11 the assistant that are directly supervised by the supervising speech-language pathologist.
111.12 At a minimum, the documentation must include:
111.13     (1) information regarding the quality of the speech-language pathology assistant's
111.14 performance of the delegated duties; and
111.15     (2) verification that any delegated clinical activity was limited to duties authorized to
111.16 be performed by the speech-language pathology assistant under this section.
111.17     (g) A supervising speech-language pathologist must review and cosign all informal
111.18 treatment notes signed or initialed by the speech-language pathology assistant.
111.19     (h) A full-time, speech-language pathologist may supervise no more than two full-time,
111.20 speech-language pathology assistants or the equivalent of two full-time assistants.
111.21     (i) If the commissioner determines that a speech-language pathology assistant licensed
111.22 under section 148.5181 violates any part of sections 148.511 to 148.5198 and is supervised
111.23 by a speech-language pathologist licensed by the Professional Educator Licensing and
111.24 Standards Board (PELSB), the commissioner must immediately notify PELSB. Upon such
111.25 notification, PELSB must initiate an investigation of the supervising speech-language
111.26 pathologist. PELSB must share the result of the investigation with the commissioner.
111.27   Sec. 19. Minnesota Statutes 2024, section 148.5194, subdivision 3b, is amended to read:
111.28     Subd. 3b. Speech-language pathology assistant licensure fees. The fee for initial
111.29 licensure as a speech-language pathology assistant is $493 must not exceed $220. The fee
111.30 for licensure renewal for a speech-language pathology assistant is $493 must not exceed
111.31 $220.
  Article 3 Sec. 19.  111
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112.1    Sec. 20. Minnesota Statutes 2024, section 148.6401, is amended to read:
112.2      148.6401 SCOPE.
112.3      Sections 148.6401 to 148.6449 148.645 apply to persons who are applicants for licensure,
112.4  who are licensed, who use protected titles, or who represent that they are licensed as
112.5  occupational therapists or occupational therapy assistants practitioners.
112.6    Sec. 21. Minnesota Statutes 2024, section 148.6402, subdivision 1, is amended to read:
112.7      Subdivision 1. Scope. For the purpose of sections 148.6401 to 148.6449 148.645, the
112.8  following terms have the meanings given them.
112.9    Sec. 22. Minnesota Statutes 2024, section 148.6402, is amended by adding a subdivision
112.10 to read:
112.11     Subd. 2a. Accreditation Council for Occupational Therapy Education or
112.12 ACOTE. "Accreditation Council for Occupational Therapy Education" or "ACOTE" means
112.13 the entity that accredits occupational therapy education programs in the United States and
112.14 its territories and establishes, approves, and administers educational standards ensuring
112.15 consistency across all occupational therapy education.
112.16   Sec. 23. Minnesota Statutes 2024, section 148.6402, is amended by adding a subdivision
112.17 to read:
112.18     Subd. 5a. Continuing competence. "Continuing competence" means the process in
112.19 which an occupational therapy practitioner develops and maintains the knowledge, critical
112.20 reasoning, interpersonal skills, performance skills, and ethical practice necessary to perform
112.21 their occupational therapy responsibilities.
112.22   Sec. 24. Minnesota Statutes 2024, section 148.6402, subdivision 7, is amended to read:
112.23     Subd. 7. Credentialing Certification examination for occupational
112.24 therapist. "Credentialing Certification examination for occupational therapist" means the
112.25 examination sponsored by the National Board for Certification in Occupational Therapy
112.26 for credentialing certification as an a registered occupational therapist, registered.
112.27   Sec. 25. Minnesota Statutes 2024, section 148.6402, subdivision 8, is amended to read:
112.28     Subd. 8. Credentialing Certification examination for occupational therapy
112.29 assistant. "Credentialing Certification examination for occupational therapy assistant"
  Article 3 Sec. 25.  112
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113.1  means the examination sponsored by the National Board for Certification in Occupational
113.2  Therapy for credentialing certification as a certified occupational therapy assistant.
113.3    Sec. 26. Minnesota Statutes 2024, section 148.6402, is amended by adding a subdivision
113.4  to read:
113.5      Subd. 12a. Face-to-face supervision. "Face-to-face supervision" means supervision
113.6  occurring between a supervisor and a supervisee within each other's sight or presence.
113.7  Face-to-face supervision includes real-time audio and video communication where the
113.8  supervisor and supervisee can see each other and clearly visualize the services being provided.
113.9    Sec. 27. Minnesota Statutes 2024, section 148.6402, subdivision 13, is amended to read:
113.10     Subd. 13. Licensed health care professional. "Licensed health care professional" means
113.11 a person licensed in good standing in Minnesota to practice medicine, osteopathic medicine,
113.12 chiropractic, podiatry, advanced practice registered nursing, or dentistry, or is a person
113.13 registered as a licensed physician assistant in Minnesota.
113.14   Sec. 28. Minnesota Statutes 2024, section 148.6402, is amended by adding a subdivision
113.15 to read:
113.16     Subd. 13a. National Board for Certification in Occupational Therapy or
113.17 NBCOT. "National Board for Certification in Occupational Therapy" or "NBCOT" means
113.18 the entity that administers the certification examination and provides initial and renewal
113.19 board certification for occupational therapy practitioners providing services in the United
113.20 States, or any successor entity performing the certification examination and initial and
113.21 renewal board certification.
113.22   Sec. 29. Minnesota Statutes 2024, section 148.6402, subdivision 14, is amended to read:
113.23     Subd. 14. Occupational therapist. "Occupational therapist" means an individual who
113.24 meets the qualifications in sections 148.6401 to 148.6449 and is licensed by the board
113.25 licensed to practice occupational therapy under sections 148.6401 to 148.645 who is
113.26 responsible for and directs the evaluation process, discharge planning process, development
113.27 of intervention plans, and provision of occupational therapy services.
113.28   Sec. 30. Minnesota Statutes 2024, section 148.6402, subdivision 16, is amended to read:
113.29     Subd. 16. Occupational therapy assistant. "Occupational therapy assistant" means an
113.30 individual who meets the qualifications for an occupational therapy assistant in sections
  Article 3 Sec. 30.  113
  06/07/25  REVISOR        DTT/LN  25-05697  as introduced
114.1  148.6401 to 148.6449 and is licensed by the board licensed to assist in the practice of
114.2  occupational therapy under sections 148.6401 to 148.645 who works under the appropriate
114.3  supervision of and in partnership with an occupational therapist, unless exempted under
114.4  section 148.6432.
114.5    Sec. 31. Minnesota Statutes 2024, section 148.6402, subdivision 16a, is amended to read:
114.6      Subd. 16a. Occupational therapy practitioner. "Occupational therapy practitioner"
114.7  means any individual licensed as either an occupational therapist or occupational therapy
114.8  assistant under sections 148.6401 to 148.6449 148.645.
114.9    Sec. 32. Minnesota Statutes 2024, section 148.6402, subdivision 19, is amended to read:
114.10     Subd. 19. License or licensed. "License" or "licensed" means the act or status of a
114.11 natural person who meets the requirements of sections 148.6401 to 148.6449 148.645.
114.12   Sec. 33. Minnesota Statutes 2024, section 148.6402, subdivision 20, is amended to read:
114.13     Subd. 20. Licensee. "Licensee" means a person who meets the requirements of sections
114.14 148.6401 to 148.6449 148.645.
114.15   Sec. 34. Minnesota Statutes 2024, section 148.6402, subdivision 23, is amended to read:
114.16     Subd. 23. Service competency. (a) "Service competency" of an occupational therapy
114.17 assistant in performing evaluation tasks means the ability of an occupational therapy assistant
114.18 to obtain the same information as the supervising occupational therapist when evaluating
114.19 a client's function.
114.20     (b) "Service competency" of an occupational therapy assistant in performing treatment
114.21 procedures means the ability of an occupational therapy assistant to perform treatment
114.22 procedures in a manner such that the outcome, documentation, and follow-up are equivalent
114.23 to that which would have been achieved had the supervising occupational therapist performed
114.24 the treatment procedure.
114.25     (c) "Service competency" of an occupational therapist means the ability of an occupational
114.26 therapist to consistently perform an assessment task or intervention procedure with the level
114.27 of skill recognized as satisfactory within the appropriate acceptable prevailing practice
114.28 national practice standards of occupational therapy.
  Article 3 Sec. 34.  114
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
115.1    Sec. 35. Minnesota Statutes 2024, section 148.6402, subdivision 25, is amended to read:
115.2      Subd. 25. Temporary licensure. "Temporary licensure" means a method of licensure
115.3  described in section 148.6418, by which an individual who (1) has completed an approved
115.4  or accredited education program but has not met the examination requirement; or (2)
115.5  possesses a credential from another jurisdiction or the National Board for Certification in
115.6  Occupational Therapy but who has not submitted the documentation required by section
115.7  148.6420, subdivisions 3 and 4, may qualify for Minnesota licensure for a limited time
115.8  period.
115.9    Sec. 36. Minnesota Statutes 2024, section 148.6403, is amended to read:
115.10     148.6403 LICENSURE; PROTECTED TITLES AND RESTRICTIONS ON USE;
115.11 EXEMPT PERSONS; SANCTIONS.
115.12     Subdivision 1. Unlicensed practice prohibited. A person must not engage in the practice
115.13 of occupational therapy unless the person is licensed as an occupational therapy practitioner
115.14 in accordance with sections 148.6401 to 148.6449 148.645.
115.15     Subd. 2. Protected titles and restrictions on use. Use of the phrase "occupational
115.16 therapy," or "occupational therapist," or "occupational therapy assistant," or the initials
115.17 "OT" or "OTA" alone or in combination with any other words or initials to form an
115.18 occupational title, or to indicate or imply that the person is licensed by the state as an
115.19 occupational therapist or occupational therapy assistant, is prohibited unless that person is
115.20 licensed under sections 148.6401 to 148.6449 148.645.
115.21     Subd. 3. Use of "Minnesota licensed." Use of the term "Minnesota licensed" in
115.22 conjunction with titles protected under this section by any person is prohibited unless that
115.23 person is licensed under sections 148.6401 to 148.6449 148.645.
115.24     Subd. 4. Persons licensed or certified in other states. A person who is licensed in
115.25 Minnesota and licensed or certified in another state jurisdiction may use the designation
115.26 "licensed" or "certified" with a protected title only if the state jurisdiction of licensure or
115.27 certification is clearly indicated.
115.28     Subd. 5. Exempt persons. This section does not apply to:
115.29     (1) a person employed as an occupational therapy practitioner by the government of the
115.30 United States or any agency of it. However, use of the protected titles under those
115.31 circumstances is allowed only in connection with performance of official duties for the
115.32 federal government;
  Article 3 Sec. 36.  115
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
116.1      (2) a student participating in supervised fieldwork or supervised coursework that is
116.2  necessary to meet the requirements of section 148.6408, subdivision 1, or 148.6410,
116.3  subdivision 1, if the person is designated by a title which clearly indicates the person's status
116.4  as a student trainee. Any use of the protected titles under these circumstances is allowed
116.5  only while the person is performing the duties of the supervised fieldwork or supervised
116.6  coursework; or
116.7      (3) a person visiting and then leaving the state and performing occupational therapy
116.8  services while in the state, if the services are performed no more than 30 days in a calendar
116.9  year as part of a professional activity that is limited in scope and duration and is in association
116.10 with an occupational therapist licensed under sections 148.6401 to 148.6449, and
116.11     (i) the (3) a person who is credentialed under the law of another state which that has
116.12 credentialing requirements at least as stringent as the requirements of sections 148.6401 to
116.13 148.6449 148.645; or
116.14     (ii) the (4) a person who meets the requirements for certification as an occupational
116.15 therapist registered (OTR) or a certified occupational therapy assistant (COTA), established
116.16 by the National Board for Certification in Occupational Therapy.; or
116.17     (5) an occupational therapy practitioner who possesses an active compact privilege under
116.18 section 148.645.
116.19     Subd. 6. Sanctions. A person who practices occupational therapy or holds out as an
116.20 occupational therapy practitioner by or through the use of any title described in subdivision
116.21 2 without prior licensure according to sections 148.6401 to 148.6449 148.645 is subject to
116.22 sanctions or action against continuing the activity according to section 148.6448, chapter
116.23 214, or other statutory authority.
116.24     Subd. 7. Exemption. Nothing in sections 148.6401 to 148.6449 148.645 shall prohibit
116.25 the practice of any profession or occupation licensed or registered by the state by any person
116.26 duly licensed or registered to practice the profession or occupation or to perform any act
116.27 that falls within the scope of practice of the profession or occupation.
116.28   Sec. 37. Minnesota Statutes 2024, section 148.6404, is amended to read:
116.29     148.6404 SCOPE OF PRACTICE.
116.30     (a) The practice of occupational therapy means the therapeutic use of everyday activities
116.31 life occupations with individuals or, groups, or populations for the purpose of enhancing
116.32 or enabling participation in those occupations. It is the promotion of The practice of
116.33 occupational therapy promotes health and well-being through the use of occupational therapy
  Article 3 Sec. 37.  116
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
117.1  services that includes screening, evaluation, intervention, and consultation to develop,
117.2  recover, and maintain a client's:
117.3      (1) sensory integrative, neuromuscular, motor, emotional, motivational, cognitive, or
117.4  psychosocial components of performance;
117.5      (2) daily living skills;
117.6      (3) feeding and swallowing skills;
117.7      (4) play and leisure skills;
117.8      (5) educational participation skills;
117.9      (6) functional performance and work participation skills;
117.10     (7) community mobility; and
117.11     (8) health and wellness.
117.12     (b) Occupational therapy services include but are not limited to:
117.13     (1) designing, fabricating, or applying rehabilitative technology, such as selected orthotic
117.14 and prosthetic devices, and providing training in the functional use of these devices;
117.15     (2) designing, fabricating, or adapting assistive technology and providing training in the
117.16 functional use of assistive devices;
117.17     (3) adapting environments using assistive technology such as environmental controls,
117.18 wheelchair modifications, and positioning; and
117.19     (4) employing applying physical agent, manual, and mechanical modalities in preparation
117.20 for or as an adjunct to purposeful activity to meet established functional occupational therapy
117.21 goals; and
117.22     (5) educating and training individuals, including families, caregivers, groups, and
117.23 populations.
117.24     (c) Occupational therapy services must be based on nationally established standards of
117.25 practice.
117.26   Sec. 38. Minnesota Statutes 2024, section 148.6405, is amended to read:
117.27     148.6405 LICENSURE APPLICATION REQUIREMENTS: PROCEDURES AND
117.28 QUALIFICATIONS.
117.29     (a) An applicant for licensure must comply with the application requirements in section
117.30 148.6420. To qualify for licensure, an applicant must satisfy one of the requirements in
  Article 3 Sec. 38.  117
  06/07/25  REVISOR       DTT/LN  25-05697  as introduced
118.1  paragraphs (b) to (f) sections 148.6408 to 148.6415, or section 148.645 and not be subject
118.2  to denial of licensure under section 148.6448.
118.3      (b) A person who applies for licensure as an occupational therapist and who has not
118.4  been credentialed by the National Board for Certification in Occupational Therapy or another
118.5  jurisdiction must meet the requirements in section 148.6408.
118.6      (c) A person who applies for licensure as an occupational therapy assistant and who has
118.7  not been credentialed by the National Board for Certification in Occupational Therapy or
118.8  another jurisdiction must meet the requirements in section 148.6410.
118.9      (d) A person who is certified by the National Board for Certification in Occupational
118.10 Therapy may apply for licensure by equivalency and must meet the requirements in section
118.11 148.6412.
118.12     (e) A person who is credentialed in another jurisdiction and who was previously certified
118.13 by the National Board for Certification in Occupational Therapy may apply for licensure
118.14 by reciprocity and must meet the requirements in section 148.6415.
118.15     (f) (b) A person who applies for temporary licensure must meet the requirements in
118.16 section 148.6418.
118.17     (c) A person who applies for licensure under section 148.6408 or 148.6410 more than
118.18 two years after the person's initial NBCOT certification was issued and who has not practiced
118.19 in any jurisdiction must submit:
118.20     (1) a completed and signed application for licensure on forms provided by the board
118.21 that meet the requirements of section 148.6420, subdivision 1, paragraph (a), clauses (1)
118.22 and (2); and
118.23     (2) proof of a minimum of 24 continuing education contact hours by an occupational
118.24 therapist applicant, or a minimum of 18 hours by an occupational therapy assistant applicant,
118.25 completed within the two years proceeding the application and meeting the requirements
118.26 of section 148.6443.
118.27     (g) (d) A person who applies for licensure under paragraph (b), (c), or (f) more than two
118.28 and less than four years after meeting the examination requirements in section 148.6408,
118.29 subdivision 2, or 148.6410, subdivision 2, section 148.6408 or 148.6410 after the person's
118.30 initial NBCOT certification has expired must submit the following:
118.31     (1) a completed and signed application for licensure on forms provided by the board
118.32 that meet the requirements of section 148.6420, subdivision 1, paragraph (a), clauses (1)
118.33 and (2); and
  Article 3 Sec. 38.  118
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119.1      (2) the license application fee required under section 148.6445; evidence of:
119.2      (i) completion of an occupational therapy refresher program that contains both theoretical
119.3  and clinical components completed within the last year; or
119.4      (ii) current NBCOT certification.
119.5      (3) if applying for occupational therapist licensure, proof of having met a minimum of
119.6  24 contact hours of continuing education in the two years preceding licensure application,
119.7  or if applying for occupational therapy assistant licensure, proof of having met a minimum
119.8  of 18 contact hours of continuing education in the two years preceding licensure application;
119.9      (4) verified documentation of successful completion of 160 hours of supervised practice
119.10 approved by the board under a limited license specified in section 148.6425, subdivision 3,
119.11 paragraph (c); and
119.12     (5) additional information as requested by the board to clarify information in the
119.13 application, including information to determine whether the individual has engaged in
119.14 conduct warranting disciplinary action under section 148.6448. The information must be
119.15 submitted within 30 calendar days from the date of the board's request.
119.16     (h) A person who applies for licensure under paragraph (b), (c), or (f) four years or more
119.17 after meeting the examination requirements in section 148.6408, subdivision 2, or 148.6410,
119.18 subdivision 2, must:
119.19     (1) meet all the requirements in paragraph (g) except clauses (3) and (4);
119.20     (2) submit documentation of having retaken and achieved a qualifying score on the
119.21 credentialing examination for occupational therapists or occupational therapy assistants, or
119.22 of having completed an occupational therapy refresher program that contains both a
119.23 theoretical and clinical component approved by the board; and
119.24     (3) submit verified documentation of successful completion of 480 hours of supervised
119.25 practice approved by the board under a limited license specified in section 148.6425,
119.26 subdivision 3, paragraph (c). The 480 hours of supervised practice must be completed in
119.27 six months and may be completed at the applicant's place of work. Only refresher courses
119.28 completed within one year prior to the date of application qualify for approval.
119.29   Sec. 39. Minnesota Statutes 2024, section 148.6408, is amended by adding a subdivision
119.30 to read:
119.31     Subd. 1a. Qualifications. To be licensed as an occupational therapist, an applicant must:
119.32     (1) satisfy the education and examination requirements of subdivisions 1b and 2; or
  Article 3 Sec. 39.  119
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120.1      (2) satisfy the requirements for licensure by equivalency under section 148.6412 or
120.2  licensure by reciprocity under section 148.6415 as applicable based on the current status of
120.3  the applicant's NBCOT certification.
120.4    Sec. 40. Minnesota Statutes 2024, section 148.6408, subdivision 2, is amended to read:
120.5      Subd. 2. Qualifying examination score required. (a) An applicant must achieve a
120.6  qualifying score on the credentialing certification examination for occupational therapist.
120.7      (b) The board shall determine the qualifying score for the credentialing certification
120.8  examination for occupational therapist. In determining the qualifying score, the board shall
120.9  consider the cut score as recommended by the National Board for Certification in
120.10 Occupational Therapy, or other national credentialing certification organization approved
120.11 by the board, using the modified Angoff method for determining cut score or another method
120.12 for determining cut score that is recognized as appropriate and acceptable by industry
120.13 standards.
120.14     (c) The applicant is responsible for Applicants for licensure must:
120.15     (1) making make arrangements to take the credentialing certification examination for
120.16 an occupational therapist;
120.17     (2) bearing bear all expenses associated with taking the examination; and
120.18     (3) having the examination scores sent directly to the board from the testing service that
120.19 administers the examination submit an application and other materials as required by the
120.20 board under section 148.6420.
120.21   Sec. 41. Minnesota Statutes 2024, section 148.6410, is amended by adding a subdivision
120.22 to read:
120.23     Subd. 1a. Qualifications. To be licensed as an occupational therapist assistant, an
120.24 applicant must:
120.25     (1) satisfy the education and examination requirements of subdivisions 1b and 2; or
120.26     (2) satisfy the requirements for licensure by equivalency under section 148.6412 or
120.27 licensure by reciprocity under section 148.6415 as applicable based on the current status of
120.28 the applicant's NBCOT certification.
  Article 3 Sec. 41.  120
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121.1    Sec. 42. Minnesota Statutes 2024, section 148.6410, subdivision 2, is amended to read:
121.2      Subd. 2. Qualifying examination score required. (a) An applicant for licensure must
121.3  achieve a qualifying score on the credentialing certification examination for occupational
121.4  therapy assistants.
121.5      (b) The board shall determine the qualifying score for the credentialing certification
121.6  examination for occupational therapy assistants. In determining the qualifying score, the
121.7  board shall consider the cut score as recommended by the National Board for Certification
121.8  in Occupational Therapy, or other national credentialing certification organization approved
121.9  by the board, using the modified Angoff method for determining cut score or another method
121.10 for determining cut score that is recognized as appropriate and acceptable by industry
121.11 standards.
121.12     (c) The applicant is responsible for Applicants for licensure must:
121.13     (1) making make all arrangements to take the credentialing certification examination
121.14 for occupational therapy assistants;
121.15     (2) bearing bear all expense associated with taking the examination; and
121.16     (3) having the examination scores sent directly to the board from the testing service that
121.17 administers the examination submit an application and other materials as required by the
121.18 board under section 148.6420.
121.19   Sec. 43. Minnesota Statutes 2024, section 148.6412, subdivision 2, is amended to read:
121.20     Subd. 2. Persons currently certified by National Board for Certification in
121.21 Occupational Therapy NBCOT. The board may license any person certified by the National
121.22 Board for Certification in Occupational Therapy who holds current NBCOT certification
121.23 as an occupational therapist if the board determines the requirements for certification are
121.24 equivalent to or exceed the requirements for licensure as an occupational therapist under
121.25 section 148.6408 therapy practitioner. The board may license any person certified by the
121.26 National Board for Certification in Occupational Therapy as an occupational therapy assistant
121.27 if the board determines the requirements for certification are equivalent to or exceed the
121.28 requirements for licensure as an occupational therapy assistant under section 148.6410.
121.29 Nothing in this section limits the board's authority to deny licensure based upon the grounds
121.30 for discipline in sections 148.6401 to 148.6449 148.645.
121.31   Sec. 44. Minnesota Statutes 2024, section 148.6412, subdivision 3, is amended to read:
121.32     Subd. 3. Application procedures. Applicants for licensure by equivalency must provide:
  Article 3 Sec. 44.  121
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122.1      (1) the application materials as required by section 148.6420, subdivisions subdivision
122.2  1, 3, and 4; and.
122.3      (2) the fees required by section 148.6445.
122.4    Sec. 45. Minnesota Statutes 2024, section 148.6415, is amended to read:
122.5      148.6415 LICENSURE BY RECIPROCITY.
122.6      A person who is not certified by the National Board for Certification in Occupational
122.7  Therapy The board may license any person who does not hold current NBCOT certification
122.8  but who holds a compact privilege or a current credential as an occupational therapist therapy
122.9  practitioner in the District of Columbia or a state or territory of the United States whose
122.10 standards for credentialing are determined by the board to be equivalent to or exceed the
122.11 requirements for licensure under section 148.6408 may be eligible for licensure by reciprocity
122.12 as an occupational therapist. A person who is not certified by the National Board for
122.13 Certification in Occupational Therapy but who holds a current credential as an occupational
122.14 therapy assistant in the District of Columbia or a state or territory of the United States whose
122.15 standards for credentialing are determined by the board to be equivalent to or exceed the
122.16 requirements for licensure under section 148.6410 may be eligible for licensure by reciprocity
122.17 as an occupational therapy assistant. or 148.6410 as an occupational therapy practitioner.
122.18 Nothing in this section limits the board's authority to deny licensure based upon the grounds
122.19 for discipline in sections 148.6401 to 148.6449 148.645. An applicant must provide:
122.20     (1) the application materials as required by section 148.6420, subdivisions subdivision
122.21 1, 3, and 4; and
122.22     (2) the fees required by section 148.6445;
122.23     (3) a copy of a current and unrestricted credential for the practice of occupational therapy
122.24 as either an occupational therapist or occupational therapy assistant;
122.25     (4) a letter from the jurisdiction that issued the credential describing the applicant's
122.26 qualifications that entitled the applicant to receive the credential; and
122.27     (5) (2) other information necessary to determine whether the credentialing standards of
122.28 the jurisdiction that issued the credential are equivalent to or exceed the requirements for
122.29 licensure under sections 148.6401 to 148.6449 148.645.
  Article 3 Sec. 45.  122
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123.1    Sec. 46. Minnesota Statutes 2024, section 148.6418, is amended to read:
123.2      148.6418 TEMPORARY LICENSURE.
123.3      Subdivision 1. Application. The board shall issue temporary licensure as an occupational
123.4  therapist or occupational therapy assistant practitioner to applicants who are not the subject
123.5  of a disciplinary action or past disciplinary action, nor disqualified on the basis of items
123.6  listed in section 148.6448, subdivision 1.
123.7      Subd. 2. Procedures. To be eligible for temporary licensure, an applicant must submit
123.8  a completed application for temporary licensure on forms provided by the board, the fees
123.9  required by section 148.6445, and one of the following:
123.10     (1) evidence of successful completion of the requirements in section 148.6408,
123.11 subdivision 1, or 148.6410, subdivision 1;
123.12     (2) a copy of a current and unrestricted credential for the practice of occupational therapy
123.13 as either an occupational therapist or occupational therapy assistant practitioner in another
123.14 jurisdiction; or
123.15     (3) a copy of a current and unrestricted certificate certification from the National Board
123.16 for Certification in Occupational Therapy stating that the applicant is certified as an
123.17 occupational therapist or occupational therapy assistant practitioner.
123.18     Subd. 3. Additional documentation. Persons who are credentialed certified by the
123.19 National Board for Certification in Occupational Therapy or credentialed by another
123.20 jurisdiction must provide an affidavit a statement with the application for temporary licensure
123.21 stating that they are not the subject of a pending investigation or disciplinary action and
123.22 have not been the subject of a disciplinary action in the past.
123.23     Subd. 4. Supervision required. An applicant who has graduated from an accredited
123.24 occupational therapy program, as required by section 148.6408, subdivision 1, or 148.6410,
123.25 subdivision 1, and who has not passed the examination required by section 148.6408,
123.26 subdivision 2, or 148.6410, subdivision 2, must practice under the supervision of a licensed
123.27 occupational therapist. The supervising therapist must, at a minimum, supervise the person
123.28 working under temporary licensure in the performance of the initial evaluation, determination
123.29 of the appropriate intervention plan, and periodic review and modification of the intervention
123.30 plan. The supervising therapist must observe the person working under temporary licensure
123.31 in order to ensure service competency in carrying out evaluation, intervention planning,
123.32 and intervention implementation. The frequency of face-to-face collaboration between the
123.33 person working under temporary licensure and the supervising therapist must be based on
  Article 3 Sec. 46.  123
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124.1  the condition of each patient or client, the complexity of intervention and evaluation
124.2  procedures, and the proficiencies of the person practicing under temporary licensure.
124.3  Following demonstrated service competency of the applicant, supervision must occur no
124.4  less than every ten intervention days or every 30 calendar days, whichever occurs first. The
124.5  occupational therapist or occupational therapy assistant practitioner working under temporary
124.6  licensure must provide verification of supervision on the application form provided by the
124.7  board. Supervising occupational therapists must have a minimum of six months of fully
124.8  licensed practice to supervise a temporary licensee. The occupational therapy practitioner
124.9  working under temporary licensure must notify the board before changing supervision.
124.10     Subd. 5. Qualifying examination requirement; expiration and renewability. (a) A
124.11 person issued a temporary license pursuant to subdivision 2, clause (1), must demonstrate
124.12 to the board within the temporary licensure period successful completion of the qualifying
124.13 examination requirement under section 148.6408, subdivision 2, or section 148.6410,
124.14 subdivision 2. A temporary license holder who fails the qualifying examination for a second
124.15 time shall have their temporary license revoked effective upon notification to the temporary
124.16 license holder of the examination score. It is the temporary license holder's obligation to
124.17 submit to the board their qualifying examination scores and to refrain from practice if their
124.18 temporary license is revoked. Failure to do so subjects the temporary license holder to
124.19 disciplinary action pursuant to section 148.6448, subdivision 1, clause (5) (6). The board
124.20 must not issue a temporary license to a person with two or more certification examination
124.21 failures.
124.22     (b) A temporary license expires six months from the date of issuance or on the date the
124.23 board grants or denies licensure, whichever occurs first.
124.24     (c) A temporary license is not renewable.
124.25   Sec. 47. Minnesota Statutes 2024, section 148.6420, subdivision 1, is amended to read:
124.26     Subdivision 1. Applications for initial licensure. (a) An applicant for initial licensure
124.27 must:
124.28     (1) submit a completed application for licensure on forms provided by the board and
124.29 must supply the all information and documentation requested on the application, including:
124.30     (i) the applicant's name, business address and business telephone number, business
124.31 setting, primary email address, and daytime home or mobile telephone number;
124.32     (ii) the name and location of the occupational therapy program the applicant completed;
  Article 3 Sec. 47.  124
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125.1      (iii) (ii) a description of the applicant's education and training, including the name and
125.2  location of the occupational therapy program the applicant completed and a list of degrees
125.3  received from all other educational institutions attended;
125.4      (iv) (iii) the applicant's work history for the six years preceding the application;
125.5      (v) (iv) a list of all credentials currently and previously held in Minnesota and other
125.6  jurisdictions;
125.7      (vi) (v) a description of any jurisdiction's refusal to credential the applicant;
125.8      (vii) (vi) a description of all professional disciplinary actions initiated against the applicant
125.9  in any jurisdiction;
125.10     (viii) (vii) information on any physical or mental condition or substance use disorder
125.11 that impairs the person's ability to engage in the practice of occupational therapy with
125.12 reasonable judgment or safety;
125.13     (ix) (viii) a description of any misdemeanor or felony conviction that relates to honesty
125.14 or to the practice of occupational therapy charges or convictions; and
125.15     (x) (ix) a description of any state or federal court order, including a conciliation court
125.16 judgment or a disciplinary order, related to the individual's occupational therapy practice;
125.17     (2) submit with the application all fees required by section 148.6445;
125.18     (3) sign a statement that the information in the application is true and correct to the best
125.19 of the applicant's knowledge and belief;
125.20     (4) sign a waiver authorizing the board to obtain access to the applicant's records in this
125.21 or any other state in which the applicant holds or previously held a credential for the practice
125.22 of an occupation, has completed an accredited occupational therapy education program, or
125.23 engaged in the practice of occupational therapy;
125.24     (x) any legal information required under chapter 214;
125.25     (xi) either documentation to demonstrate the completion of the required education and
125.26 examination requirements under section 148.6408, subdivisions 1b and 2, or 148.6410,
125.27 subdivisions 1b and 2; for applicants for licensure by equivalency under section 148.6412,
125.28 documentation of current NBCOT certification; for applicants for licensure by reciprocity
125.29 under section 148.6415, documentation submitted directly by the appropriate commission
125.30 or government body verifying the license or credential; or verification from the Compact
125.31 Commission of the applicant's practice status in Compact Commission states;
125.32     (xii) all application fees required by section 148.6445;
  Article 3 Sec. 47.  125
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126.1      (xiii) evidence of completing a criminal background check according to section 214.075;
126.2  and
126.3      (xiv) a signed statement affirming that the information in the application is true and
126.4  correct to the best of the applicant's knowledge and belief;
126.5      (5) (2) submit additional information as requested by the board; and
126.6      (6) (3) submit the any additional information required for licensure by equivalency,
126.7  licensure by reciprocity, licensure by compact privilege, and temporary licensure as specified
126.8  in sections 148.6408 to 148.6418. and 148.645. An applicant applying under section 148.6418
126.9  is exempt from providing documentation related to a criminal background check under
126.10 clause (1), item (xiii). An applicant applying under section 148.6418, subdivision 4, is
126.11 exempt from providing documentation related to previously held licenses or credentials
126.12 under clause (1), item (iv).
126.13     (b) The board must not verify the status of an applicant under paragraph (a), clause (1),
126.14 item (xi), by using another jurisdiction's publicly available website unless the other
126.15 jurisdiction fails to provide the requested documentation after the applicant provides
126.16 documentation of making the request.
126.17   Sec. 48. Minnesota Statutes 2024, section 148.6423, subdivision 1, is amended to read:
126.18     Subdivision 1. Renewal requirements. To be eligible for licensure renewal, a licensee
126.19 must:
126.20     (1) submit a completed and signed application for licensure renewal; on forms provided
126.21 by the board, including:
126.22     (i) updated personal information, including the renewal applicant's name, business
126.23 address and business telephone number, primary email address, and home or mobile telephone
126.24 number;
126.25     (ii) information regarding any change to the renewal applicant's responses to section
126.26 148.6420, subdivision 1, paragraph (a), clause (1), items (v) to (ix);
126.27     (iii) a signed statement affirming that the information in the renewal application is true
126.28 and correct to the best of the applicant's knowledge and belief; and
126.29     (iv) any legal information required under chapter 214;
126.30     (2) submit the renewal fee required under section 148.6445;
  Article 3 Sec. 48.  126
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127.1      (3) if audited, submit proof of having met the continuing education requirement of section
127.2  148.6443; and
127.3      (4) submit additional information as requested by the board to clarify information
127.4  presented in the renewal application. The information must be submitted within 30 calendar
127.5  days of the board's request.
127.6    Sec. 49. Minnesota Statutes 2024, section 148.6423, is amended by adding a subdivision
127.7  to read:
127.8      Subd. 1a. License period. Following the initial license period, a license period begins
127.9  on the first day of the month after the licensee's birth month and must be renewed biennially.
127.10   Sec. 50. Minnesota Statutes 2024, section 148.6423, subdivision 2, is amended to read:
127.11     Subd. 2. Renewal deadline. (a) Except as provided in paragraph (c), licenses must be
127.12 renewed every two years on or before the first day of the month after the licensee's birth
127.13 month. Licensees must comply with the following procedures in paragraphs (b) to (e).
127.14     (b) Each license must state an expiration date. An application for licensure renewal must
127.15 be received by the board at least 30 calendar days on or before the expiration date.
127.16     (c) If the board changes the renewal schedule and the expiration date is less than two
127.17 years, the fee and the continuing education contact hours to be reported at the next renewal
127.18 must be prorated.
127.19     (d) An application for licensure renewal not received within the time required under
127.20 paragraph (b), but received on or before the expiration date, must be accompanied by a late
127.21 fee in addition to the renewal fee specified by section 148.6445.
127.22     (e) Licensure renewals received after the expiration date must comply with the
127.23 requirements of section 148.6425.
127.24   Sec. 51. Minnesota Statutes 2024, section 148.6425, subdivision 2, is amended to read:
127.25     Subd. 2. Licensure renewal within one year after licensure expiration date. A licensee
127.26 whose application for licensure renewal is received after the licensure expiration date but
127.27 within one year of the expiration date must submit the following:
127.28     (1) a completed and signed renewal application for licensure following lapse in licensed
127.29 status; on forms provided by the board, including:
  Article 3 Sec. 51.  127
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128.1      (i) updated personal information, including the renewal applicant's name, business
128.2  address and business telephone number, primary email address, and home or mobile telephone
128.3  number;
128.4      (ii) information regarding any change to the renewal applicant's responses to section
128.5  148.6420, subdivision 1, paragraph (a), clause (1), items (v) to (ix);
128.6      (iii) a signed statement affirming that the information in the renewal application is true
128.7  and correct to the best of the applicant's knowledge and belief;
128.8      (iv) information regarding any change to the renewal applicant's responses to section
128.9  148.6420, subdivision 1, paragraph (a), clause (1), item (xi);
128.10     (v) NBCOT verification of certification documentation; and
128.11     (vi) any legal information required under chapter 214;
128.12     (2) the renewal fee and the late fee required under section 148.6445;
128.13     (3) proof of having met the continuing education requirements in section 148.6443,
128.14 subdivision 1; and
128.15     (4) an employment verification form; and
128.16     (4) (5) additional information as requested by the board to clarify information in the
128.17 application, including information to determine whether the licensee has engaged in conduct
128.18 warranting disciplinary action as set forth in section 148.6448. The information must be
128.19 submitted within 30 calendar days from the date of the board's request.
128.20   Sec. 52. Minnesota Statutes 2024, section 148.6425, is amended by adding a subdivision
128.21 to read:
128.22     Subd. 4. Licensure renewal within two years after license expiration date. A licensee
128.23 whose application for license renewal is received more than one year but less than two years
128.24 after the expiration date must submit the following:
128.25     (1) a completed and signed renewal application for licensure following lapse in licensed
128.26 status on forms provided by the board, including all information listed in subdivision 2,
128.27 clause (1);
128.28     (2) the renewal fee and the late fee required under section 148.6445;
128.29     (3) proof of having met the continuing education requirements in section 148.6443;
128.30     (4) an employment verification form;
  Article 3 Sec. 52.  128
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129.1      (5) evidence of completion of a criminal background check as required under section
129.2  214.075 and the associated fee; and
129.3      (6) additional information as requested by the board to clarify information in the
129.4  application, including information to determine whether the licensee has engaged in conduct
129.5  warranting disciplinary action as set forth in section 148.6448. The information must be
129.6  submitted within 30 calendar days from the date of the board's request.
129.7    Sec. 53. Minnesota Statutes 2024, section 148.6425, is amended by adding a subdivision
129.8  to read:
129.9      Subd. 5. Expiration due to nonrenewal after two years. The board shall not renew,
129.10 reissue, reinstate, or restore a license that is not subject to a pending review, investigation,
129.11 or disciplinary action and has not been renewed within one biennial renewal cycle of the
129.12 license expiration. An individual whose license has expired under this subdivision for
129.13 nonrenewal must obtain a new license by applying for licensure and fulfilling all requirements
129.14 then in existence for an initial license to practice occupational therapy in Minnesota.
129.15   Sec. 54. Minnesota Statutes 2024, section 148.6428, is amended to read:
129.16     148.6428 CHANGE OF CONTACT INFORMATION OR EMPLOYMENT.
129.17     A licensee who changes a name, primary email address, address, employment, business
129.18 address, or business telephone number must inform the board of the change of name, primary
129.19 email address, address, employment, business address, or business telephone number within
129.20 30 calendar days from the effective date of the change. A change in name must be
129.21 accompanied by a copy of a marriage certificate, government-issued identification card,
129.22 Social Security card, or court order. All notices or other correspondence served on a licensee
129.23 by the board at the licensee's contact information on file with the board must be considered
129.24 as having been received by the licensee.
129.25   Sec. 55. [148.6431] JURISPRUDENCE EXAMINATION.
129.26     The board may require occupational therapy practitioners to take an open-book
129.27 jurisprudence examination on state laws and rules regarding the practice of occupational
129.28 therapy and occupational therapy assisting.
129.29   Sec. 56. Minnesota Statutes 2024, section 148.6432, subdivision 1, is amended to read:
129.30     Subdivision 1. Applicability. If the professional standards identified in section 148.6430
129.31 subdivision 1a permit an occupational therapist to delegate an evaluation, reevaluation, or
  Article 3 Sec. 56.  129
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130.1  treatment procedure, the occupational therapist must provide supervision consistent with
130.2  this section.
130.3    Sec. 57. Minnesota Statutes 2024, section 148.6432, is amended by adding a subdivision
130.4  to read:
130.5      Subd. 1a. Delegation of duties. (a) The occupational therapist may delegate to an
130.6  occupational therapy assistant those portions of the client's evaluation, reevaluation, and
130.7  intervention that, according to prevailing national practice standards, can be performed by
130.8  an occupational therapy assistant.
130.9      (b) The occupational therapist is responsible for all duties delegated to the occupational
130.10 therapy assistant.
130.11     (c) The occupational therapist may not delegate portions of an evaluation or reevaluation
130.12 of a person whose condition is changing rapidly.
130.13   Sec. 58. Minnesota Statutes 2024, section 148.6432, subdivision 2, is amended to read:
130.14     Subd. 2. Evaluations. The occupational therapist shall determine the frequency of
130.15 evaluations and reevaluations for each client. The occupational therapy assistant shall inform
130.16 the occupational therapist of the need for more frequent reevaluation if indicated by the
130.17 client's condition or response to treatment. Before delegating a portion of a client's evaluation
130.18 pursuant to section 148.6430 subdivision 1a, the occupational therapist shall ensure the
130.19 service competency of the occupational therapy assistant in performing the evaluation
130.20 procedure and shall provide supervision consistent with the condition of the patient or client
130.21 and the complexity of the evaluation procedure.
130.22   Sec. 59. Minnesota Statutes 2024, section 148.6432, subdivision 3, is amended to read:
130.23     Subd. 3. Intervention. (a) The occupational therapist must determine the frequency and
130.24 manner of supervision of an occupational therapy assistant performing intervention
130.25 procedures delegated pursuant to section 148.6430 subdivision 1a based on the condition
130.26 of the patient or client, the complexity of the intervention procedure, and the service
130.27 competency of the occupational therapy assistant.
130.28     (b) Face-to-face collaboration between the occupational therapist and the occupational
130.29 therapy assistant must occur for all clients every ten intervention days or every 30 days,
130.30 whichever comes first, during which time the occupational therapist is responsible for:
  Article 3 Sec. 59.  130
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131.1      (1) planning and documenting an initial intervention plan and discharge from
131.2  interventions;
131.3      (2) reviewing intervention goals, therapy programs, and client progress;
131.4      (3) supervising changes in the intervention plan;
131.5      (4) conducting or observing intervention procedures for selected clients and documenting
131.6  appropriateness of intervention procedures. Clients must be selected based on the
131.7  occupational therapy services provided to the client and the role of the occupational therapist
131.8  and the occupational therapy assistant in those services; and
131.9      (5) ensuring the service competency of the occupational therapy assistant in performing
131.10 delegated intervention procedures.
131.11     (c) Face-to-face collaboration must occur more frequently if necessary to meet the
131.12 requirements of paragraph (a) or (b).
131.13     (d) The occupational therapist must document compliance with this subdivision in the
131.14 client's file or chart.
131.15   Sec. 60. Minnesota Statutes 2024, section 148.6432, subdivision 4, is amended to read:
131.16     Subd. 4. Exception. (a) The supervision requirements of this section do not apply to an
131.17 occupational therapy assistant who:
131.18     (1) works in an activities program; and
131.19     (2) does not perform occupational therapy services.
131.20     (b) The occupational therapy assistant must meet all other applicable requirements of
131.21 sections 148.6401 to 148.6449 148.645.
131.22   Sec. 61. Minnesota Statutes 2024, section 148.6435, is amended to read:
131.23     148.6435 COORDINATION OF SERVICES.
131.24     An occupational therapist must:
131.25     (1) collect information necessary to ensure that the provision of occupational therapy
131.26 services are consistent with the client's physical and mental health status. The information
131.27 required to make this determination may include, but is not limited to, contacting the client's
131.28 licensed health care professional for health history, current health status, current medications,
131.29 and precautions;
  Article 3 Sec. 61.  131
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132.1      (2) modify or terminate occupational therapy intervention of a client that is not beneficial
132.2  to the client, not tolerated by the client, or refused by the client, and if intervention was
132.3  terminated for a medical reason, notify the client's licensed health care professional by
132.4  correspondence postmarked or delivered to the licensed health care professional within one
132.5  week of the termination of intervention;
132.6      (3) (2) refer a client to an appropriate health care, social service, or education practitioner
132.7  if the client's condition requires services not within the occupational therapist's service
132.8  competency or not within the practice of occupational therapy generally, or if the client's
132.9  acuity warrants alternative care; and
132.10     (4) (3) participate and cooperate in the coordination of occupational therapy services
132.11 with other related services, as a member of the professional community serving the client.
132.12   Sec. 62. Minnesota Statutes 2024, section 148.6438, is amended to read:
132.13     148.6438 RECIPIENT NOTIFICATION.
132.14     Subdivision 1. Required notification. (a) In the absence of a physician, advanced
132.15 practice registered nurse, or physician assistant licensed health care provider referral or
132.16 prior authorization, and before providing occupational therapy services for remuneration
132.17 or expectation of payment from the client, an occupational therapist must provide the
132.18 following written notification in all capital letters of 12-point or larger boldface type, to the
132.19 client, parent, or guardian in a format meeting national accessibility standards and the needs
132.20 of the client, parent, or guardian:
132.21     "Your health care provider, insurer, or plan may require a physician, advanced practice
132.22 registered nurse, or physician assistant licensed health care provider referral or prior
132.23 authorization and you may be obligated for partial or full payment for occupational therapy
132.24 services rendered."
132.25     (b) Information other than this notification may be included as long as the notification
132.26 remains conspicuous on the face of the document. A nonwritten disclosure format may be
132.27 used to satisfy the recipient notification requirement when necessary to accommodate the
132.28 physical condition of a client or client's guardian.
132.29     Subd. 2. Evidence of recipient notification. The occupational therapist is responsible
132.30 for providing evidence of compliance with the recipient notification requirement of this
132.31 section with documentation of the client, parent, or guardian agreement.
  Article 3 Sec. 62.  132
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133.1    Sec. 63. Minnesota Statutes 2024, section 148.6443, subdivision 3, is amended to read:
133.2Subd. 3. Activities qualifying for continuing education contact hours. (a) The activities
133.3  in this subdivision qualify for continuing education contact hours if they meet all other
133.4  requirements of this section.
133.5(b) A minimum of one-half of the required contact hours must be directly related to
133.6  occupational therapy practice. The remaining contact hours may be related to occupational
133.7  therapy practice, the delivery of occupational therapy services, or to the practitioner's current
133.8  professional role.
133.9(c) A licensee may obtain an unlimited number of contact hours in any two-year
133.10 continuing education period through participation in the following:
133.11(1) attendance at educational programs of annual conferences, lectures, panel discussions,
133.12 workshops, in-service training, seminars, and symposiums;
133.13(2) successful completion of college or university courses. The licensee must obtain a
133.14 grade of at least a "C" or a pass in a pass/fail course in order to receive credit. One college
133.15 credit equals six continuing education contact hours; or
133.16(3) successful completion of home study courses that require the participant to
133.17 demonstrate the participant's knowledge following completion of the course provide
133.18 documentation that the course was completed and that meet the requirements in subdivision
133.19 2.
133.20(d) A licensee may obtain a maximum of one-half of the required contact hours in any
133.21 two-year continuing education period for:
133.22(1) teaching continuing education or occupational therapy related courses that meet the
133.23 requirements of this section. A licensee is entitled to earn a maximum of two contact hours
133.24 as preparation time for each contact hour of presentation time. Contact hours may be claimed
133.25 only once for teaching the same course in any two-year continuing education period. A
133.26 course schedule or brochure must be maintained for audit;
133.27(2) supervising occupational therapist or occupational therapy assistant students. A
133.28 licensee may earn one contact hour for every eight hours of student supervision. Licensees
133.29 must ensure they receive documentation regarding each student supervised and the dates
133.30 and hours each student was supervised. Contact hours obtained by student supervision must
133.31 be obtained by supervising students from an occupational therapy education program
133.32 accredited by the Accreditation Council for Occupational Therapy Education; and
  Article 3 Sec. 63.  133
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134.1      (3) teaching or participating in courses related to leisure activities, recreational activities,
134.2  or hobbies if the practitioner uses these interventions within the practitioner's current practice
134.3  or employment; and
134.4      (4) (3) engaging in research activities or outcome studies that are related to the practice
134.5  of occupational therapy and associated with grants, postgraduate studies, or publications in
134.6  professional journals or books.
134.7      (e) A licensee may obtain a maximum of two contact hours in any two-year continuing
134.8  education period for continuing education activities in the following areas:
134.9      (1) personal skill topics: career burnout, communication skills, human relations, and
134.10 similar topics;
134.11     (2) training that is obtained in conjunction with a licensee's employment, occurs during
134.12 a licensee's normal workday, and does not include subject matter specific to the fundamentals
134.13 of occupational therapy basic life support and CPR training; and
134.14     (3) participation for a minimum of one year on a professional committee or board.
134.15   Sec. 64. Minnesota Statutes 2024, section 148.6443, subdivision 4, is amended to read:
134.16     Subd. 4. Activities not qualifying for continuing education contact hours. Credit
134.17 must not be granted for the following activities: hospital patient rounds,; entertainment or
134.18 recreational activities,; volunteering; noneducational association meetings,; and employment
134.19 orientation sessions and meetings, including but not limited to training required at the
134.20 beginning of employment, annually, or routinely that is related to the employer's organization
134.21 requirements.
134.22   Sec. 65. Minnesota Statutes 2024, section 148.6443, subdivision 5, is amended to read:
134.23     Subd. 5. Reporting continuing education contact hours. Each licensee must use the
134.24 continuing education reporting form to verify meeting the continuing education requirements
134.25 of this section. The licensee must maintain documentation, including but not limited to a
134.26 signed certificate, transcript, or similar evidence of participation in an activity. The
134.27 documentation must include a:
134.28     (1) the title of the continuing education activity;
134.29     (2) a brief description of the continuing education activity prepared by the presenter or
134.30 sponsor;
134.31     (3) the name of the sponsor, presenter, or author;
  Article 3 Sec. 65.  134
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135.1      (4) the location and attendance dates;
135.2      (5) the number of contact hours; and
135.3      (6) the licensee's name.
135.4    Sec. 66. Minnesota Statutes 2024, section 148.6443, subdivision 6, is amended to read:
135.5      Subd. 6. Auditing continuing education reports. (a) The board may audit a percentage
135.6  of the continuing education reports based on random selection. A licensee shall maintain
135.7  all documentation required by this section for two years after the last day of the biennial
135.8  licensure period in which the contact hours were earned.
135.9      (b) All renewal applications that are received after the expiration date may be subject
135.10 to a continuing education report audit.
135.11     (c) Any licensee against whom a complaint is filed may be subject to a continuing
135.12 education report audit.
135.13     (d) The licensee shall make the following information available to the board for auditing
135.14 purposes:
135.15     (1) a copy of the completed continuing education reporting form for the continuing
135.16 education reporting period that is the subject of the audit including all supporting
135.17 documentation required by subdivision 5;
135.18     (2) documentation of university, college, or vocational school courses by a transcript
135.19 and a course syllabus, listing in a course bulletin, or equivalent documentation that includes
135.20 the course title, instructor's name, course dates, number of contact hours, and course content,
135.21 objectives, or goals; and
135.22     (3) verification of attendance by that meets the requirements of subdivision 5 by
135.23 submitting:
135.24     (i) a signature of certificate of attendance, or if a certificate is not available, other
135.25 documentation from the presenter or a designee at the continuing education activity on the
135.26 continuing education report form or a certificate of attendance with the course name, course
135.27 date, and licensee's name submitted directly to the board confirming the requirements; or
135.28     (ii) a summary or outline of the educational content of an audio or video educational
135.29 activity to verify the licensee's participation in the activity if a designee is not available to
135.30 sign the continuing education report form; or
  Article 3 Sec. 66.  135
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136.1      (iii) (ii) verification of self-study programs by a certificate of completion or other
136.2  documentation indicating that the individual has demonstrated knowledge and has
136.3  successfully completed the program.
136.4    Sec. 67. Minnesota Statutes 2024, section 148.6443, subdivision 7, is amended to read:
136.5      Subd. 7. Waiver Deferral of continuing education requirements. The board may
136.6  waive or defer all or part of the continuing education requirements of this section if the
136.7  licensee submits a written request and provides satisfactory evidence to the board of illness,
136.8  injury, financial hardship, family hardship, or other similar extenuating circumstances that
136.9  preclude completion of the requirements during the licensure period. The request for a
136.10 waiver deferral must be in writing, state the circumstances that constitute hardship, state
136.11 the period of time the licensee wishes to have the continuing education requirement waived
136.12 deferred, and state the alternative measures that will be taken if a waiver deferral is granted.
136.13 The board must set forth, in writing, the reasons for granting or denying the waiver deferral.
136.14 Waivers Deferrals granted by the board must specify, in writing, the time limitation and
136.15 required alternative measures to be taken by the licensee. A request for waiver deferral must
136.16 be denied if the board finds that the circumstances stated by the licensee do not support a
136.17 claim of hardship, the requested time period for waiver deferral is unreasonable, the
136.18 alternative measures proposed by the licensee are not equivalent to the continuing education
136.19 activity being waived deferred, or the request for waiver deferral is not submitted to the
136.20 board within 60 calendar days of the expiration date.
136.21   Sec. 68. Minnesota Statutes 2024, section 148.6443, subdivision 8, is amended to read:
136.22     Subd. 8. Penalties for noncompliance. The board shall refuse to renew or grant, or
136.23 shall suspend, condition, limit, or otherwise qualify the license of any person who the board
136.24 determines has failed to comply with the continuing education requirements of this section.
136.25 A licensee may request reconsideration of the board's determination of noncompliance or
136.26 the penalty imposed under this section by making a written request to the board within 30
136.27 calendar days of the date of notification to the applicant. Individuals requesting
136.28 reconsideration may submit information that the licensee wants considered in the
136.29 reconsideration.
136.30   Sec. 69. Minnesota Statutes 2024, section 148.6445, is amended by adding a subdivision
136.31 to read:
136.32     Subd. 5a. Compact privilege fee. The fee for interstate licensure compact privilege to
136.33 practice is $150.
  Article 3 Sec. 69.  136
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137.1    Sec. 70. Minnesota Statutes 2024, section 148.6445, is amended by adding a subdivision
137.2  to read:
137.3      Subd. 7a. Active mailing list. The fee for the standard active licensee mailing list
137.4  delivered electronically is $500.
137.5    Sec. 71. Minnesota Statutes 2024, section 148.6448, subdivision 1, is amended to read:
137.6      Subdivision 1. Grounds for denial of licensure or discipline. The board may deny an
137.7  application for licensure, may approve licensure with conditions, or may discipline a licensee
137.8  using any disciplinary actions listed in subdivision 3 on proof that the individual has:
137.9      (1) intentionally submitted false or misleading information to the board;
137.10     (2) obtained a license by means of fraud, misrepresentation, or concealment of material
137.11 facts;
137.12     (3) failed, within 30 days, to provide information in response to a written request by the
137.13 board;
137.14     (3) (4) performed services of an occupational therapist or occupational therapy assistant
137.15 practitioner in an incompetent manner or in a manner that falls below the community standard
137.16 of care or national practice standards of care;
137.17     (4) (5) failed to satisfactorily perform occupational therapy services during a period of
137.18 temporary licensure;
137.19     (5) (6) violated sections 148.6401 to 148.6449 148.645;
137.20     (6) (7) failed to perform services with reasonable judgment, skill, or safety due to the
137.21 use of alcohol or drugs, or other physical or mental impairment;
137.22     (7) (8) been convicted of violating any state or federal law, rule, or regulation which
137.23 directly that reasonably relates to the practice of occupational therapy;
137.24     (9) failed to report other licensees that have violated sections 148.6401 to 148.645;
137.25     (8) (10) aided or abetted another person in violating any provision of sections 148.6401
137.26 to 148.6449 148.645;
137.27     (9) (11) been disciplined for conduct in the practice of an occupation by the state of
137.28 Minnesota, another jurisdiction, or a national professional association, if any of the grounds
137.29 for discipline are the same or substantially equivalent to those in sections 148.6401 to
137.30 148.6449 148.645;
  Article 3 Sec. 71.  137
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138.1      (10) (12) not cooperated with the board in an investigation conducted according to
138.2  subdivision 2;
138.3      (11) (13) advertised in a manner that is false or misleading;
138.4      (12) (14) engaged in dishonest, unethical, or unprofessional conduct in connection with
138.5  the practice of occupational therapy that is likely to deceive, defraud, or harm the public;
138.6      (15) improperly managed client records, including but not limited to failure to maintain
138.7  client records in a manner that meets community standards of care or nationally accepted
138.8  practice standards;
138.9      (13) (16) demonstrated a willful or careless disregard for the health, welfare, or safety
138.10 of a client;
138.11     (17) inappropriately supervised or delegated or assigned tasks to an occupational therapy
138.12 assistant, occupational therapy student, rehabilitation aide, or other licensed professional;
138.13     (14) (18) performed medical diagnosis or provided intervention, other than occupational
138.14 therapy, without being licensed to do so under the laws of this state;
138.15     (15) (19) paid or promised to pay a commission or part of a fee to any person who
138.16 contacts the occupational therapist therapy practitioner for consultation or sends patients to
138.17 the occupational therapist therapy practitioner for intervention;
138.18     (16) (20) engaged in an incentive payment arrangement, other than that prohibited by
138.19 clause (15) (19), that promotes occupational therapy overutilization, whereby the referring
138.20 person or person who controls the availability of occupational therapy services to a client
138.21 profits unreasonably as a result of client intervention;
138.22     (17) (21) engaged in abusive or fraudulent billing practices, including violations of
138.23 federal Medicare and Medicaid laws, Food and Drug Administration regulations, or state
138.24 medical assistance laws;
138.25     (18) (22) obtained money, property, or services from a consumer through the use of
138.26 undue influence, high pressure sales tactics, harassment, duress, deception, or fraud;
138.27     (19) (23) performed services for a client who had no possibility of benefiting from the
138.28 services;
138.29     (20) (24) failed to refer a client for medical evaluation when appropriate or when a client
138.30 indicated symptoms associated with diseases that could be medically or surgically treated;
  Article 3 Sec. 71.  138
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139.1      (21) (25) engaged in conduct with a client that is sexual or may reasonably be interpreted
139.2  by the client as sexual, or in any verbal behavior that is seductive or sexually demeaning to
139.3  a patient;
139.4      (22) (26) violated a federal or state court order, including a conciliation court judgment,
139.5  or a disciplinary order issued by the board, related to the person's occupational therapy
139.6  practice; or
139.7      (23) (27) any other just cause related to the practice of occupational therapy.
139.8    Sec. 72. Minnesota Statutes 2024, section 148.6448, subdivision 2, is amended to read:
139.9      Subd. 2. Investigation of complaints. The board may initiate an investigation upon
139.10 receiving a complaint or other oral or written communication that alleges or implies that a
139.11 person has violated sections 148.6401 to 148.6449 148.645. In the receipt, investigation,
139.12 and hearing of a complaint that alleges or implies a person has violated sections 148.6401
139.13 to 148.6449 148.645, the board must follow the procedures in sections 214.10 and 214.103.
139.14   Sec. 73. Minnesota Statutes 2024, section 148.6448, subdivision 4, is amended to read:
139.15     Subd. 4. Effect of specific disciplinary action on use of title. Upon notice from the
139.16 board denying licensure renewal or upon notice that disciplinary actions have been imposed
139.17 and the person is no longer entitled to practice occupational therapy and use the occupational
139.18 therapy and licensed titles, the person shall cease to practice occupational therapy, to use
139.19 titles protected by sections 148.6401 to 148.6449 148.645, and to represent to the public
139.20 that the person is licensed by the board.
139.21   Sec. 74. Minnesota Statutes 2024, section 148.6448, subdivision 6, is amended to read:
139.22     Subd. 6. Authority to contract. The board shall contract with the health professionals
139.23 services program as authorized by sections 214.31 to 214.37 to provide these services to
139.24 practitioners under this chapter. The health professionals services program does not affect
139.25 the board's authority to discipline violations of sections 148.6401 to 148.6449 148.645.
139.26   Sec. 75. Minnesota Statutes 2024, section 148.6449, subdivision 1, is amended to read:
139.27     Subdivision 1. Creation. The Board of Occupational Therapy Practice consists of 11
139.28 members appointed by the governor. The members are:
139.29     (1) five occupational therapists licensed under sections 148.6401 to 148.6449 148.645;
  Article 3 Sec. 75.  139
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140.1      (2) three occupational therapy assistants licensed under sections 148.6401 to 148.6449
140.2  148.645; and
140.3      (3) three public members, including two members who have received occupational
140.4  therapy services or have a family member who has received occupational therapy services,
140.5  and one member who is a health care professional or health care provider licensed in
140.6  Minnesota.
140.7    Sec. 76. Minnesota Statutes 2024, section 148.6449, subdivision 2, is amended to read:
140.8      Subd. 2. Qualifications of board members. (a) The occupational therapy practitioners
140.9  appointed to the board must represent a variety of practice areas and settings.
140.10     (b) At least two occupational therapy practitioners three members of the board must be
140.11 employed or reside outside the seven-county metropolitan area.
140.12     (c) Board members must not serve for more than two full consecutive terms.
140.13     (d) Interstate licensure compact privilege holders are not eligible to serve on the board.
140.14   Sec. 77. Minnesota Statutes 2024, section 148.6449, subdivision 7, is amended to read:
140.15     Subd. 7. Duties of the Board of Occupational Therapy Practice. (a) The board shall:
140.16     (1) adopt and enforce rules and laws necessary for licensing occupational therapy
140.17 practitioners;
140.18     (2) adopt and enforce rules for regulating the professional conduct of the practice of
140.19 occupational therapy;
140.20     (3) issue licenses to qualified individuals in accordance with sections 148.6401 to
140.21 148.6449 148.645;
140.22     (4) assess and collect fees for the issuance and renewal of licenses;
140.23     (5) educate the public about the requirements for licensing occupational therapy
140.24 practitioners, educate occupational therapy practitioners about the rules of conduct, and
140.25 enable the public to file complaints against applicants and licensees who may have violated
140.26 sections 148.6401 to 148.6449 148.645; and
140.27     (6) investigate individuals engaging in practices that violate sections 148.6401 to
140.28 148.6449 148.645 and take necessary disciplinary, corrective, or other action according to
140.29 section 148.6448.
  Article 3 Sec. 77.  140
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141.1      (b) The board may adopt rules necessary to define standards or carry out the provisions
141.2  of sections 148.6401 to 148.6449 148.645. Rules shall be adopted according to chapter 14.
141.3    Sec. 78. Minnesota Statutes 2024, section 148B.53, subdivision 3, is amended to read:
141.4      Subd. 3. Fee Fees. Nonrefundable fees are as follows:
141.5      (1) initial license application fee for licensed professional counseling (LPC) - $150;
141.6      (2) initial license fee for LPC - $250;
141.7      (3) annual active license renewal fee for LPC - $250 or equivalent;
141.8      (4) annual inactive license renewal fee for LPC - $125;
141.9      (5) initial license application fee for licensed professional clinical counseling (LPCC) -
141.10 $150;
141.11     (6) initial license fee for LPCC - $250;
141.12     (7) annual active license renewal fee for LPCC - $250 or equivalent;
141.13     (8) annual inactive license renewal fee for LPCC - $125;
141.14     (9) license renewal late fee - $100 per month or portion thereof;
141.15     (10) copy of board order or stipulation - $10;
141.16     (11) certificate of good standing or license verification - $25;
141.17     (12) duplicate certificate fee - $25;
141.18     (13) professional firm renewal fee - $25;
141.19     (14) sponsor application for approval of a continuing education course - $60;
141.20     (15) initial registration fee - $50;
141.21     (16) annual registration renewal fee - $25;
141.22     (17) approved supervisor application processing fee - $30; and
141.23     (18) temporary license for members of the military - $250; and
141.24     (19) interstate compact privilege to practice fee - not to exceed $100.
141.25     EFFECTIVE DATE. This section is effective the day following final enactment.
  Article 3 Sec. 78.  141
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142.1    Sec. 79. Minnesota Statutes 2024, section 148E.180, subdivision 1, is amended to read:
142.2      Subdivision 1. Application fees. (a) Nonrefundable application fees for licensure may
142.3  not exceed the following amounts but may be adjusted lower by board action:
142.4      (1) for a licensed social worker, $75;
142.5      (2) for a licensed graduate social worker, $75;
142.6      (3) for a licensed independent social worker, $75;
142.7      (4) for a licensed independent clinical social worker, $75;
142.8      (5) for a temporary license, $50; and
142.9      (6) for a license by endorsement, $115; and
142.10     (7) for a compact multistate license, $75.
142.11     (b) The fee for criminal background checks is the fee charged by the Bureau of Criminal
142.12 Apprehension. The criminal background check fee must be included with the application
142.13 fee as required according to section 148E.055.
142.14     EFFECTIVE DATE. This section is effective the day following final enactment.
142.15   Sec. 80. Minnesota Statutes 2024, section 148E.180, is amended by adding a subdivision
142.16 to read:
142.17     Subd. 2a. Compact multistate license fees. Nonrefundable compact multistate license
142.18 fees must not exceed the following amounts but may be adjusted lower by board action:
142.19     (1) for a licensed social worker, $115;
142.20     (2) for a licensed graduate social worker, $210;
142.21     (3) for a licensed independent social worker, $305; and
142.22     (4) for a licensed independent clinical social worker, $335.
142.23     EFFECTIVE DATE. This section is effective the day following final enactment.
142.24   Sec. 81. Minnesota Statutes 2024, section 148E.180, is amended by adding a subdivision
142.25 to read:
142.26     Subd. 3a. Compact multistate renewal fees. Nonrefundable renewal fees for compact
142.27 multistate licensure must not exceed the following amounts but may be adjusted lower by
142.28 board action:
  Article 3 Sec. 81.  142
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143.1      (1) for a licensed social worker, $115;
143.2      (2) for a licensed graduate social worker, $210;
143.3      (3) for a licensed independent social worker, $305; and
143.4      (4) for a licensed independent clinical social worker, $335.
143.5      EFFECTIVE DATE. This section is effective the day following final enactment.
143.6    Sec. 82. Minnesota Statutes 2024, section 148E.180, subdivision 5, is amended to read:
143.7      Subd. 5. Late fees. Late fees are the following nonrefundable amounts:
143.8      (1) renewal late fee, one-fourth of the applicable renewal fee specified in subdivision
143.9  subdivisions 3 and 3a;
143.10     (2) supervision plan late fee, $40; and
143.11     (3) license late fee, $100 plus the prorated share of the applicable license fee fees specified
143.12 in subdivision subdivisions 2 and 2a for the number of months during which the individual
143.13 practiced social work without a license.
143.14     EFFECTIVE DATE. This section is effective the day following final enactment.
143.15   Sec. 83. Minnesota Statutes 2024, section 148E.180, subdivision 7, is amended to read:
143.16     Subd. 7. Reactivation fees. Reactivation fees are the following nonrefundable amounts:
143.17     (1) reactivation from a temporary leave or emeritus status, the prorated share of the
143.18 renewal fee specified in subdivision 3; and
143.19     (2) reactivation of an expired license, 1-1/2 times the applicable renewal fees specified
143.20 in subdivision subdivisions 3 and 3a.
143.21     EFFECTIVE DATE. This section is effective the day following final enactment.
143.22   Sec. 84. [148G.01] TITLE.
143.23     This chapter shall be referred to as the Minnesota Certified Midwife Practice Act.
143.24   Sec. 85. [148G.02] SCOPE.
143.25     This chapter applies to all applicants and licensees, all persons who use the title certified
143.26 midwife, and all persons in or out of this state who provide certified midwifery services to
143.27 patients who reside in this state, unless there are specific applicable exemptions provided
143.28 by law.
  Article 3 Sec. 85.  143
  06/07/25  REVISOR        DTT/LN  25-05697  as introduced
144.1    Sec. 86. [148G.03] DEFINITIONS.
144.2      Subdivision 1. Scope. For purposes of this chapter, the definitions in this section have
144.3  the meanings given.
144.4      Subd. 2. Board. "Board" means the Minnesota Board of Nursing.
144.5      Subd. 3. Certification. "Certification" means the formal recognition by the American
144.6  Midwifery Certification Board of the knowledge, skills, and experience demonstrated by
144.7  the achievement of standards identified by the American College of Nurse Midwives or any
144.8  successor organization.
144.9      Subd. 4. Certified midwife. "Certified midwife" means an individual who holds a current
144.10 and valid national certification as a certified midwife from the American Midwifery
144.11 Certification Board or any successor organization and who is licensed by the board under
144.12 this chapter.
144.13     Subd. 5. Certified midwifery practice. "Certified midwifery practice" means:
144.14     (1) managing, diagnosing, and treating women's primary health care beginning in
144.15 adolescence, including pregnancy, childbirth, the postpartum period, care of the newborn,
144.16 family planning, partner care management relating to sexual health, and gynecological care
144.17 of women;
144.18     (2) ordering, performing, supervising, and interpreting diagnostic studies within the
144.19 scope of certified midwifery practice, excluding:
144.20     (i) interpreting and performing specialized ultrasound examinations; and
144.21     (ii) interpreting computed tomography scans, magnetic resonance imaging scans, positron
144.22 emission tomography scans, nuclear scans, and mammography;
144.23     (3) prescribing pharmacologic and nonpharmacologic therapies appropriate to midwifery
144.24 practice;
144.25     (4) consulting with, collaborating with, or referring to other health care providers as
144.26 warranted by the needs of the patient; and
144.27     (5) performing the role of educator in the theory and practice of midwifery.
144.28     Subd. 6. Collaborating. "Collaborating" means the process in which two or more health
144.29 care professionals work together to meet the health care needs of a patient, as warranted by
144.30 the needs of the patient.
  Article 3 Sec. 86.  144
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
145.1      Subd. 7. Consulting. "Consulting" means the process in which a certified midwife who
145.2  maintains primary management responsibility for a patient's care seeks advice or opinion
145.3  of a physician, an advanced practice registered nurse, or another member of the health care
145.4  team.
145.5      Subd. 8. Encumbered. "Encumbered" means:
145.6      (1) a license or other credential that is revoked, is suspended, or contains limitations on
145.7  the full and unrestricted practice of certified midwifery when the revocation, suspension,
145.8  or limitation is imposed by a state licensing board or other state regulatory entity; or
145.9      (2) a license or other credential that is voluntarily surrendered.
145.10     Subd. 9. Licensure period. "Licensure period" means the interval of time during which
145.11 the certified midwife is authorized to engage in certified midwifery. The initial licensure
145.12 period is from six to 29 full calendar months starting on the day of licensure and ending on
145.13 the last day of the certified midwife's month of birth in an even-numbered year if the year
145.14 of birth is an even-numbered year, or in an odd-numbered year if the year of birth is an
145.15 odd-numbered year. Subsequent licensure renewal periods are 24 months. For licensure
145.16 renewal, the period starts on the first day of the month following expiration of the previous
145.17 licensure period. The period ends the last day of the certified midwife's month of birth in
145.18 an even- or odd-numbered year according to the certified midwife's year of birth.
145.19     Subd. 10. Licensed practitioner. "Licensed practitioner" means a physician licensed
145.20 under chapter 147, an advanced practice registered nurse licensed under sections 148.171
145.21 to 148.235, or a certified midwife licensed under this chapter.
145.22     Subd. 11. Midwifery education program. "Midwifery education program" means a
145.23 program of theory and practice offered by a university or college that leads to the preparation
145.24 and eligibility for certification in midwifery and is accredited by the Accreditation
145.25 Commission for Midwifery Education or any successor organization recognized by the
145.26 United States Department of Education or the Council for Higher Education Accreditation.
145.27     Subd. 12. Patient. "Patient" means a recipient of care provided by a certified midwife
145.28 within the scope of certified midwifery practice, including an individual, family, group, or
145.29 community.
145.30     Subd. 13. Prescribing. "Prescribing" means the act of generating a prescription for the
145.31 preparation of, use of, or manner of using a drug or therapeutic device under section 148G.09.
145.32 Prescribing does not include recommending the use of a drug or therapeutic device that is
  Article 3 Sec. 86.  145
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
146.1  not required by the federal Food and Drug Administration to meet the labeling requirements
146.2  for prescription drugs and devices.
146.3      Subd. 14. Prescription. "Prescription" means a written direction or an oral direction
146.4  reduced to writing provided to or for a patient for the preparation or use of a drug or
146.5  therapeutic device. The requirements of section 151.01, subdivisions 16, 16a, and 16b, apply
146.6  to prescriptions for drugs.
146.7      Subd. 15. Referral. "Referral" means the process in which a certified midwife directs
146.8  a patient to a physician or another health care professional for management of a particular
146.9  problem or aspect of the patient's care.
146.10     Subd. 16. Supervision. "Supervision" means monitoring and establishing the initial
146.11 direction of, setting expectations for, directing activities in, evaluating, and changing a
146.12 course of action in certified midwifery care.
146.13   Sec. 87. [148G.04] CERTIFIED MIDWIFE LICENSING.
146.14     Subdivision 1. Licensure. (a) No person shall practice as a certified midwife or serve
146.15 as the faculty of record for clinical instruction in a midwifery distance learning program
146.16 unless the person is licensed by the board under this chapter.
146.17     (b) An applicant for a license to practice as a certified midwife must apply to the board
146.18 in a format prescribed by the board and pay a fee in an amount determined under section
146.19 148G.11.
146.20     (c) To be eligible for licensure, an applicant must:
146.21     (1) not hold an encumbered license or other credential as a certified midwife or equivalent
146.22 professional designation in any state or territory;
146.23     (2) hold a current and valid certification as a certified midwife from the American
146.24 Midwifery Certification Board or any successor organization acceptable to the board and
146.25 provide primary source verification of certification to the board in a format prescribed by
146.26 the board;
146.27     (3) have completed a graduate-level midwifery education program that includes clinical
146.28 experience, is accredited by the Accreditation Commission for Midwifery Education or any
146.29 successor organization recognized by the United States Department of Education or the
146.30 Council for Higher Education Accreditation, and leads to a graduate degree. The applicant
146.31 must submit primary source verification of program completion to the board in a format
146.32 prescribed by the board. The primary source verification must verify the applicant completed
  Article 3 Sec. 87.  146
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
147.1  three separate graduate-level courses in physiology and pathophysiology; advanced health
147.2  assessment; and advanced pharmacology, including pharmacodynamics, pharmacokinetics,
147.3  and pharmacotherapeutics of all broad categories of agents;
147.4      (4) report any criminal conviction, nolo contendere plea, Alford plea, or other plea
147.5  arrangement in lieu of conviction; and
147.6      (5) not have committed any acts or omissions that are grounds for disciplinary action in
147.7  another jurisdiction or, if these acts were committed and would be grounds for disciplinary
147.8  action as set forth in section 148G.13, the board has found after an investigation that sufficient
147.9  remediation was made.
147.10     Subd. 2. Clinical practice component. If more than five years have elapsed since the
147.11 applicant has practiced in the certified midwife role, the applicant must complete a
147.12 reorientation plan as a certified midwife. The plan must include supervision during the
147.13 clinical component by a licensed practitioner with experience in providing care to patients
147.14 with the same or similar health care needs. The applicant must submit the plan and the name
147.15 of the practitioner to the board. The plan must include a minimum of 500 hours of supervised
147.16 certified midwifery practice. The certified midwife must submit verification of completion
147.17 of the clinical reorientation to the board when the reorientation is complete.
147.18   Sec. 88. [148G.05] LICENSURE RENEWAL; RELICENSURE.
147.19     Subdivision 1. Renewal; current applicants. (a) A certified midwife must apply for
147.20 renewal of the certified midwife's license before the certified midwife's licensure period
147.21 ends. To be considered timely, the board must receive the certified midwife's application
147.22 on or before the last day of the certified midwife's licensure period. A certified midwife's
147.23 license lapses if the certified midwife's application is untimely.
147.24     (b) An applicant for license renewal must provide the board evidence of current
147.25 certification or recertification as a certified midwife by the American Midwifery Certification
147.26 Board or any successor organization.
147.27     (c) An applicant for license renewal must submit to the board the fee under section
147.28 148G.11, subdivision 2.
147.29     Subd. 2. Clinical practice component. If more than five years have elapsed since the
147.30 applicant has practiced as a certified midwife, the applicant must complete a reorientation
147.31 plan as a certified midwife. The plan must include supervision during the clinical component
147.32 by a licensed practitioner with experience in providing care to patients with the same or
147.33 similar health care needs. The licensee must submit the plan and the name of the practitioner
  Article 3 Sec. 88.  147
  06/07/25  REVISOR        DTT/LN  25-05697  as introduced
148.1  to the board. The plan must include a minimum of 500 hours of supervised certified
148.2  midwifery practice. The certified midwife must submit verification of completion of the
148.3  clinical reorientation to the board when the reorientation is complete.
148.4      Subd. 3. Relicensure; lapsed applicants. A person whose license has lapsed who desires
148.5  to resume practice as a certified midwife must apply for relicensure, submit to the board
148.6  satisfactory evidence of compliance with the procedures and requirements established by
148.7  the board, and pay the board the relicensure fee under section 148G.11, subdivision 4, for
148.8  the current licensure period. A penalty fee under section 148G.11, subdivision 4, is required
148.9  from a person who practiced certified midwifery without current licensure. The board must
148.10 relicense a person who meets the requirements of this subdivision.
148.11   Sec. 89. [148G.06] FAILURE OR REFUSAL TO PROVIDE INFORMATION.
148.12     Subdivision 1. Notification requirement. An individual licensed as a certified midwife
148.13 must notify the board when the individual renews their certification. If a licensee fails to
148.14 provide notification, the licensee is prohibited from practicing as a certified midwife.
148.15     Subd. 2. Denial of license. Refusal of an applicant to supply information necessary to
148.16 determine the applicant's qualifications, failure to demonstrate qualifications, or failure to
148.17 satisfy the requirements for a license contained in this chapter or rules of the board may
148.18 result in denial of a license. The burden of proof is upon the applicant to demonstrate the
148.19 qualifications and satisfaction of the requirements.
148.20   Sec. 90. [148G.07] NAME CHANGE AND CHANGE OF ADDRESS.
148.21     A certified midwife must maintain a current name and address with the board and must
148.22 notify the board in writing within 30 days of any change in name or address. All notices or
148.23 other correspondence mailed to or served upon a certified midwife by the board at the
148.24 licensee's address on file with the board are considered received by the licensee.
148.25   Sec. 91. [148G.08] IDENTIFICATION OF CERTIFIED MIDWIVES.
148.26     Only those persons who hold a current license to practice certified midwifery in
148.27 Minnesota may use the title of certified midwife. A certified midwife licensed by the board
148.28 must use the designation of "CM" for professional identification and in documentation of
148.29 services provided.
  Article 3 Sec. 91.  148
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
149.1    Sec. 92. [148G.09] PRESCRIBING DRUGS AND THERAPEUTIC DEVICES.
149.2      Subdivision 1. Diagnosing, prescribing, and ordering. Certified midwives, within the
149.3  scope of certified midwifery practice, are authorized to:
149.4      (1) diagnose, prescribe, and institute therapy or referrals of patients to health care agencies
149.5  and providers;
149.6      (2) prescribe, procure, sign for, record, administer, and dispense over-the-counter, legend,
149.7  and controlled substances, including sample drugs; and
149.8      (3) plan and initiate a therapeutic regimen that includes ordering and prescribing durable
149.9  medical devices and equipment, nutrition, diagnostic services, and supportive services,
149.10 including but not limited to home health care, physical therapy, and occupational therapy.
149.11     Subd. 2. Drug Enforcement Administration requirements. (a) Certified midwives
149.12 must:
149.13     (1) comply with federal Drug Enforcement Administration (DEA) requirements related
149.14 to controlled substances; and
149.15     (2) file the certified midwife's DEA registrations and numbers, if any, with the board.
149.16     (b) The board must maintain current records of all certified midwives with a DEA
149.17 registration and number.
149.18   Sec. 93. [148G.10] FEES.
149.19     The fees specified in section 148G.11 are nonrefundable and must be deposited in the
149.20 state government special revenue fund.
149.21   Sec. 94. [148G.11] FEE AMOUNTS.
149.22     Subdivision 1. Licensure. The fee for licensure is $105.
149.23     Subd. 2. Renewal. The fee for licensure renewal is $85.
149.24     Subd. 3. Practicing without current certification. The penalty fee for a person who
149.25 practices certified midwifery without a current certification or recertification, or who practices
149.26 certified midwifery without current certification or recertification on file with the board, is
149.27 $200 for the first month or part of a month and an additional $100 for each subsequent
149.28 month or parts of months of practice. The penalty fee must be calculated from the first day
149.29 the certified midwife practiced without a current certification to the last day of practice
149.30 without a current certification, or from the first day the certified midwife practiced without
  Article 3 Sec. 94.  149
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
150.1  a current certification or recertification on file with the board until the day the current
150.2  certification or recertification is filed with the board.
150.3      Subd. 4. Relicensure. The fee for relicensure is $105. The fee for practicing without
150.4  current licensure is two times the amount of the current renewal fee for any part of the first
150.5  calendar month, plus the current renewal fee for any part of each subsequent month up to
150.6  24 months.
150.7      Subd. 5. Dishonored check fee. The service fee for a dishonored check is as provided
150.8  in section 604.113.
150.9    Sec. 95. [148G.12] APPROVED MIDWIFERY EDUCATION PROGRAM.
150.10     Subdivision 1. Initial approval. A university or college desiring to conduct a certified
150.11 midwifery education program must submit evidence to the board that the university or
150.12 college is prepared to:
150.13     (1) provide a program of theory and practice in certified midwifery leading to eligibility
150.14 for certification in midwifery;
150.15     (2) achieve preaccreditation and eventual full accreditation by the American Commission
150.16 for Midwifery Education or any successor organization recognized by the United States
150.17 Department of Education or the Council for Higher Education Accreditation. Instruction
150.18 and required experience may be obtained in one or more institutions or agencies outside
150.19 the applying university or college if the program retains accountability for all clinical and
150.20 nonclinical teaching; and
150.21     (3) meet other standards established by law and by the board.
150.22     Subd. 2. Continuing approval. The board must, through the board's representative,
150.23 annually survey all midwifery education programs in Minnesota for current accreditation
150.24 status by the American Commission for Midwifery Education or any successor organization
150.25 recognized by the United States Department of Education or the Council for Higher Education
150.26 Accreditation. If the results of the survey show that a certified midwifery education program
150.27 meets all standards for continuing accreditation, the board must continue approval of the
150.28 certified midwifery education program.
150.29     Subd. 3. Loss of approval. If the board determines that an accredited certified midwifery
150.30 education program is not maintaining the standards required by the American Commission
150.31 on Midwifery Education or any successor organization, the board must obtain the defect in
150.32 writing from the accrediting body. If a program fails to correct the defect to the satisfaction
150.33 of the accrediting body and the accrediting body revokes the program's accreditation, the
  Article 3 Sec. 95.  150
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
151.1  board must remove the program from the list of approved certified midwifery education
151.2  programs.
151.3      Subd. 4. Reinstatement of approval. The board must reinstate approval of a certified
151.4  midwifery education program upon submission of satisfactory evidence that the certified
151.5  midwifery education program of theory and practice meets the standards required by the
151.6  accrediting body.
151.7    Sec. 96. [148G.13] GROUNDS FOR DISCIPLINARY ACTION.
151.8      Subdivision 1. Grounds listed. The board may deny, revoke, suspend, limit, or condition
151.9  the license of any person to practice certified midwifery under this chapter or otherwise
151.10 discipline a licensee or applicant as described in section 148G.14. The following are grounds
151.11 for disciplinary action:
151.12     (1) failure to demonstrate the qualifications or satisfy the requirements for a license
151.13 contained in this chapter or rules of the board. In the case of an applicant for licensure, the
151.14 burden of proof is upon the applicant to demonstrate the qualifications or satisfaction of the
151.15 requirements;
151.16     (2) employing fraud or deceit in procuring or attempting to procure a license to practice
151.17 certified midwifery;
151.18     (3) conviction of a felony or gross misdemeanor reasonably related to the practice of
151.19 certified midwifery. Conviction, as used in this subdivision, includes a conviction of an
151.20 offense that if committed in this state would be considered a felony or gross misdemeanor
151.21 without regard to its designation elsewhere, or a criminal proceeding where a finding or
151.22 verdict of guilt is made or returned, but the adjudication of guilt is either withheld or not
151.23 entered;
151.24     (4) revocation, suspension, limitation, conditioning, or other disciplinary action against
151.25 the person's certified midwife credential in another state, territory, or country; failure to
151.26 report to the board that charges regarding the person's certified midwifery license,
151.27 certification, or other credential are pending in another state, territory, or country; or failure
151.28 to report to the board having been refused a license or other credential by another state,
151.29 territory, or country;
151.30     (5) failure or inability to practice as a certified midwife with reasonable skill and safety,
151.31 or departure from or failure to conform to standards of acceptable and prevailing certified
151.32 midwifery practice, including failure of a certified midwife to adequately supervise or
151.33 monitor the performance of acts by any person working at the certified midwife's direction;
  Article 3 Sec. 96.  151
  06/07/25  REVISOR        DTT/LN  25-05697  as introduced
152.1      (6) engaging in unprofessional conduct, including but not limited to a departure from
152.2  or failure to conform to statutes relating to certified midwifery practice or to the minimal
152.3  standards of acceptable and prevailing certified midwifery practice, or engaging in any
152.4  certified midwifery practice that may create unnecessary danger to a patient's life, health,
152.5  or safety. Actual injury to a patient need not be established under this clause;
152.6      (7) supervision or accepting the supervision of a midwifery function or a prescribed
152.7  health care function when the acceptance could reasonably be expected to result in unsafe
152.8  or ineffective patient care;
152.9      (8) actual or potential inability to practice certified midwifery with reasonable skill and
152.10 safety to patients by reason of illness; by the reason of use of alcohol, drugs, chemicals, or
152.11 any other material; or as a result of any mental or physical condition;
152.12     (9) adjudication as mentally incompetent, mentally ill, a chemically dependent person,
152.13 or a person dangerous to the public by a court of competent jurisdiction, within or outside
152.14 of Minnesota;
152.15     (10) engaging in any unethical conduct, including but not limited to conduct likely to
152.16 deceive, defraud, or harm the public, or demonstrating a willful or careless disregard for
152.17 the health, welfare, or safety of a patient. Actual injury need not be established under this
152.18 clause;
152.19     (11) engaging in conduct with a patient that is sexual or may reasonably be interpreted
152.20 by the patient as sexual, in any verbal behavior that is seductive or sexually demeaning to
152.21 a patient, or in sexual exploitation of a patient or former patient;
152.22     (12) obtaining money, property, or services from a patient, other than reasonable fees
152.23 for services provided to the patient, through the use of undue influence, harassment, duress,
152.24 deception, or fraud;
152.25     (13) revealing a privileged communication from or relating to a patient except when
152.26 otherwise required or permitted by law;
152.27     (14) engaging in abusive or fraudulent billing practices, including violations of federal
152.28 Medicare and Medicaid laws or state medical assistance laws;
152.29     (15) improper management of patient records, including failure to maintain adequate
152.30 patient records, to comply with a patient's request made pursuant to sections 144.291 to
152.31 144.298, or to furnish a patient record or report required by law;
152.32     (16) knowingly aiding, assisting, advising, or allowing an unlicensed person to engage
152.33 in the unlawful practice of certified midwifery;
  Article 3 Sec. 96.  152
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
153.1      (17) violating a rule adopted by the board, an order of the board, a state or federal law
153.2  relating to the practice of certified midwifery, or a state or federal narcotics or controlled
153.3  substance law;
153.4      (18) knowingly providing false or misleading information to a patient that is directly
153.5  related to the care of that patient unless done for an accepted therapeutic purpose such as
153.6  the administration of a placebo;
153.7      (19) aiding suicide or aiding attempted suicide in violation of section 609.215 as
153.8  established by any of the following:
153.9      (i) a copy of the record of criminal conviction or plea of guilty for a felony in violation
153.10 of section 609.215, subdivision 1 or 2;
153.11     (ii) a copy of the record of a judgment of contempt of court for violating an injunction
153.12 issued under section 609.215, subdivision 4;
153.13     (iii) a copy of the record of a judgment assessing damages under section 609.215,
153.14 subdivision 5; or
153.15     (iv) a finding by the board that the person violated section 609.215, subdivision 1 or 2.
153.16 The board must investigate any complaint of a violation of section 609.215, subdivision 1
153.17 or 2;
153.18     (20) practicing outside the scope of certified midwifery practice as defined under section
153.19 148G.03, subdivision 5;
153.20     (21) making a false statement or knowingly providing false information to the board,
153.21 failing to make reports as required by section 148G.15, or failing to cooperate with an
153.22 investigation of the board as required by section 148G.17;
153.23     (22) engaging in false, fraudulent, deceptive, or misleading advertising;
153.24     (23) failure to inform the board of the person's certification or recertification status as
153.25 a certified midwife;
153.26     (24) engaging in certified midwifery practice without a license and current certification
153.27 or recertification by the American Midwifery Certification Board or any successor
153.28 organization; or
153.29     (25) failure to maintain appropriate professional boundaries with a patient. A certified
153.30 midwife must not engage in practices that create an unacceptable risk of patient harm or of
153.31 the impairment of a certified midwife's objectivity or professional judgment. A certified
153.32 midwife must not act or fail to act in a way that, as judged by a reasonable and prudent
  Article 3 Sec. 96.  153
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
154.1  certified midwife, inappropriately encourages the patient to relate to the certified midwife
154.2  outside of the boundaries of the professional relationship or in a way that interferes with
154.3  the patient's ability to benefit from certified midwife services. A certified midwife must not
154.4  use the professional relationship with a patient, student, supervisee, or intern to further the
154.5  certified midwife's personal, emotional, financial, sexual, religious, political, or business
154.6  benefit or interests.
154.7      Subd. 2. Conviction of a felony-level criminal sexual offense. (a) Except as provided
154.8  in paragraph (e), the board must not grant or renew a license to practice certified midwifery
154.9  to any person who has been convicted on or after August 1, 2014, of any of the provisions
154.10 of section 609.342, subdivision 1 or 1a; 609.343, subdivision 1 or 1a; 609.344, subdivision
154.11 1 or 1a, paragraphs (c) to (g); or 609.345, subdivision 1 or 1a, paragraphs (c) to (g); or a
154.12 similar statute in another jurisdiction.
154.13     (b) A license to practice certified midwifery is automatically revoked if the licensee is
154.14 convicted of an offense listed in paragraph (a).
154.15     (c) A license to practice certified midwifery that has been denied or revoked under this
154.16 subdivision is not subject to chapter 364.
154.17     (d) For purposes of this subdivision, "conviction" means a plea of guilty, a verdict of
154.18 guilty by a jury, or a finding of guilty by the court, unless the court stays imposition or
154.19 execution of the sentence and final disposition of the case is accomplished at a nonfelony
154.20 level.
154.21     (e) The board may establish criteria whereby an individual convicted of an offense listed
154.22 in paragraph (a) may become licensed if the criteria:
154.23     (1) utilize a rebuttable presumption that the applicant is not suitable for licensing;
154.24     (2) provide a standard for overcoming the presumption; and
154.25     (3) require that a minimum of ten years has elapsed since the applicant's sentence was
154.26 discharged.
154.27     (f) The board must not consider an application under paragraph (e) if the board determines
154.28 that the victim involved in the offense was a patient or a client of the applicant at the time
154.29 of the offense.
154.30     Subd. 3. Evidence. In disciplinary actions alleging a violation of subdivision 1, clause
154.31 (3) or (4), or 2, a copy of the judgment or proceeding under the seal of the court administrator
154.32 or of the administrative agency that entered the same is admissible into evidence without
154.33 further authentication and constitutes prima facie evidence of the violation concerned.
  Article 3 Sec. 96.  154
  06/07/25  REVISOR        DTT/LN  25-05697  as introduced
155.1      Subd. 4. Examination; access to medical data. (a) If the board has probable cause to
155.2  believe that grounds for disciplinary action exist under subdivision 1, clause (8) or (9), it
155.3  may direct the applicant or certified midwife to submit to a mental or physical examination
155.4  or chemical dependency evaluation. For the purpose of this subdivision, when a certified
155.5  midwife licensed under this chapter is directed in writing by the board to submit to a mental
155.6  or physical examination or chemical dependency evaluation, that person is considered to
155.7  have consented and to have waived all objections to admissibility on the grounds of privilege.
155.8  Failure of the applicant or certified midwife to submit to an examination when directed
155.9  constitutes an admission of the allegations against the applicant or certified midwife, unless
155.10 the failure was due to circumstances beyond the person's control, and the board may enter
155.11 a default and final order without taking testimony or allowing evidence to be presented. A
155.12 certified midwife affected under this paragraph must, at reasonable intervals, be given an
155.13 opportunity to demonstrate that the competent practice of certified midwifery can be resumed
155.14 with reasonable skill and safety to patients. Neither the record of proceedings nor the orders
155.15 entered by the board in a proceeding under this paragraph may be used against a certified
155.16 midwife in any other proceeding.
155.17     (b) Notwithstanding sections 13.384, 144.651, and 595.02, or any other law limiting
155.18 access to medical or other health data, the board may obtain medical data and health records
155.19 relating to a certified midwife or applicant for a license without that person's consent if the
155.20 board has probable cause to believe that grounds for disciplinary action exist under
155.21 subdivision 1, clause (8) or (9). The medical data may be requested from a provider, as
155.22 defined in section 144.291, subdivision 2; an insurance company; or a government agency,
155.23 including the Department of Human Services or Direct Care and Treatment. A provider,
155.24 insurance company, or government agency must comply with any written request of the
155.25 board under this subdivision and is not liable in any action for damages for releasing the
155.26 data requested by the board if the data are released pursuant to a written request under this
155.27 subdivision, unless the information is false and the provider giving the information knew
155.28 or had reason to believe the information was false. Information obtained under this
155.29 subdivision is classified as private data on individuals as defined in section 13.02.
155.30   Sec. 97. [148G.14] FORMS OF DISCIPLINARY ACTION; AUTOMATIC
155.31 SUSPENSION; TEMPORARY SUSPENSION; REISSUANCE.
155.32     Subdivision 1. Forms of disciplinary action. If the board finds that grounds for
155.33 disciplinary action exist under section 148G.13, it may take one or more of the following
155.34 actions:
  Article 3 Sec. 97.  155
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156.1      (1) deny the license application or application for license renewal;
156.2      (2) revoke the license;
156.3      (3) suspend the license;
156.4      (4) impose limitations on the certified midwife's practice of certified midwifery, including
156.5  but not limited to limitation of scope of practice or the requirement of practice under
156.6  supervision;
156.7      (5) impose conditions on the retention of the license, including but not limited to the
156.8  imposition of retraining or rehabilitation requirements or the conditioning of continued
156.9  practice on demonstration of knowledge or skills by appropriate examination, monitoring,
156.10 or other review;
156.11     (6) impose a civil penalty not exceeding $10,000 for each separate violation. The amount
156.12 of the civil penalty must be fixed so as to deprive the certified midwife of any economic
156.13 advantage gained by reason of the violation charged; to reimburse the board for the cost of
156.14 counsel, investigation, and proceeding; and to discourage repeated violations;
156.15     (7) order the certified midwife to provide unremunerated service;
156.16     (8) censure or reprimand the certified midwife; or
156.17     (9) any other action justified by the facts in the case.
156.18     Subd. 2. Automatic suspension of license. (a) Unless the board orders otherwise, a
156.19 license to practice certified midwifery is automatically suspended if:
156.20     (1) a guardian of a certified midwife is appointed by order of a court under sections
156.21 524.5-101 to 524.5-502;
156.22     (2) the certified midwife is committed by order of a court under chapter 253B; or
156.23     (3) the certified midwife is determined to be mentally incompetent, mentally ill,
156.24 chemically dependent, or a person dangerous to the public by a court of competent
156.25 jurisdiction within or outside of Minnesota.
156.26     (b) The license remains suspended until the certified midwife is restored to capacity by
156.27 a court and, upon petition by the certified midwife, the suspension is terminated by the
156.28 board after a hearing or upon agreement between the board and the certified midwife.
156.29     Subd. 3. Temporary suspension of license. In addition to any other remedy provided
156.30 by law, the board may, through its designated board member under section 214.10,
156.31 subdivision 2, temporarily suspend the license of a certified midwife without a hearing if
  Article 3 Sec. 97.  156
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157.1  the board finds that there is probable cause to believe the certified midwife has violated a
157.2  statute or rule the board is empowered to enforce and continued practice by the certified
157.3  midwife would create a serious risk of harm to others. The suspension takes effect upon
157.4  written notice to the certified midwife, served by first-class mail, specifying the statute or
157.5  rule violated. The suspension must remain in effect until the board issues a temporary stay
157.6  of suspension or a final order in the matter after a hearing or upon agreement between the
157.7  board and the certified midwife. At the time it issues the suspension notice, the board must
157.8  schedule a disciplinary hearing to be held under the Administrative Procedure Act. The
157.9  board must provide the certified midwife at least 20 days' notice of any hearing held under
157.10 this subdivision. The board must schedule the hearing to begin no later than 30 days after
157.11 the issuance of the suspension order.
157.12     Subd. 4. Reissuance. The board may reinstate and reissue a license to practice certified
157.13 midwifery, but as a condition may impose any disciplinary or corrective measure that it
157.14 might originally have imposed. Any person whose license has been revoked, suspended, or
157.15 limited may have the license reinstated and a new license issued when, at the discretion of
157.16 the board, the action is warranted, provided that the board must require the person to pay
157.17 the costs of the proceedings resulting in the revocation, suspension, or limitation of the
157.18 license; the relicensure fee; and the fee for the current licensure period. The cost of
157.19 proceedings includes but is not limited to the cost paid by the board to the Office of
157.20 Administrative Hearings and the Office of the Attorney General for legal and investigative
157.21 services; the costs of a court reporter and witnesses, reproduction of records, board staff
157.22 time, travel, and expenses; and the costs of board members' per diem reimbursements, travel
157.23 costs, and expenses.
157.24   Sec. 98. [148G.15] REPORTING OBLIGATIONS.
157.25     Subdivision 1. Permission to report. A person who has knowledge of any conduct
157.26 constituting grounds for discipline under section 148G.13 may report the alleged violation
157.27 to the board.
157.28     Subd. 2. Institutions. The chief nursing executive or chief administrative officer of any
157.29 hospital, clinic, prepaid medical plan, or other health care institution or organization located
157.30 in Minnesota must report to the board any action taken by the institution or organization or
157.31 any of its administrators or committees to revoke, suspend, limit, or condition a certified
157.32 midwife's privilege to practice in the institution or as part of the organization, any denial of
157.33 privileges, any dismissal from employment, or any other disciplinary action. The institution
157.34 or organization must also report the resignation of any certified midwife before the conclusion
  Article 3 Sec. 98.  157
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158.1  of any disciplinary proceeding or before commencement of formal charges, but after the
158.2  certified midwife had knowledge that formal charges were contemplated or in preparation.
158.3  The reporting described by this subdivision is required only if the action pertains to grounds
158.4  for disciplinary action under section 148G.13.
158.5      Subd. 3. Licensed professionals. A person licensed by a health-related licensing board
158.6  as defined in section 214.01, subdivision 2, must report to the board personal knowledge
158.7  of any conduct the person reasonably believes constitutes grounds for disciplinary action
158.8  under section 148G.13 by any certified midwife, including conduct indicating that the
158.9  certified midwife may be incompetent, may have engaged in unprofessional or unethical
158.10 conduct, or may be mentally or physically unable to engage safely in the practice of certified
158.11 midwifery.
158.12     Subd. 4. Insurers. (a) By the first day of February, May, August, and November each
158.13 year, each insurer authorized to sell insurance described in section 60A.06, subdivision 1,
158.14 clause (13), and providing professional liability insurance to certified midwives must submit
158.15 to the board a report concerning any certified midwife against whom a malpractice award
158.16 has been made or who has been a party to a settlement. The report must contain at least the
158.17 following information:
158.18     (1) the total number of settlements or awards;
158.19     (2) the date a settlement or award was made;
158.20     (3) the allegations contained in the claim or complaint leading to the settlement or award;
158.21     (4) the dollar amount of each malpractice settlement or award and whether that amount
158.22 was paid as a result of a settlement or of an award; and
158.23     (5) the name and address of the practice of the certified midwife against whom an award
158.24 was made or with whom a settlement was made.
158.25     (b) An insurer must also report to the board any information it possesses that tends to
158.26 substantiate a charge that a certified midwife may have engaged in conduct in violation of
158.27 this chapter.
158.28     Subd. 5. Courts. The court administrator of district court or another court of competent
158.29 jurisdiction must report to the board any judgment or other determination of the court that
158.30 adjudges or includes a finding that a certified midwife is a person who is mentally ill,
158.31 mentally incompetent, chemically dependent, dangerous to the public, guilty of a felony or
158.32 gross misdemeanor, guilty of a violation of federal or state narcotics laws or controlled
158.33 substances act, guilty of operating a motor vehicle while under the influence of alcohol or
  Article 3 Sec. 98.  158
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159.1  a controlled substance, or guilty of an abuse or fraud under Medicare or Medicaid; or if the
159.2  court appoints a guardian of the certified midwife under sections 524.5-101 to 524.5-502
159.3  or commits a certified midwife under chapter 253B.
159.4      Subd. 6. Deadlines; forms. Reports required by subdivisions 2, 3, and 5 must be
159.5  submitted no later than 30 days after the occurrence of the reportable event or transaction.
159.6  The board may provide forms for the submission of reports required under this section, may
159.7  require that the reports be submitted on the forms provided, and may adopt rules necessary
159.8  to ensure prompt and accurate reporting. The board must review all reports, including those
159.9  submitted after the deadline.
159.10     Subd. 7. Failure to report. Any person, institution, insurer, or organization that fails to
159.11 report as required under subdivisions 2 to 6 is subject to civil penalties for failing to report
159.12 as required by law.
159.13   Sec. 99. [148G.16] IMMUNITY.
159.14     Subdivision 1. Reporting. Any person, health care facility, business, or organization is
159.15 immune from civil liability and criminal prosecution for submitting in good faith a report
159.16 to the board under section 148G.15 or for otherwise reporting in good faith to the board
159.17 violations or alleged violations of this chapter. All such reports are investigative data as
159.18 defined in chapter 13.
159.19     Subd. 2. Investigation. (a) Members of the board, persons employed by the board or
159.20 engaged in the investigation of violations and in the preparation and management of charges
159.21 of violations of this chapter on behalf of the board, or persons participating in the
159.22 investigation or testifying regarding charges of violations are immune from civil liability
159.23 and criminal prosecution for any actions, transactions, or publications in the execution of,
159.24 or relating to, their duties under this chapter.
159.25     (b) Members of the board and persons employed by the board or engaged in maintaining
159.26 records and making reports regarding adverse health care events are immune from civil
159.27 liability and criminal prosecution for any actions, transactions, or publications in the
159.28 execution of, or relating to, their duties under this chapter.
159.29   Sec. 100. [148G.17] CERTIFIED MIDWIFE COOPERATION.
159.30     A certified midwife who is the subject of an investigation by or on behalf of the board
159.31 must cooperate fully with the investigation. Cooperation includes responding fully and
159.32 promptly to any question raised by or on behalf of the board relating to the subject of the
  Article 3 Sec. 100.  159
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160.1  investigation and providing copies of patient or other records in the certified midwife's
160.2  possession, as reasonably requested by the board, to assist the board in its investigation and
160.3  to appear at conferences and hearings scheduled by the board. The board must pay for copies
160.4  requested. If the board does not have written consent from a patient permitting access to
160.5  the patient's records, the certified midwife must delete any data in the record that identify
160.6  the patient before providing it to the board. The board must maintain any records obtained
160.7  pursuant to this section as investigative data under chapter 13. The certified midwife must
160.8  not be excused from giving testimony or producing any documents, books, records, or
160.9  correspondence on the grounds of self-incrimination, but the testimony or evidence must
160.10 not be used against the certified midwife in any criminal case.
160.11   Sec. 101. [148G.18] DISCIPLINARY RECORD ON JUDICIAL REVIEW.
160.12Upon judicial review of any board disciplinary action taken under this chapter, the
160.13 reviewing court must seal the administrative record, except for the board's final decision,
160.14 and must not make the administrative record available to the public.
160.15   Sec. 102. [148G.19] EXEMPTIONS.
160.16The provisions of this chapter do not prohibit:
160.17(1) the furnishing of certified midwifery assistance in an emergency;
160.18(2) the practice of certified midwifery by any legally qualified certified midwife of
160.19 another state who is employed by the United States government or any bureau, division, or
160.20 agency thereof while in the discharge of official duties;
160.21(3) the practice of any profession or occupation licensed by Minnesota, other than
160.22 certified midwifery, by any person licensed to practice the profession or occupation, or the
160.23 performance by a person of any acts properly coming within the scope of the profession,
160.24 occupation, or license;
160.25(4) the practice of traditional midwifery as specified under section 147D.03;
160.26(5) certified midwifery practice by a student practicing under the supervision of an
160.27 instructor while the student is enrolled in an approved certified midwifery education program;
160.28 or
160.29(6) certified midwifery practice by a certified midwife licensed in another state, territory,
160.30 or jurisdiction who is in Minnesota temporarily:
160.31(i) providing continuing or in-service education;
  Article 3 Sec. 102.  160
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161.1      (ii) serving as a guest lecturer;
161.2      (iii) presenting at a conference; or
161.3      (iv) teaching didactic content via distance education to a student located in Minnesota
161.4  who is enrolled in a formal, structured course of study, such as a course leading to a higher
161.5  degree in midwifery.
161.6    Sec. 103. [148G.20] VIOLATIONS; PENALTY.
161.7      Subdivision 1. Violations described. It is unlawful for any person, corporation, firm,
161.8  or association to:
161.9      (1) sell or fraudulently obtain or furnish any certified midwifery diploma, license, or
161.10 record, or aid or abet therein;
161.11     (2) practice certified midwifery under cover of any diploma, permit, license, certified
161.12 midwife credential, or record illegally or fraudulently obtained or signed or issued unlawfully
161.13 or under fraudulent representation;
161.14     (3) practice certified midwifery unless the person is licensed to do so under this chapter;
161.15     (4) use the professional title certified midwife or licensed certified midwife unless
161.16 licensed to practice certified midwifery under this chapter;
161.17     (5) use any abbreviation or other designation tending to imply licensure as a certified
161.18 midwife unless licensed to practice certified midwifery under this chapter;
161.19     (6) practice certified midwifery in a manner prohibited by the board in any limitation
161.20 of a license issued under this chapter;
161.21     (7) practice certified midwifery during the time a license issued under this chapter is
161.22 suspended or revoked;
161.23     (8) knowingly employ persons in the practice of certified midwifery who have not been
161.24 issued a current license to practice as a certified midwife in this state; or
161.25     (9) conduct a certified midwifery program for the education of persons to become certified
161.26 midwives unless the program has been approved by the board.
161.27     Subd. 2. Penalty. Any person, corporation, firm, or association violating any provision
161.28 of subdivision 1 is guilty of a gross misdemeanor and must be punished according to law.
161.29     Subd. 3. Penalty; certified midwives. In addition to subdivision 2, a person who practices
161.30 certified midwifery without a current license and certification or recertification, or without
  Article 3 Sec. 103.  161
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162.1  current certification or recertification on file with the board, is subject to the applicable
162.2  penalties in section 148G.11.
162.3    Sec. 104. [148G.21] UNAUTHORIZED PRACTICE OF MIDWIFERY.
162.4      The practice of certified midwifery by any person who is not licensed to practice certified
162.5  midwifery under this chapter, whose license has been suspended or revoked, or whose
162.6  national certification credential has expired is inimical to the public health and welfare and
162.7  constitutes a public nuisance. Upon a complaint being made by the board or any prosecuting
162.8  officer and upon a proper showing of the facts, the district court of the county where the
162.9  practice occurred may enjoin such acts and practice. The injunction proceeding is in addition
162.10 to, and not in lieu of, all other penalties and remedies provided by law.
162.11   Sec. 105. Minnesota Statutes 2024, section 150A.105, is amended by adding a subdivision
162.12 to read:
162.13     Subd. 3a. Collaborative management agreement under armed forces. (a) While
162.14 practicing under the auspices of the Minnesota National Guard or any branch of the armed
162.15 forces, including the Navy, Marines, Army, Coast Guard, or Space Force, the collaborating
162.16 dentist may be determined by the command structure of the armed service for which the
162.17 dental therapist is a member assigned or contracted.
162.18     (b) A collaborating dentist for a dental therapist when in civilian practice will not be
162.19 responsible for supervising the dental services performed by the dental therapist while the
162.20 dental therapist is practicing under the auspices of the armed forces.
162.21   Sec. 106. Minnesota Statutes 2024, section 151.01, subdivision 15, is amended to read:
162.22     Subd. 15. Pharmacist intern or intern. "Pharmacist intern" or "intern" means:
162.23     (1) a natural person who has completed college or school of pharmacy orientation or is
162.24 otherwise enrolled in a doctor of pharmacy program accredited by the Accreditation Council
162.25 for Pharmacy Education (ACPE) and is satisfactorily progressing toward the degree in
162.26 pharmacy required for licensure, or;
162.27     (2) a graduate of the University of Minnesota College of Pharmacy, or other pharmacy
162.28 college approved by the board, a doctor of pharmacy program accredited by ACPE who is
162.29 registered by the Board of Pharmacy for the purpose of obtaining practical experience as a
162.30 requirement for licensure as a pharmacist, or;
162.31     (3) a qualified applicant awaiting examination for licensure.;
  Article 3 Sec. 106.  162
  06/07/25  REVISOR       DTT/LN  25-05697  as introduced
163.1      (4) a participant in a residency or fellowship program who is not licensed to practice
163.2  pharmacy in Minnesota but is:
163.3      (i) licensed to practice pharmacy in another state; or
163.4      (ii) a graduate of a doctor of pharmacy program accredited by ACPE and not registered
163.5  by the board under clause (2); or
163.6      (5) a foreign pharmacy graduate who:
163.7      (i) has passed the Foreign Pharmacy Graduate Equivalency Examination;
163.8      (ii) is certified by the Foreign Pharmacy Graduate Equivalency Commission; and
163.9      (iii) is seeking internship experience in accordance with Minnesota Rules, part 6800.1250.
163.10   Sec. 107. Minnesota Statutes 2024, section 151.01, subdivision 23, is amended to read:
163.11     Subd. 23. Practitioner. "Practitioner" means a licensed doctor of medicine, licensed
163.12 doctor of osteopathic medicine duly licensed to practice medicine, licensed doctor of
163.13 dentistry, licensed doctor of optometry, licensed podiatrist, licensed veterinarian, licensed
163.14 advanced practice registered nurse, licensed certified midwife, or licensed physician assistant.
163.15 For purposes of sections 151.15, subdivision 4; 151.211, subdivision 3; 151.252, subdivision
163.16 3; 151.37, subdivision 2, paragraph (b); and 151.461, "practitioner" also means a dental
163.17 therapist authorized to dispense and administer under chapter 150A. For purposes of sections
163.18 151.252, subdivision 3, and 151.461, "practitioner" also means a pharmacist authorized to
163.19 prescribe self-administered hormonal contraceptives, nicotine replacement medications, or
163.20 opiate antagonists under section 151.37, subdivision 14, 15, or 16, or authorized to prescribe
163.21 drugs to prevent the acquisition of human immunodeficiency virus (HIV) under section
163.22 151.37, subdivision 17.
163.23   Sec. 108. Minnesota Statutes 2024, section 151.065, subdivision 1, is amended to read:
163.24     Subdivision 1. Application fees. Application fees for licensure and registration are as
163.25 follows:
163.26     (1) pharmacist licensed by examination, $225;
163.27     (2) pharmacist licensed by reciprocity, $300;
163.28     (3) pharmacy intern, $75 $25;
163.29     (4) pharmacy technician, $60;
163.30     (5) pharmacy, $450;
  Article 3 Sec. 108.  163
  06/07/25  REVISOR       DTT/LN  25-05697  as introduced
164.1      (6) drug wholesaler, legend drugs only, $5,500;
164.2      (7) drug wholesaler, legend and nonlegend drugs, $5,500;
164.3      (8) drug wholesaler, nonlegend drugs, veterinary legend drugs, or both, $5,500;
164.4      (9) drug wholesaler, medical gases, $5,500 for the first facility and $500 for each
164.5  additional facility;
164.6      (10) third-party logistics provider, $300;
164.7      (11) drug manufacturer, nonopiate legend drugs only, $5,500;
164.8      (12) drug manufacturer, nonopiate legend and nonlegend drugs, $5,500;
164.9      (13) drug manufacturer, nonlegend or veterinary legend drugs, $5,500;
164.10     (14) drug manufacturer, medical gases, $5,500 for the first facility and $500 for each
164.11 additional facility;
164.12     (15) drug manufacturer, also licensed as a pharmacy in Minnesota, $5,500;
164.13     (16) drug manufacturer of opiate-containing controlled substances listed in section
164.14 152.02, subdivisions 3 to 5, $55,500;
164.15     (17) medical gas dispenser, $400;
164.16     (18) controlled substance researcher, $150; and
164.17     (19) pharmacy professional corporation, $150.
164.18   Sec. 109. Minnesota Statutes 2024, section 151.065, subdivision 3, is amended to read:
164.19     Subd. 3. Annual renewal fees. Annual licensure and registration renewal fees are as
164.20 follows:
164.21     (1) pharmacist, $225;
164.22     (2) pharmacy technician, $60;
164.23     (3) beginning January 1, 2026, pharmacy intern, $25;
164.24     (3) (4) pharmacy, $450;
164.25     (4) (5) drug wholesaler, legend drugs only, $5,500;
164.26     (5) (6) drug wholesaler, legend and nonlegend drugs, $5,500;
164.27     (6) (7) drug wholesaler, nonlegend drugs, veterinary legend drugs, or both, $5,500;
  Article 3 Sec. 109.  164
  06/07/25  REVISOR        DTT/LN  25-05697  as introduced
165.1      (7) (8) drug wholesaler, medical gases, $5,500 for the first facility and $500 for each
165.2  additional facility;
165.3      (8) (9) third-party logistics provider, $300;
165.4      (9) (10) drug manufacturer, nonopiate legend drugs only, $5,500;
165.5      (10) (11) drug manufacturer, nonopiate legend and nonlegend drugs, $5,500;
165.6      (11) (12) drug manufacturer, nonlegend, veterinary legend drugs, or both, $5,500;
165.7      (12) (13) drug manufacturer, medical gases, $5,500 for the first facility and $500 for
165.8  each additional facility;
165.9      (13) (14) drug manufacturer, also licensed as a pharmacy in Minnesota, $5,500;
165.10     (14) (15) drug manufacturer of opiate-containing controlled substances listed in section
165.11 152.02, subdivisions 3 to 5, $55,500;
165.12     (15) (16) medical gas dispenser, $400;
165.13     (16) (17) controlled substance researcher, $150; and
165.14     (17) (18) pharmacy professional corporation, $150.
165.15   Sec. 110. Minnesota Statutes 2024, section 151.065, subdivision 6, is amended to read:
165.16     Subd. 6. Reinstatement fees. (a) A pharmacist who has allowed the pharmacist's license
165.17 to lapse may reinstate the license with board approval and upon payment of any fees and
165.18 late fees in arrears, up to a maximum of $1,000.
165.19     (b) A pharmacy technician who has allowed the technician's registration to lapse may
165.20 reinstate the registration with board approval and upon payment of any fees and late fees
165.21 in arrears, up to a maximum of $250.
165.22     (c) A pharmacy intern who has allowed the intern's registration to lapse may reinstate
165.23 the registration with board approval and upon payment of any fees and late fees in arrears,
165.24 up to a maximum of $100.
165.25     (c) (d) An owner of a pharmacy, a drug wholesaler, a drug manufacturer, third-party
165.26 logistics provider, or a medical gas dispenser who has allowed the license of the establishment
165.27 to lapse may reinstate the license with board approval and upon payment of any fees and
165.28 late fees in arrears.
  Article 3 Sec. 110.  165
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
166.1      (d) (e) A controlled substance researcher who has allowed the researcher's registration
166.2  to lapse may reinstate the registration with board approval and upon payment of any fees
166.3  and late fees in arrears.
166.4      (e) (f) A pharmacist owner of a professional corporation who has allowed the corporation's
166.5  registration to lapse may reinstate the registration with board approval and upon payment
166.6  of any fees and late fees in arrears.
166.7    Sec. 111. Minnesota Statutes 2024, section 151.101, is amended to read:
166.8      151.101 INTERNSHIP.
166.9      Subdivision 1. Registration requirements. (a) Upon payment of the fee specified in
166.10 section 151.065, the board may register as an intern any natural persons who have satisfied
166.11 the board that they are of good moral character, not physically or mentally unfit, and who
166.12 have successfully completed the educational requirements for intern registration prescribed
166.13 by the board. The board shall prescribe standards and requirements for interns,
166.14 pharmacist-preceptors, and internship training but may not require more than one year of
166.15 such training.
166.16     (b) The board in its discretion may accept internship experience obtained in another
166.17 state provided the internship requirements in such other state are in the opinion of the board
166.18 equivalent to those herein provided.
166.19     Subd. 2. Renewal requirements. (a) Beginning January 1, 2026, an intern registration
166.20 expires on September 30 each year or when the intern receives a pharmacist license,
166.21 whichever is earlier.
166.22     (b) To renew an intern registration, the intern must file an application for renewal and
166.23 submit the fee established under section 151.065 on or before September 1 each year.
166.24     (c) If the board does not receive the intern's registration renewal application on or before
166.25 September 1 each year, the intern is subject to a late filing fee equal to 50 percent of the
166.26 renewal fee under section 151.065 in addition to the renewal fee.
166.27     (d) An individual who received an intern registration under the criteria in section 151.01,
166.28 subdivision 15, clause (1), and paid $75 for the individual's application fee between May
166.29 1, 2024, and June 30, 2025, is not subject to the $25 renewal fee for the first two renewal
166.30 cycles following the $75 fee payment.
  Article 3 Sec. 111.  166
  06/07/25  REVISOR        DTT/LN  25-05697  as introduced
167.1      (e) If an individual is no longer enrolled in a doctor of pharmacy program accredited by
167.2  the Accreditation Council for Pharmacy Education, the board must terminate that individual's
167.3  intern registration effective the last date the individual was enrolled in a qualifying program.
167.4      (f) The board must not renew an intern registration unless the individual:
167.5      (1) has maintained current notices of employment for internship training with the board;
167.6      (2) submitted a progress report affidavit of the intern credit hours completed by June 15
167.7  each year;
167.8      (3) meets all other eligibility criteria for a pharmacist intern; and
167.9      (4) demonstrates to the board's satisfaction the individual is in good faith and with
167.10 reasonable diligence pursuing a degree in pharmacy or is completing a pharmacy residency
167.11 or fellowship.
167.12     (g) An intern whose registration has lapsed may renew the intern registration within one
167.13 year of expiration, subject to the fees in paragraph (c). An intern whose registration has
167.14 lapsed for more than one year must meet the registration requirements for an initial intern
167.15 applicant in effect at the time the individual applies for reinstatement and pay any fees and
167.16 late fees in arrears in accordance with section 151.065.
167.17     (h) If the board receives a late renewal, reinstatement, or initial intern application from
167.18 an eligible individual within 90 days before September 30, the board may extend the
167.19 registration expiration date for that applicant to September 30 of the subsequent calendar
167.20 year and prorate the application fee accordingly.
167.21     Subd. 3. Internship credit hour requirements. (a) To apply for licensure as a pharmacist
167.22 under section 151.10, an individual must complete at least 1,600 intern credit hours under
167.23 the direction and supervision of a preceptor.
167.24     (b) Of the 1,600 credit hours required under this subdivision, an intern may earn:
167.25     (1) a maximum of 80 credit hours in the individual's first professional academic year
167.26 for a structured experience directed by the college of pharmacy that the individual attends
167.27 and is overseen by college faculty, registered preceptors, or supervising licensed pharmacists;
167.28     (2) a maximum of 400 credit hours of concurrent time internship; and
167.29     (3) a maximum of 54 credit hours per week that may be earned from more than one site.
  Article 3 Sec. 111.  167
  06/07/25  REVISOR        DTT/LN  25-05697  as introduced
168.1    Sec. 112. Minnesota Statutes 2024, section 151.555, subdivision 6, is amended to read:
168.2      Subd. 6. Standards and procedures for accepting donations of drugs and supplies
168.3  and purchasing drugs from licensed wholesalers. (a) Notwithstanding any other law or
168.4  rule, a donor may donate drugs or medical supplies to the central repository or a local
168.5  repository if the drug or supply meets the requirements of this section as determined by a
168.6  pharmacist or practitioner who is employed by or under contract with the central repository
168.7  or a local repository.
168.8      (b) A drug is eligible for donation under the medication repository program if the
168.9  following requirements are met:
168.10     (1) the drug's expiration date is at least six months after the date the drug was donated.
168.11 If a donated drug bears an expiration date that is less than six months from the donation
168.12 date, the drug may be accepted and distributed if the drug is in high demand and can be
168.13 dispensed for use by a patient before the drug's expiration date;
168.14     (2) the drug is in its original, sealed, unopened, tamper-evident packaging that includes
168.15 the expiration date. Single-unit-dose drugs may be accepted if the single-unit-dose packaging
168.16 is unopened;
168.17     (3) the drug or the packaging does not have any physical signs of tampering, misbranding,
168.18 deterioration, compromised integrity, or adulteration;
168.19     (4) the drug does not require storage temperatures other than normal room temperature
168.20 as specified by the manufacturer or United States Pharmacopoeia, unless the drug is being
168.21 donated directly by its manufacturer, a wholesale drug distributor, or a pharmacy located
168.22 in Minnesota; and
168.23     (5) the drug is not a controlled substance.
168.24     (c) A medical supply is eligible for donation under the medication repository program
168.25 if the following requirements are met:
168.26     (1) the supply has no physical signs of tampering, misbranding, or alteration and there
168.27 is no reason to believe it has been adulterated, tampered with, or misbranded;
168.28     (2) the supply is in its original, unopened, sealed packaging; and
168.29     (3) if the supply bears an expiration date, the date is at least six months later than the
168.30 date the supply was donated. If the donated supply bears an expiration date that is less than
168.31 six months from the date the supply was donated, the supply may be accepted and distributed
  Article 3 Sec. 112.  168
  06/07/25  REVISOR        DTT/LN  25-05697  as introduced
169.1  if the supply is in high demand and can be dispensed for use by a patient before the supply's
169.2  expiration date.
169.3      (d) The board shall develop the medication repository donor form and make it available
169.4  on the board's website. Prior to the first donation from a new donor, a central repository or
169.5  local repository shall verify and record the following information on the donor form:
169.6      (1) the donor's name, address, phone number, and license number, if applicable;
169.7      (2) that the donor will only make donations in accordance with the program;
169.8      (3) to the best of the donor's knowledge, only drugs or supplies that have been properly
169.9  stored under appropriate temperature and humidity conditions will be donated; and
169.10     (4) to the best of the donor's knowledge, only drugs or supplies that have never been
169.11 opened, used, tampered with, adulterated, or misbranded will be donated.
169.12     (e) Notwithstanding any other law or rule, a central repository or a local repository may
169.13 receive donated drugs from donors. Donated drugs and supplies may be shipped or delivered
169.14 to the premises of the central repository or a local repository, and shall be inspected by a
169.15 pharmacist or an authorized practitioner who is employed by or under contract with the
169.16 repository and who has been designated by the repository prior to dispensing. A drop box
169.17 must not be used to deliver or accept donations.
169.18     (f) The central repository and local repository shall maintain a written or electronic
169.19 inventory of all drugs and supplies donated to the repository upon acceptance of each drug
169.20 or supply. For each drug, the inventory must include the drug's name, strength, quantity,
169.21 manufacturer, expiration date, and the date the drug was donated. For each medical supply,
169.22 the inventory must include a description of the supply, its manufacturer, the date the supply
169.23 was donated, and, if applicable, the supply's brand name and expiration date. The board
169.24 may waive the requirement under this paragraph if an entity is under common ownership
169.25 or control with a central repository or local repository and either the entity or the repository
169.26 maintains an inventory containing all the information required under this paragraph.
169.27     (g) The central repository may purchase a drug from a wholesaler licensed by the board
169.28 to fill prescriptions for eligible patients when the repository does not have a sufficient supply
169.29 of donated drugs to fill the prescription. The central repository may use any purchased drugs
169.30 remaining after filling the prescriptions for which the drugs were initially purchased to fill
169.31 other prescriptions. Whenever possible, the repository must use donated drugs to fill
169.32 prescriptions.
  Article 3 Sec. 112.  169
  06/07/25  REVISOR       DTT/LN  25-05697  as introduced
170.1    Sec. 113. Minnesota Statutes 2024, section 151.555, subdivision 10, is amended to read:
170.2      Subd. 10. Distribution of donated drugs and supplies. (a) The central repository and
170.3  local repositories may distribute drugs and supplies donated under the medication repository
170.4  program to other participating repositories for use pursuant to this program.
170.5      (b) A local repository that elects not to dispense donated drugs or supplies that are
170.6  suitable for donation and dispensing must transfer all those donated drugs and supplies to
170.7  the central repository. A copy of the donor form that was completed by the original donor
170.8  under subdivision 6 must be provided to the central repository at the time of transfer. A
170.9  local repository must dispose of drugs and supplies in its possession that are not suitable
170.10 for donation or dispensing pursuant to subdivision 7.
170.11   Sec. 114. Minnesota Statutes 2024, section 152.12, subdivision 1, is amended to read:
170.12     Subdivision 1. Prescribing, dispensing, administering controlled substances in
170.13 Schedules II through V. A licensed doctor of medicine, a doctor of osteopathic medicine,
170.14 duly licensed to practice medicine, a doctor of dental surgery, a doctor of dental medicine,
170.15 a licensed doctor of podiatry, a licensed advanced practice registered nurse, a licensed
170.16 certified midwife, a licensed physician assistant, or a licensed doctor of optometry limited
170.17 to Schedules IV and V, and in the course of professional practice only, may prescribe,
170.18 administer, and dispense a controlled substance included in Schedules II through V of section
170.19 152.02, may cause the same to be administered by a nurse, an intern or an assistant under
170.20 the direction and supervision of the doctor, and may cause a person who is an appropriately
170.21 certified and licensed health care professional to prescribe and administer the same within
170.22 the expressed legal scope of the person's practice as defined in Minnesota Statutes.
170.23   Sec. 115. [153.30] FEES.
170.24     Subdivision 1. Nonrefundable fees. The fees in this section are nonrefundable.
170.25     Subd. 2. Fee amounts. The amount of fees must be set by the board so that the total
170.26 fees collected by the board equals as closely as possible the anticipated expenditures during
170.27 the fiscal biennium, as provided in section 16A.1285. Fees must not exceed the following
170.28 amounts but may be adjusted lower by board action:
170.29     (1) application for licensure fee, $1,000;
170.30     (2) renewal licensure fee, $1,000;
170.31     (3) late renewal fee, $250;
  Article 3 Sec. 115.  170
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
171.1      (4) temporary permit fee, $250;
171.2      (5) duplicate license fee or duplicate renewal certificate fee, $25;
171.3      (6) reinstatement fee, $1,250;
171.4      (7) examination administration fee for persons who have not applied for a license or
171.5  permit, $50;
171.6      (8) verification of licensure fee, $50;
171.7      (9) label fee, $50;
171.8      (10) list of licensees fee, $50; and
171.9      (11) copies fee, $0.50 per page.
171.10     Subd. 3. Current fee information. Information about fees in effect at any time must
171.11 be available from the board office.
171.12     Subd. 4. Deposit of fees. The license fees collected under this section must be deposited
171.13 in the state government special revenue fund.
171.14     EFFECTIVE DATE. This section is effective the day following final enactment.
171.15   Sec. 116. Minnesota Statutes 2024, section 153B.85, subdivision 1, is amended to read:
171.16     Subdivision 1. Fees. (a) The application fee for initial licensure shall not exceed $600.
171.17     (b) The biennial renewal fee for a license to practice as an orthotist, prosthetist, prosthetist
171.18 orthotist, or pedorthist shall not exceed $600.
171.19     (c) The biennial renewal fee for a license to practice as an assistant or a fitter shall not
171.20 exceed $300.
171.21     (d) The fee for license restoration shall not exceed $600.
171.22     (e) The fee for license verification shall not exceed $30 $50.
171.23     (f) The fee to obtain a list of licensees shall not exceed $25 $50.
171.24     EFFECTIVE DATE. This section is effective the day following final enactment.
171.25   Sec. 117. Minnesota Statutes 2024, section 153B.85, subdivision 3, is amended to read:
171.26     Subd. 3. Late fee. The fee for late license renewal is the license renewal fee in effect at
171.27 the time of renewal plus $100 $250.
171.28     EFFECTIVE DATE. This section is effective the day following final enactment.
  Article 3 Sec. 117.  171
  06/07/25  REVISOR  DTT/LN  25-05697       as introduced
172.1    Sec. 118. Minnesota Statutes 2024, section 156.015, is amended by adding a subdivision
172.2  to read:
172.3      Subd. 1a. Nonrefundable fees. All fees are nonrefundable.
172.4    Sec. 119. Minnesota Statutes 2024, section 156.015, is amended by adding a subdivision
172.5  to read:
172.6      Subd. 3. Fee amounts. Fees must not exceed the following amounts but may be adjusted
172.7  lower by board action:
172.8      (1) initial application fee, $75;
172.9      (2) state examination fee, $75;
172.10     (3) duplicate license fee, $25;
172.11     (4) continuing education sponsor application fee, $75;
172.12     (5) mailing list fee, $250;
172.13     (6) initial veterinary license fee, $300;
172.14     (7) initial veterinary technician fee, $100;
172.15     (8) active veterinary renewal fee, $300;
172.16     (9) active veterinary technician renewal fee, $100;
172.17     (10) inactive veterinary renewal fee, $150;
172.18     (11) inactive veterinary technician renewal fee, $50;
172.19     (12) institutional license fee, $300;
172.20     (13) active late veterinary renewal fee, $150;
172.21     (14) active late veterinary technician renewal fee, $50;
172.22     (15) inactive late veterinary renewal fee, $100;
172.23     (16) inactive late veterinary technician renewal fee, $25; and
172.24     (17) institutional late renewal fee, $150.
  Article 3 Sec. 119.  172
  06/07/25  REVISOR        DTT/LN  25-05697  as introduced
173.1    Sec. 120. Minnesota Statutes 2024, section 156.015, is amended by adding a subdivision
173.2  to read:
173.3      Subd. 4. License verification. The board may charge a fee not to exceed $25 per license
173.4  verification to a licensee for verification of licensure status provided to other veterinary
173.5  licensing boards.
173.6    Sec. 121. Minnesota Statutes 2024, section 156.015, is amended by adding a subdivision
173.7  to read:
173.8      Subd. 5. Deposit of fees. The license fees collected under this section must be deposited
173.9  in the state government special revenue fund.
173.10   Sec. 122. Minnesota Statutes 2024, section 214.06, is amended by adding a subdivision
173.11 to read:
173.12     Subd. 4. Reports on one year or more of operating funds of health-related licensing
173.13 boards. At the time of the delivery of each February and November forecast of state revenue
173.14 and expenditures under section 16A.103, the commissioner of management and budget
173.15 must submit a report to the chairs and ranking minority members of the legislative committees
173.16 with jurisdiction over health-related licensing boards identifying the health-related licensing
173.17 boards that have accumulated one year or more of operating funds. This subdivision is
173.18 effective the day following the date on which the transfer required under article 23, section
173.19 7, of this act takes place, and expires June 30, 2030.
173.20   Sec. 123. Minnesota Statutes 2024, section 256B.0625, is amended by adding a subdivision
173.21 to read:
173.22     Subd. 28c. Certified midwifery practice services. Medical assistance covers services
173.23 performed by a licensed certified midwife if:
173.24     (1) the service provided on an inpatient basis is not included as part of the cost for
173.25 inpatient services included in the facility payment;
173.26     (2) the service is otherwise covered under this chapter as a physician service; and
173.27     (3) the service is within the scope of practice of the certified midwife's license as defined
173.28 under chapter 148G.
  Article 3 Sec. 123.  173
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
174.1    Sec. 124. REVISOR INSTRUCTION.
174.2(a) The revisor of statutes shall renumber Minnesota Statutes, section 148.6408,
174.3  subdivision 1, as Minnesota Statutes, section 148.6408, subdivision 1b.
174.4(b) The revisor of statutes shall renumber Minnesota Statutes, section 148.6410,
174.5  subdivision 1, as Minnesota Statutes, section 148.6410, subdivision 1b.
174.6    Sec. 125. REPEALER.
174.7(a) Minnesota Statutes 2024, sections 148.108, subdivisions 2, 3, and 4; 148.6402,
174.8  subdivision 22a; 148.6420, subdivisions 2, 3, and 4; 148.6423, subdivisions 4, 5, 7, 8, and
174.9  9; 148.6425, subdivision 3; 148.6430; 148.6445, subdivisions 5, 6, and 8; and 156.015,
174.10 subdivision 1, are repealed.
174.11(b) Minnesota Rules, parts 2500.1150; 2500.2030; 6800.5100, subpart 5; 6800.5400,
174.12 subparts 5 and 6; 9100.0400, subparts 1 and 3; 9100.0500; and 9100.0600, are repealed.
174.13(c) Minnesota Rules, part 6900.0250, subparts 1 and 2, are repealed.
174.14EFFECTIVE DATE. Paragraph (c) is effective the day following final enactment.
174.15ARTICLE 4
174.16PHARMACY BENEFITS
174.17   Section 1. [62Q.83] FORMULARY CHANGES.
174.18Subdivision 1. Definitions. (a) For purposes of this section, the following terms have
174.19 the meanings given.
174.20(b) "Drug" has the meaning given in section 151.01, subdivision 5.
174.21(c) "Enrollee" has the meaning given in section 62Q.01, subdivision 2b.
174.22(d) "Formulary" means a current list of covered prescription drug products that is subject
174.23 to periodic review and update.
174.24(e) "Health plan" has the meaning given in section 62Q.01, subdivision 3.
174.25(f) "Pharmacy benefit manager" has the meaning given in section 62W.02, subdivision
174.26 15.
174.27(g) "Prescription" has the meaning given in section 151.01, subdivision 16a.
174.28Subd. 2. Formulary changes. (a) Except as provided in paragraphs (b) and (c), a health
174.29 plan must not, with respect to an enrollee who was previously prescribed the drug during
  Article 4 Section 1.  174
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
175.1  the plan year, remove a drug from the health plan's formulary or place a drug in a benefit
175.2  category that increases the enrollee's cost for the duration of the enrollee's plan year.
175.3      (b) Paragraph (a) does not apply if a health plan changes the health plan's formulary:
175.4      (1) for a drug that has been deemed unsafe by the United States Food and Drug
175.5  Administration (FDA);
175.6      (2) for a drug that has been withdrawn by the FDA or the drug manufacturer; or
175.7      (3) when an independent source of research, clinical guidelines, or evidence-based
175.8  standards has issued drug-specific warnings or recommended changes with respect to a
175.9  drug's use for reasons related to previously unknown and imminent patient harm.
175.10     (c) Paragraph (a) does not apply if a health plan removes a brand name drug from the
175.11 health plan's formulary or places a brand name drug in a benefit category that increases the
175.12 enrollee's cost if the health plan:
175.13     (1) adds to the health plan's formulary a generic or multisource brand name drug rated
175.14 as therapeutically equivalent according to the FDA Orange Book, a biologic drug rated as
175.15 interchangeable according to the FDA Purple Book, or a biosimilar at the same or lower
175.16 cost to the enrollee; and
175.17     (2) provides at least a 60-day notice to prescribers, pharmacists, and affected enrollees.
175.18     EFFECTIVE DATE. This section is effective January 1, 2026, and applies to health
175.19 plans offered, sold, issued, or renewed on or after that date.
175.20   Sec. 2. Minnesota Statutes 2024, section 256B.0625, subdivision 13, is amended to read:
175.21     Subd. 13. Drugs. (a) Medical assistance covers drugs, except for fertility drugs when
175.22 specifically used to enhance fertility, if prescribed by a licensed practitioner and dispensed
175.23 by a licensed pharmacist, by a physician enrolled in the medical assistance program as a
175.24 dispensing physician, or by a physician, a physician assistant, or an advanced practice
175.25 registered nurse employed by or under contract with a community health board as defined
175.26 in section 145A.02, subdivision 5, for the purposes of communicable disease control.
175.27     (b) The dispensed quantity of a prescription drug must not exceed a 34-day supply unless
175.28 authorized by the commissioner or as provided in paragraph (h) or the drug appears on the
175.29 90-day supply list published by the commissioner. The 90-day supply list shall be published
175.30 by the commissioner on the department's website. The commissioner may add to, delete
175.31 from, and otherwise modify the 90-day supply list after providing public notice and the
  Article 4 Sec. 2.  175
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
176.1  opportunity for a 15-day public comment period. The 90-day supply list may include
176.2  cost-effective generic drugs and shall not include controlled substances.
176.3      (c) For the purpose of this subdivision and subdivision 13d, an "active pharmaceutical
176.4  ingredient" is defined as a substance that is represented for use in a drug and when used in
176.5  the manufacturing, processing, or packaging of a drug becomes an active ingredient of the
176.6  drug product. An "excipient" is defined as an inert substance used as a diluent or vehicle
176.7  for a drug. The commissioner shall establish a list of active pharmaceutical ingredients and
176.8  excipients which are included in the medical assistance formulary. Medical assistance covers
176.9  selected active pharmaceutical ingredients and excipients used in compounded prescriptions
176.10 when the compounded combination is specifically approved by the commissioner or when
176.11 a commercially available product:
176.12     (1) is not a therapeutic option for the patient;
176.13     (2) does not exist in the same combination of active ingredients in the same strengths
176.14 as the compounded prescription; and
176.15     (3) cannot be used in place of the active pharmaceutical ingredient in the compounded
176.16 prescription.
176.17     (d) Medical assistance covers the following over-the-counter drugs when prescribed by
176.18 a licensed practitioner or by a licensed pharmacist who meets standards established by the
176.19 commissioner, in consultation with the board of pharmacy: antacids, acetaminophen, family
176.20 planning products, aspirin, insulin, products for the treatment of lice, vitamins for adults
176.21 with documented vitamin deficiencies, vitamins for children under the age of seven and
176.22 pregnant or nursing women, and any other over-the-counter drug identified by the
176.23 commissioner, in consultation with the Formulary Committee, as necessary, appropriate,
176.24 and cost-effective for the treatment of certain specified chronic diseases, conditions, or
176.25 disorders, and this determination shall not be subject to the requirements of chapter 14. A
176.26 pharmacist may prescribe over-the-counter medications as provided under this paragraph
176.27 for purposes of receiving reimbursement under Medicaid. When prescribing over-the-counter
176.28 drugs under this paragraph, licensed pharmacists must consult with the recipient to determine
176.29 necessity, provide drug counseling, review drug therapy for potential adverse interactions,
176.30 and make referrals as needed to other health care professionals.
176.31     (e) Effective January 1, 2006, medical assistance shall not cover drugs that are coverable
176.32 under Medicare Part D as defined in the Medicare Prescription Drug, Improvement, and
176.33 Modernization Act of 2003, Public Law 108-173, section 1860D-2(e), for individuals eligible
176.34 for drug coverage as defined in the Medicare Prescription Drug, Improvement, and
  Article 4 Sec. 2.  176
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
177.1  Modernization Act of 2003, Public Law 108-173, section 1860D-1(a)(3)(A). For these
177.2  individuals, medical assistance may cover drugs from the drug classes listed in United States
177.3  Code, title 42, section 1396r-8(d)(2), subject to this subdivision and subdivisions 13a to
177.4  13g, except that drugs listed in United States Code, title 42, section 1396r-8(d)(2)(E), shall
177.5  not be covered.
177.6      (f) Medical assistance covers drugs acquired through the federal 340B Drug Pricing
177.7  Program and dispensed by 340B covered entities and ambulatory pharmacies under common
177.8  ownership of the 340B covered entity. Medical assistance does not cover drugs acquired
177.9  through the federal 340B Drug Pricing Program and dispensed by 340B contract pharmacies.
177.10     (g) Notwithstanding paragraph (a), medical assistance covers self-administered hormonal
177.11 contraceptives prescribed and dispensed by a licensed pharmacist in accordance with section
177.12 151.37, subdivision 14; nicotine replacement medications prescribed and dispensed by a
177.13 licensed pharmacist in accordance with section 151.37, subdivision 15; and opiate antagonists
177.14 used for the treatment of an acute opiate overdose prescribed and dispensed by a licensed
177.15 pharmacist in accordance with section 151.37, subdivision 16.
177.16     (h) Medical assistance coverage for a prescription contraceptive must provide a 12-month
177.17 supply for any prescription contraceptive if a 12-month supply is prescribed by the
177.18 prescribing health care provider. The prescribing health care provider must determine the
177.19 appropriate duration for which to prescribe the prescription contraceptives, up to 12 months.
177.20 For purposes of this paragraph, "prescription contraceptive" means any drug or device that
177.21 requires a prescription and is approved by the Food and Drug Administration to prevent
177.22 pregnancy. Prescription contraceptive does not include an emergency contraceptive drug
177.23 approved to prevent pregnancy when administered after sexual contact. For purposes of this
177.24 paragraph, "health plan" has the meaning provided in section 62Q.01, subdivision 3.
177.25     (i) Notwithstanding a removal of a drug from the drug formulary under subdivision 13d,
177.26 except as provided in paragraphs (j) and (k), medical assistance covers a drug, with respect
177.27 to an enrollee who was previously prescribed the drug during the calendar year when the
177.28 drug was on the formulary, at the same level until January 1 of the calendar year following
177.29 the year in which the commissioner removed the drug from the formulary.
177.30     (j) Paragraph (i) does not apply if the commissioner changes the drug formulary:
177.31     (1) for a drug that has been deemed unsafe by the United States Food and Drug
177.32 Administration (FDA);
177.33     (2) for a drug that has been withdrawn by the FDA or the drug manufacturer; or
  Article 4 Sec. 2.  177
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
178.1      (3) when an independent source of research, clinical guidelines, or evidence-based
178.2  standards has issued drug-specific warnings or recommended changes with respect to a
178.3  drug's use for reasons related to previously unknown and imminent patient harm.
178.4      (k) Paragraph (i) does not apply when the commissioner removes a brand name drug
178.5  from the formulary if the commissioner adds to the formulary a generic or multisource brand
178.6  name drug rated as therapeutically equivalent according to the FDA Orange Book, or a
178.7  biologic drug rated as interchangeable according to the FDA Purple Book, at the same or
178.8  lower cost to the enrollee.
178.9      EFFECTIVE DATE. This section is effective January 1, 2026, or upon federal approval,
178.10 whichever is later. The commissioner of human services shall notify the revisor of statutes
178.11 when federal approval is obtained.
178.12   Sec. 3. Minnesota Statutes 2024, section 256B.0625, subdivision 13c, is amended to read:
178.13     Subd. 13c. Formulary Committee. The commissioner, after receiving recommendations
178.14 from professional medical associations and professional pharmacy associations, and consumer
178.15 groups shall designate a Formulary Committee to carry out duties as described in subdivisions
178.16 13 to 13g. The Formulary Committee shall be comprised of at least five licensed physicians
178.17 actively engaged in the practice of medicine in Minnesota, one of whom is an actively
178.18 practicing psychiatrist, one of whom specializes in the diagnosis and treatment of rare
178.19 diseases, one of whom specializes in pediatrics, and one of whom actively treats persons
178.20 with disabilities; at least three licensed pharmacists actively engaged in the practice of
178.21 pharmacy in Minnesota, one of whom practices outside the metropolitan counties listed in
178.22 section 473.121, subdivision 4, one of whom practices in the metropolitan counties listed
178.23 in section 473.121, subdivision 4, and one of whom is a practicing hospital pharmacist; at
178.24 least two consumer representatives, all of whom must have a personal or professional
178.25 connection to medical assistance; and one representative designated by the Minnesota Rare
178.26 Disease Advisory Council established under section 256.4835; the remainder to be made
178.27 up of health care professionals who are licensed in their field and have recognized knowledge
178.28 in the clinically appropriate prescribing, dispensing, and monitoring of covered outpatient
178.29 drugs. Members of the Formulary Committee shall not be employed by the Department of
178.30 Human Services or have a personal interest in a pharmaceutical company, pharmacy benefits
178.31 manager, health plan company, or their affiliate organizations, but the committee shall be
178.32 staffed by an employee of the department who shall serve as an ex officio, nonvoting member
178.33 of the committee. For the purposes of this subdivision, "personal interest" means that a
178.34 person owns at least five percent of the voting interest or equity interest in the entity, the
  Article 4 Sec. 3.  178
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
179.1  equity interest owned by a person represents at least five percent of that person's net worth,
179.2  or more than five percent of a person's gross income for the preceding year was derived
179.3  from the entity. A committee member must notify the committee of any potential conflict
179.4  of interest and recuse themselves from any communications, discussion, or vote on any
179.5  matter where a conflict of interest exists. A conflict of interest alone, without a personal
179.6  interest, does not preclude an applicant from serving as a member of the Formulary
179.7  Committee. Members may be removed from the committee for cause after a recommendation
179.8  for removal by a majority of the committee membership. For the purposes of this subdivision,
179.9  "cause" does not include offering a differing or dissenting clinical opinion on a drug or drug
179.10 class. The department's medical director shall also serve as an ex officio, nonvoting member
179.11 for the committee. Committee members shall serve three-year terms and may be reappointed
179.12 twice by the commissioner. The committee members shall vote on a chair and vice chair
179.13 from among their membership. The chair shall preside over all committee meetings, and
179.14 the vice chair shall preside over the meetings if the chair is not present. The Formulary
179.15 Committee shall meet at least three times per year. The commissioner may require more
179.16 frequent Formulary Committee meetings as needed. An honorarium of $100 per meeting
179.17 and reimbursement for mileage shall be paid to each committee member in attendance. The
179.18 Formulary Committee expires June 30, 2027 2029. The Formulary Committee is subject to
179.19 the Open Meeting Law under chapter 13D. For purposes of establishing a quorum to transact
179.20 business, vacant committee member positions do not count in the calculation as long as at
179.21 least 60 percent of the committee member positions are filled.
179.22     EFFECTIVE DATE. This section is effective the day following final enactment.
179.23   Sec. 4. Minnesota Statutes 2024, section 256B.0625, subdivision 13d, is amended to read:
179.24     Subd. 13d. Drug formulary. (a) The commissioner shall establish a drug formulary. Its
179.25 establishment and publication shall not be subject to the requirements of the Administrative
179.26 Procedure Act, but the Formulary Committee shall review and comment on the formulary
179.27 contents.
179.28     (b) The formulary shall not include:
179.29     (1) drugs, active pharmaceutical ingredients, or products for which there is no federal
179.30 funding;
179.31     (2) over-the-counter drugs, except as provided in subdivision 13;
179.32     (3) drugs or active pharmaceutical ingredients when used for the treatment of impotence
179.33 or erectile dysfunction;
  Article 4 Sec. 4.  179
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180.1      (4) drugs or active pharmaceutical ingredients for which medical value has not been
180.2  established;
180.3      (5) drugs from manufacturers who have not signed a rebate agreement with the
180.4  Department of Health and Human Services pursuant to section 1927 of title XIX of the
180.5  Social Security Act; and
180.6      (6) medical cannabis flower as defined in section 342.01, subdivision 54, or medical
180.7  cannabinoid products as defined in section 342.01, subdivision 52.
180.8      (c) If a single-source drug used by at least two percent of the fee-for-service medical
180.9  assistance recipients is removed from the formulary due to the failure of the manufacturer
180.10 to sign a rebate agreement with the Department of Health and Human Services, the
180.11 commissioner shall notify prescribing practitioners within 30 days of receiving notification
180.12 from the Centers for Medicare and Medicaid Services (CMS) that a rebate agreement was
180.13 not signed.
180.14     (d) Within ten calendar days of any commissioner determination to change the drug
180.15 formulary, the commissioner must provide written notice to all enrollees, prescribers, and
180.16 pharmacists affected by the change. The notice must include a description of the change,
180.17 the reason for the change, and the date the change will become effective.
180.18     (e) By January 15, 2026, and annually thereafter, the commissioner of human services
180.19 must provide a report with data and information related to the effects on enrollees of drug
180.20 formulary changes made in the prior calendar year to the chairs and ranking minority
180.21 members of the legislative committees with jurisdiction over health and human services
180.22 policy and finance. The report must include but is not limited to data and information on:
180.23     (1) the number of times the formulary was changed;
180.24     (2) the reasons for the formulary changes and how frequently the formulary was changed
180.25 for each reason;
180.26     (3) the drugs that were removed from the formulary;
180.27     (4) for each drug that was removed from the formulary, the number of enrollees who
180.28 were prescribed that drug when it was removed;
180.29     (5) for each drug that was removed from the formulary, whether a therapeutically
180.30 equivalent drug was added;
180.31     (6) the drugs that were added to the formulary;
  Article 4 Sec. 4.  180
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181.1      (7) the fiscal impacts to the Department of Human Services resulting from the changes
181.2  to the formulary; and
181.3      (8) enrollee populations or medical conditions disproportionately affected by the
181.4  formulary changes.
181.5    Sec. 5. Minnesota Statutes 2024, section 256B.0625, subdivision 13e, is amended to read:
181.6      Subd. 13e. Payment rates. (a) The basis for determining the amount of payment shall
181.7  be the lower of the ingredient costs of the drugs plus the professional dispensing fee; or the
181.8  usual and customary price charged to the public. The usual and customary price means the
181.9  lowest price charged by the provider to a patient who pays for the prescription by cash,
181.10 check, or charge account and includes prices the pharmacy charges to a patient enrolled in
181.11 a prescription savings club or prescription discount club administered by the pharmacy or
181.12 pharmacy chain, unless the prescription savings club or prescription discount club is one
181.13 in which an individual pays a recurring monthly access fee for unlimited access to a defined
181.14 list of drugs for which the pharmacy does not bill the member or a payer on a
181.15 per-standard-transaction basis. The amount of payment basis must be reduced to reflect all
181.16 discount amounts applied to the charge by any third-party provider/insurer agreement or
181.17 contract for submitted charges to medical assistance programs. The net submitted charge
181.18 may not be greater than the patient liability for the service. The professional dispensing fee
181.19 shall be $11.55 for prescriptions filled with legend drugs meeting the definition of "covered
181.20 outpatient drugs" according to United States Code, title 42, section 1396r-8(k)(2). The
181.21 dispensing fee for intravenous solutions that must be compounded by the pharmacist shall
181.22 be $11.55 per claim. The professional dispensing fee for prescriptions filled with
181.23 over-the-counter drugs meeting the definition of covered outpatient drugs shall be $11.55
181.24 for dispensed quantities equal to or greater than the number of units contained in the
181.25 manufacturer's original package. The professional dispensing fee shall be prorated based
181.26 on the percentage of the package dispensed when the pharmacy dispenses a quantity less
181.27 than the number of units contained in the manufacturer's original package. The pharmacy
181.28 dispensing fee for prescribed over-the-counter drugs not meeting the definition of covered
181.29 outpatient drugs shall be $3.65 for quantities equal to or greater than the number of units
181.30 contained in the manufacturer's original package and shall be prorated based on the
181.31 percentage of the package dispensed when the pharmacy dispenses a quantity less than the
181.32 number of units contained in the manufacturer's original package. The ingredient cost for
181.33 a drug is either: (1) the lower of the National Average Drug Acquisition Cost (NADAC)
181.34 shall be used to determine the ingredient cost of a drug. or the Minnesota actual acquisition
181.35 cost (MNAAC) under paragraph (i); (2) the maximum allowable cost, if a drug ingredient
  Article 4 Sec. 5.  181
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182.1  cost is unreported in the NADAC and the MNAAC; or (3) for drugs for which a NADAC
182.2  is not reported, the commissioner shall estimate the ingredient cost at the wholesale
182.3  acquisition cost minus two percent, if a drug ingredient cost is unreported in the NADAC
182.4  and the MNAAC and a maximum allowable cost is unavailable. The ingredient cost of a
182.5  drug for a provider participating in the federal 340B Drug Pricing Program shall be is either:
182.6  (1) the lowest of the 340B Drug Pricing Program ceiling price established by the Health
182.7  Resources and Services Administration or, the NADAC, whichever is lower. or the MNAAC;
182.8  (2) the maximum allowable cost, if the 340B ceiling price is unknown and the drug ingredient
182.9  cost is unreported in the NADAC and the MNAAC; or (3) the wholesale acquisition cost
182.10 minus two percent, if the 340B ceiling price is unknown, the drug ingredient cost is
182.11 unreported in the NADAC and the MNAAC, and the maximum allowable cost is unavailable.
182.12 Wholesale acquisition cost is defined as the manufacturer's list price for a drug or biological
182.13 to wholesalers or direct purchasers in the United States, not including prompt pay or other
182.14 discounts, rebates, or reductions in price, for the most recent month for which information
182.15 is available, as reported in wholesale price guides or other publications of drug or biological
182.16 pricing data. The maximum allowable cost of a multisource drug may be set by the
182.17 commissioner and it shall be comparable to the actual acquisition cost of the drug product
182.18 and no higher than the NADAC of the generic product. Establishment of the amount of
182.19 payment for drugs shall not be subject to the requirements of the Administrative Procedure
182.20 Act.
182.21     (b) Pharmacies dispensing prescriptions to residents of long-term care facilities using
182.22 an automated drug distribution system meeting the requirements of section 151.58, or a
182.23 packaging system meeting the packaging standards set forth in Minnesota Rules, part
182.24 6800.2700, that govern the return of unused drugs to the pharmacy for reuse, may employ
182.25 retrospective billing for prescription drugs dispensed to long-term care facility residents. A
182.26 retrospectively billing pharmacy must submit a claim only for the quantity of medication
182.27 used by the enrolled recipient during the defined billing period. A retrospectively billing
182.28 pharmacy must use a billing period not less than one calendar month or 30 days.
182.29     (c) A pharmacy provider using packaging that meets the standards set forth in Minnesota
182.30 Rules, part 6800.2700, is required to credit the department for the actual acquisition cost
182.31 of all unused drugs that are eligible for reuse, unless the pharmacy is using retrospective
182.32 billing. The commissioner may permit the drug clozapine to be dispensed in a quantity that
182.33 is less than a 30-day supply.
182.34     (d) If a pharmacy dispenses a multisource drug, the ingredient cost shall be the is either:
182.35 (1) the lower of the NADAC or the MNAAC of the generic product or; (2) the maximum
  Article 4 Sec. 5.  182
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
183.1  allowable cost, if the generic product ingredient cost is unreported in the NADAC and the
183.2  MNAAC; or (3) the wholesale acquisition cost minus two percent of the generic product
183.3  established by the commissioner, if the generic drug ingredient cost is unreported in the
183.4  NADAC and the MNAAC and a maximum allowable cost is unavailable, unless prior
183.5  authorization for the brand name product has been granted according to the criteria
183.6  established by the Drug Formulary Committee as required by subdivision 13f, paragraph
183.7  (a), and the prescriber has indicated "dispense as written" on the prescription in a manner
183.8  consistent with section 151.21, subdivision 2. If prior authorization is granted, the ingredient
183.9  cost is either: (1) the lower of the NADAC or the MNAAC of the brand name product; (2)
183.10 the maximum allowable cost, if the drug ingredient cost is unreported in the NADAC and
183.11 MNAAC; or (3) the wholesale acquisition cost minus two percent, if the drug ingredient
183.12 cost is unreported in the NADAC and the MNAAC and the maximum allowable cost is
183.13 unavailable. A generic product includes a generic drug, an authorized generic drug, and a
183.14 biosimilar biological product as defined in Code of Federal Regulations, title 42, section
183.15 423.4. A brand name product includes a brand name drug, a brand name biological product,
183.16 and an unbranded biological product as defined in Code of Federal Regulations, title 42,
183.17 section 423.4.
183.18     (e) The basis for determining the amount of payment for drugs administered in an
183.19 outpatient setting shall be is the lower lowest of the usual and customary cost submitted by
183.20 the provider, 106 percent of the average sales price as determined by the United States
183.21 Department of Health and Human Services pursuant to title XVIII, section 1847a of the
183.22 federal Social Security Act, the specialty pharmacy rate MNAAC, or the maximum allowable
183.23 cost set by the commissioner. If the average sales price is, the MNAAC, and the maximum
183.24 allowable cost are unavailable, the amount of payment must be the lower of the usual and
183.25 customary cost submitted by the provider, or the wholesale acquisition cost, the specialty
183.26 pharmacy rate, or the maximum allowable cost set by the commissioner. The commissioner
183.27 shall discount the payment rate for drugs obtained through the federal 340B Drug Pricing
183.28 Program by 28.6 percent. The payment for drugs administered in an outpatient setting shall
183.29 be made to the administering facility or practitioner. A retail or specialty pharmacy dispensing
183.30 a drug for administration in an outpatient setting is not eligible for direct reimbursement.
183.31     (f) The commissioner may establish maximum allowable cost rates for specialty pharmacy
183.32 products that are lower than the ingredient cost formulas specified in paragraph (a). The
183.33 commissioner may require individuals enrolled in the health care programs administered
183.34 by the department to obtain specialty pharmacy products from providers with whom the
183.35 commissioner has negotiated lower reimbursement rates. Specialty pharmacy products are
  Article 4 Sec. 5.  183
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
184.1  defined as those used by a small number of recipients or recipients with complex and chronic
184.2  diseases that require expensive and challenging drug regimens. Examples of these conditions
184.3  include, but are not limited to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis C,
184.4  growth hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms of
184.5  cancer. Specialty pharmaceutical products include injectable and infusion therapies,
184.6  biotechnology drugs, antihemophilic factor products, high-cost therapies, and therapies that
184.7  require complex care. The commissioner shall consult with the Formulary Committee to
184.8  develop a list of specialty pharmacy products subject to maximum allowable cost
184.9  reimbursement. In consulting with the Formulary Committee in developing this list, the
184.10 commissioner shall take into consideration the population served by specialty pharmacy
184.11 products, the current delivery system and standard of care in the state, and access to care
184.12 issues. The commissioner shall have the discretion to adjust the maximum allowable cost
184.13 to prevent access to care issues.
184.14     (g) (f) Home infusion therapy services provided by home infusion therapy pharmacies
184.15 must be paid at rates according to subdivision 8d.
184.16     (h) (g) The commissioner shall contract with a vendor to conduct a cost of dispensing
184.17 survey for all pharmacies that are physically located in the state of Minnesota that dispense
184.18 outpatient drugs under medical assistance. The commissioner shall ensure that the vendor
184.19 has prior experience in conducting cost of dispensing surveys. Each pharmacy enrolled with
184.20 the department to dispense outpatient prescription drugs to fee-for-service members must
184.21 respond to the cost of dispensing survey. The commissioner may sanction a pharmacy under
184.22 section 256B.064 for failure to respond. The commissioner shall require the vendor to
184.23 measure a single statewide cost of dispensing for specialty prescription drugs and a single
184.24 statewide cost of dispensing for nonspecialty prescription drugs for all responding pharmacies
184.25 to measure the mean, mean weighted by total prescription volume, mean weighted by
184.26 medical assistance prescription volume, median, median weighted by total prescription
184.27 volume, and median weighted by total medical assistance prescription volume. The
184.28 commissioner shall post a copy of the final cost of dispensing survey report on the
184.29 department's website. The initial survey must be completed no later than January 1, 2021,
184.30 and repeated every three years. The commissioner shall provide a summary of the results
184.31 of each cost of dispensing survey and provide recommendations for any changes to the
184.32 dispensing fee to the chairs and ranking minority members of the legislative committees
184.33 with jurisdiction over medical assistance pharmacy reimbursement. Notwithstanding section
184.34 256.01, subdivision 42, this paragraph does not expire.
  Article 4 Sec. 5.  184
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
185.1      (i) (h) The commissioner shall increase the ingredient cost reimbursement calculated in
185.2  paragraphs (a), (d), and (f) (e) by 1.8 percent the amount of the wholesale drug distributor
185.3  tax under section 295.52 for prescription and nonprescription drugs subject to the wholesale
185.4  drug distributor tax under section 295.52.
185.5      (i) The commissioner shall contract with a vendor to create the MNAAC through a
185.6  periodic survey of enrolled pharmacy providers. The initial MNAAC must be completed
185.7  by January 1, 2027. Each pharmacy enrolled with the department to dispense outpatient
185.8  prescription drugs must respond to the periodic surveys. The commissioner may sanction
185.9  a pharmacy under section 256B.064 for failure to respond. The commissioner must exclude
185.10 drug purchases under the federal 340B Drug Pricing Program and Federal Supply Schedule
185.11 invoices from any measure and calculation of the MNAAC. The current MNAAC rates
185.12 must be publicly available on the department's or vendor's website. The commissioner must
185.13 require that the MNAAC is measured and calculated at least quarterly. The commissioner
185.14 must ensure that the vendor has an appeal process available to providers for the time between
185.15 the measurement and calculation of the periodically updated MNAAC rates if price
185.16 fluctuations result in a MNAAC that is lower than the price at which enrolled providers can
185.17 purchase a drug. Establishment of the MNAAC and survey reporting requirements are not
185.18 subject to the requirements of the Administrative Procedure Act. Data provided by
185.19 pharmacies for the measurement and calculation of the MNAAC are nonpublic data as
185.20 defined in section 13.02, subdivision 9.
185.21     EFFECTIVE DATE. This section is effective January 1, 2027, or upon federal approval,
185.22 whichever is later. The commissioner of human services must notify the revisor of statutes
185.23 when federal approval is obtained.
185.24   Sec. 6. Minnesota Statutes 2024, section 256B.064, subdivision 1a, as amended by Laws
185.25 2025, chapter 38, article 5, section 28, is amended to read:
185.26     Subd. 1a. Grounds for sanctions. (a) The commissioner may impose sanctions against
185.27 any individual or entity that receives payments from medical assistance or provides goods
185.28 or services for which payment is made from medical assistance for any of the following:
185.29     (1) fraud, theft, or abuse in connection with the provision of goods and services to
185.30 recipients of public assistance for which payment is made from medical assistance;
185.31     (2) a pattern of presentment of false or duplicate claims or claims for services not
185.32 medically necessary;
  Article 4 Sec. 6.  185
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
186.1      (3) a pattern of making false statements of material facts for the purpose of obtaining
186.2  greater compensation than that to which the individual or entity is legally entitled;
186.3      (4) suspension or termination as a Medicare vendor;
186.4      (5) refusal to grant the state agency access during regular business hours to examine all
186.5  records necessary to disclose the extent of services provided to program recipients and
186.6  appropriateness of claims for payment;
186.7      (6) failure to repay an overpayment or a fine finally established under this section;
186.8      (7) failure to correct errors in the maintenance of health service or financial records for
186.9  which a fine was imposed or after issuance of a warning by the commissioner; and
186.10     (8) any reason for which an individual or entity could be excluded from participation in
186.11 the Medicare program under section 1128, 1128A, or 1866(b)(2) of the Social Security Act.
186.12     (b) For the purposes of this section, goods or services for which payment is made from
186.13 medical assistance includes but is not limited to care and services identified in section
186.14 256B.0625 or provided pursuant to any federally approved waiver.
186.15     (c) Regardless of the source of payment or other item of value, the commissioner may
186.16 impose sanctions against any individual or entity that solicits, receives, pays, or offers to
186.17 pay any illegal remuneration as described in section 142E.51, subdivision 6a, in violation
186.18 of section 609.542, subdivision 2, or in violation of United States Code, title 42, section
186.19 1320a-7b(b)(1) or (2). No conviction is required before the commissioner can impose
186.20 sanctions under this paragraph.
186.21     (d) The commissioner may impose sanctions against a pharmacy provider for failure to
186.22 respond to a cost of dispensing survey under section 256B.0625, subdivision 13e, paragraph
186.23 (h) (g).
186.24     (e) The commissioner may impose sanctions against a pharmacy provider for failure to
186.25 respond to a Minnesota drug acquisition cost survey under section 256B.0625, subdivision
186.26 13e, paragraph (i).
186.27     EFFECTIVE DATE. This section is effective January 1, 2027, or upon federal approval,
186.28 whichever is later. The commissioner of human services must notify the revisor of statutes
186.29 when federal approval is obtained.
186.30   Sec. 7. Minnesota Statutes 2024, section 256B.69, subdivision 6d, is amended to read:
186.31     Subd. 6d. Prescription drugs. (a) The commissioner may exclude or modify coverage
186.32 for prescription drugs from the prepaid managed care contracts entered into under this
  Article 4 Sec. 7.  186
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
187.1  section in order to increase savings to the state by collecting additional prescription drug
187.2  rebates.
187.3      (b) The contracts must maintain incentives for the managed care plan to manage drug
187.4  costs and utilization and may require that the managed care plans maintain an open drug
187.5  formulary. In order to manage drug costs and utilization, the contracts may authorize the
187.6  managed care plans to use preferred drug lists and prior authorization. The contracts must
187.7  require that the managed care plans enter into contracts with the state's selected pharmacy
187.8  benefit manager vendor to administer the pharmacy benefit.
187.9      (c) This subdivision is contingent on federal approval of the managed care contract
187.10 changes and the collection of additional prescription drug rebates.
187.11   Sec. 8. Minnesota Statutes 2024, section 256B.69, is amended by adding a subdivision to
187.12 read:
187.13     Subd. 6i. Directed pharmacy dispensing payment. (a) The commissioner shall provide
187.14 a directed pharmacy dispensing payment of $4.50 per filled prescription to eligible outpatient
187.15 retail pharmacies in Minnesota to improve and maintain access to pharmaceutical services
187.16 in rural and underserved areas of Minnesota. Managed care and county-based purchasing
187.17 plans delivering services under section 256B.69 or 256B.692, and any pharmacy benefit
187.18 managers under contract with these entities, must pay the directed pharmacy dispensing
187.19 payment to eligible outpatient retail pharmacies for drugs dispensed to medical assistance
187.20 enrollees. The directed pharmacy dispensing payment is in addition to, and must not supplant
187.21 or reduce, any other dispensing fee paid by these entities to the pharmacy. Entities paying
187.22 the directed pharmacy dispensing payment must not reduce other payments to the pharmacy
187.23 as a result of payment of the directed pharmacy dispensing payment.
187.24     (b) For purposes of this subdivision, "eligible outpatient retail pharmacy" means an
187.25 outpatient retail pharmacy licensed under chapter 151 that is not owned, either directly or
187.26 indirectly or through an affiliate or subsidiary, by a pharmacy benefit manager licensed
187.27 under chapter 62W or a health carrier, as defined in section 62A.011, subdivision 2, and
187.28 that:
187.29     (1) is located in a medically underserved area or primarily serves a medically underserved
187.30 population, as defined by the United States Department of Health and Human Services
187.31 Health Resources and Services Administration under United States Code, title 42, section
187.32 254; or
187.33     (2) shares common ownership with 13 or fewer Minnesota pharmacies.
  Article 4 Sec. 8.  187
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
188.1      (c) In order to receive the directed pharmacy dispensing payment, a pharmacy must
188.2  submit to the commissioner a form, developed by the commissioner, attesting that the
188.3  pharmacy meets the requirements of paragraph (b).
188.4      (d) Managed care and county-based purchasing plans, and any pharmacy benefit managers
188.5  under contract with these entities, shall pay the directed pharmacy dispensing payment to
188.6  eligible outpatient retail pharmacies. The commissioner shall monitor the effect of this
188.7  requirement on access to pharmaceutical services in rural and underserved areas of
188.8  Minnesota. If, for any contract year, federal approval is not received for this subdivision,
188.9  the commissioner must adjust the capitation rates paid to managed care plans and
188.10 county-based purchasing plans for that contract year to reflect removal of this subdivision.
188.11 Contracts between managed care plans and county-based purchasing plans, and any pharmacy
188.12 benefit managers under contract with these entities, and providers to whom this subdivision
188.13 applies must allow recovery of payments from those providers if capitation rates are adjusted
188.14 in accordance with this paragraph. Payment recoveries must not exceed the amount equal
188.15 to any increase in rates that results from this subdivision. This subdivision expires if federal
188.16 approval is not received for this subdivision at any time.
188.17     (e) This subdivision expires on December 31, 2026.
188.18     EFFECTIVE DATE. This section is effective July 1, 2025, or upon federal approval,
188.19 whichever is later. The commissioner of human services shall notify the revisor of statutes
188.20 when federal approval is obtained.
188.21   Sec. 9. [256B.696] PRESCRIPTION DRUGS; STATE PHARMACY BENEFIT
188.22 MANAGER.
188.23     Subdivision 1. Definitions. (a) For purposes of this section, the following terms have
188.24 the meanings given.
188.25     (b) "Managed care enrollees" means medical assistance and MinnesotaCare enrollees
188.26 receiving coverage from managed care plans.
188.27     (c) "Managed care organizations" means health plan companies and county-based
188.28 purchasing organizations providing coverage to medical assistance and MinnesotaCare
188.29 enrollees under the managed care delivery system.
188.30     (d) "State pharmacy benefit manager" means the pharmacy benefit manager selected
188.31 pursuant to the procurement process in subdivision 2.
188.32     Subd. 2. Procurement process. (a) The commissioner must, through a competitive
188.33 procurement process in compliance with paragraph (b), select a state pharmacy benefit
  Article 4 Sec. 9.  188
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
189.1  manager to comply with the requirements set forth in subdivision 3. The state pharmacy
189.2  benefit manager selected under this subdivision must be a prepaid ambulatory health plan,
189.3  as defined in Code of Federal Regulations, title 42, section 438.2.
189.4      (b) When selecting the state pharmacy benefit manager, the commissioner must:
189.5      (1) accept applications for entities seeking to become the state pharmacy benefit manager;
189.6      (2) establish eligibility criteria an entity must meet in order to become the state pharmacy
189.7  benefit manager; and
189.8      (3) enter into a master contract with a single pharmacy benefit manager.
189.9      (c) Applicants for the state pharmacy benefit manager must disclose to the commissioner
189.10 the following during the procurement process:
189.11     (1) any activity, policy, practice, contract, or arrangement of the pharmacy benefit
189.12 manager that may directly or indirectly present any conflict of interest with the pharmacy
189.13 benefit manager's relationship with or obligation to the Department of Human Services or
189.14 a managed care organization;
189.15     (2) all common ownership, members of a board of directors, managers, or other control
189.16 of the pharmacy benefit manager or any of the pharmacy benefit manager's affiliated
189.17 companies with:
189.18     (i) a managed care organization administering medical assistance or MinnesotaCare
189.19 benefits in Minnesota or an affiliate of the managed care organization;
189.20     (ii) an entity that contracts on behalf of a pharmacy or any pharmacy services
189.21 administration organization and its affiliates;
189.22     (iii) a drug wholesaler or distributor and its affiliates;
189.23     (vi) a third-party payer and its affiliates; or
189.24     (v) a pharmacy and its affiliates;
189.25     (3) any direct or indirect fees, charges, or any kind of assessments imposed by the
189.26 pharmacy benefit manager on pharmacies licensed in the state with which the pharmacy
189.27 benefit manager shares common ownership, management, or control, or that are owned,
189.28 managed, or controlled by any of the pharmacy benefit manager's affiliated companies;
189.29     (4) any direct or indirect fees, charges, or any kind of assessments imposed by the
189.30 pharmacy benefit manager on pharmacies licensed in the state; and
  Article 4 Sec. 9.  189
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
190.1      (5) any financial terms and arrangements between the pharmacy benefit manager and a
190.2  prescription drug manufacturer or labeler, including formulary management, drug substitution
190.3  programs, educational support claims processing, or data sales fees.
190.4      Subd. 3. Contract requirements. The master contract required under subdivision 2,
190.5  paragraph (b), clause (3), must include provisions that prohibit the state pharmacy benefit
190.6  manager from:
190.7      (1) requiring, enticing, or coercing an enrollee to obtain pharmacy services, including
190.8  a prescription drug, from a pharmacy owned or otherwise affiliated with the state pharmacy
190.9  benefit manager;
190.10     (2) communicating to an enrollee, in any manner, that the enrollee is required to obtain
190.11 pharmacy services or have a prescription dispensed at, or pharmacy services provided by,
190.12 a particular pharmacy owned or affiliated with the state pharmacy benefit manager if there
190.13 are other nonaffiliated pharmacies that have the ability to dispense the medication or provide
190.14 the services and are also in network;
190.15     (3) requiring an enrollee to obtain pharmacy services, including a prescription drug,
190.16 exclusively through a mail order pharmacy;
190.17     (4) directly or indirectly retroactively denying or reducing a claim or aggregate of claims
190.18 for pharmacy services, including prescription drugs, after adjudication of the claim or
190.19 aggregation of claims; and
190.20     (5) paying a rate for pharmacy services, including the prescription drug, that is less than
190.21 the sum of the following:
190.22     (i) the amount of the professional dispensing fee if it were determined pursuant to section
190.23 256B.0625, subdivision 13e; and
190.24     (ii) either:
190.25     (A) the lower of the national average drug acquisition cost or the Minnesota actual
190.26 acquisition cost under section 256B.0625, subdivision 13e, paragraph (i);
190.27     (B) the maximum allowable cost, as described in section 62W.08, if the national average
190.28 drug acquisition cost and the Minnesota actual acquisition cost are unreported; or
190.29     (C) the wholesale acquisition cost minus two percent at the time the drug is administered
190.30 or dispensed if the costs of subitems (A) and (B) are unreported or unavailable.
190.31     Subd. 4. Prescription drug coverage requirements. (a) The state pharmacy benefit
190.32 manager is responsible for processing all point of sale outpatient pharmacy claims under
  Article 4 Sec. 9.  190
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
191.1  the managed care delivery system. Managed care and county-based purchasing plans must
191.2  use the state pharmacy benefit manager pursuant to the terms of the master contract required
191.3  under subdivision 2, paragraph (b), clause (3). The state pharmacy benefit manager selected
191.4  is the exclusive pharmacy benefit manager used by managed care and county-based
191.5  purchasing plans when providing coverage to enrollees. The commissioner may require the
191.6  managed care and county-based purchasing plans and state pharmacy benefit manager to
191.7  directly exchange data and files for members enrolled with the plans.
191.8      (b) The commissioner may require the state pharmacy benefit manager to modify
191.9  utilization review limitations, requirements, and strategies imposed on prescription drug
191.10 coverage.
191.11     (c) All payment arrangements between the Department of Human Services, managed
191.12 care plans, county-based purchasing plans, and the state pharmacy benefit manager must
191.13 comply with state and federal statutes, regulations adopted by the Centers for Medicare and
191.14 Medicaid Services, and any other agreement between the department and the Centers for
191.15 Medicare and Medicaid Services. The commissioner may change a payment arrangement
191.16 to comply with this paragraph.
191.17     (d) The commissioner must administer and oversee this section to:
191.18     (1) ensure proper administration of prescription drug benefits for managed care enrollees;
191.19 and
191.20     (2) increase the transparency of prescription drug prices and other information for the
191.21 benefit of pharmacies.
191.22     Subd. 5. Reporting requirements. (a) The state pharmacy benefit manager must, on
191.23 request from the commissioner, disclose to the commissioner all sources of payment the
191.24 state pharmacy benefit manager receives for prescribed drugs, including drug rebates,
191.25 discounts, credits, clawbacks, fees, grants, chargebacks, reimbursements, or other financial
191.26 benefits or payments related to services provided for a managed care or county-based
191.27 purchasing plan.
191.28     (b) Each managed care and county-based purchasing plan must disclose to the
191.29 commissioner, in the format specified by the commissioner, the entity's administrative costs
191.30 associated with providing pharmacy services under the managed care delivery system.
191.31     (c) The state pharmacy benefit manager must provide a written quarterly report to the
191.32 commissioner containing the following information from the immediately preceding quarter:
  Article 4 Sec. 9.  191
  06/07/25  REVISOR        DTT/LN  25-05697  as introduced
192.1      (1) the prices the state pharmacy benefit manager negotiated for prescribed drugs under
192.2  the managed care delivery system. The prices must include any rebates the state pharmacy
192.3  benefit manager received from drug manufacturers;
192.4      (2) unredacted copies of contracts between the state pharmacy benefit manager and
192.5  enrolled pharmacies;
192.6      (3) any rebate amounts the state pharmacy benefit manager passed on to individual
192.7  pharmacies;
192.8      (4) any changes to the information previously disclosed in accordance with subdivision
192.9  2, paragraph (c); and
192.10     (5) any other information required by the commissioner.
192.11     (d) Data submitted pursuant to paragraph (c), clause (3), are nonpublic data, as defined
192.12 in section 13.02, subdivision 9.
192.13     (e) The commissioner may request and collect additional information and clinical data
192.14 from the state pharmacy benefit manager.
192.15     (f) At the time of contract execution, renewal, or modification, the commissioner must
192.16 modify the reporting requirements under its managed care contracts as necessary to meet
192.17 the requirements of this subdivision.
192.18     Subd. 6. Commissioner's program authority. (a) To accomplish the requirements of
192.19 subdivision 4, paragraph (d), the commissioner, in consultation with the Formulary
192.20 Committee established under section 256B.0625, subdivision 13c, has the authority to:
192.21     (1) adopt or develop a preferred drug list for managed care plans;
192.22     (2) at the commissioner's discretion, engage in price negotiations with prescription drug
192.23 manufacturers, wholesalers, or group purchasing organizations in place of the state pharmacy
192.24 benefit manager to obtain price discounts and rebates for prescription drugs for managed
192.25 care enrollees; and
192.26     (3) develop and manage a drug formulary for managed care and county-based purchasing
192.27 plans.
192.28     (b) The commissioner may contract with one or more entities to perform any of the
192.29 functions described in paragraph (a).
192.30     Subd. 7. Contracts with pharmacies. (a) The commissioner may review contracts
192.31 between the state pharmacy benefit manager and pharmacies for compliance with this section
192.32 and the master contract required under subdivision 2, paragraph (b), clause (3). The
  Article 4 Sec. 9.  192
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
193.1  commissioner may amend any term or condition of a contract that does not comply with
193.2  this section or the master contract.
193.3      (b) A master contract and a contract between a state pharmacy benefit manager and a
193.4  pharmacy are nonpublic data, as defined in section 13.02, subdivision 9.
193.5      Subd. 8. Federal approval. (a) The commissioner must seek any necessary federal
193.6  approval to implement this section.
193.7      (b) The commissioner shall monitor the effect of state directed payments under this
193.8  section on access to pharmaceutical services in rural and underserved areas of Minnesota.
193.9  If, for any contract year, federal approval is not received for a state directed payment under
193.10 this section, the commissioner must adjust payments made to the managed care entity for
193.11 that contract year to reflect removal of the payment. Contracts between the state pharmacy
193.12 benefit manager and providers to whom this section applies must allow recovery of payments
193.13 from those providers if rates are adjusted in accordance with this paragraph. Payment
193.14 recoveries must not exceed the amount equal to any increase in rates that results from state
193.15 directed payments under this section. This paragraph expires if federal approval is not
193.16 received for state directed payments under this section at any time.
193.17     EFFECTIVE DATE. This section is effective January 1, 2027, or upon federal approval,
193.18 whichever is later, except that subdivision 8 is effective the day following final enactment.
193.19 The commissioner of human services shall notify the revisor of statutes when federal approval
193.20 is obtained.
193.21ARTICLE 5
193.22OFFICE OF EMERGENCY MEDICAL SERVICES
193.23   Section 1. Minnesota Statutes 2024, section 144E.35, is amended to read:
193.24     144E.35 REIMBURSEMENT TO AMBULANCE SERVICES FOR VOLUNTEER
193.25 EDUCATION COSTS.
193.26     Subdivision 1. Repayment for volunteer Reimbursement for education costs;
193.27 ambulance service eligibility. A licensed ambulance service shall be reimbursed by the
193.28 director for the necessary expense of the initial education of a volunteer ambulance attendant
193.29 upon successful completion by the attendant of an EMT education course, or a continuing
193.30 education course for EMT care, or both, which has been approved by the director, pursuant
193.31 to section 144E.285 (a) Except as provided in subdivision 3, the director must reimburse
193.32 all eligible Minnesota licensed ambulance services that apply for reimbursement under this
193.33 section for the necessary expenses of initial EMR and EMT education and EMR and EMT
  Article 5 Section 1.  193
  06/07/25  REVISOR      DTT/LN  25-05697  as introduced
194.1  continuing education for ambulance attendants who satisfy the criteria in subdivision 2.
194.2  Reimbursement may include tuition, transportation, food, lodging, hourly payment for the
194.3  time spent in the education course, and other necessary expenditures, except that in no
194.4  instance shall a volunteer licensed ambulance attendant service be reimbursed more than
194.5  $900:
194.6      (1) $1,200 for an ambulance attendant's successful completion of an initial EMT education
194.7  course, and $375;
194.8      (2) $400 for an ambulance attendant's successful completion of a an EMT continuing
194.9  education course;
194.10     (3) $600 for an ambulance attendant's successful completion of an initial EMR education
194.11 course; and
194.12     (4) $200 for an ambulance attendant's successful completion of an EMR continuing
194.13 education course.
194.14     (b) To be eligible for reimbursement, a licensed ambulance service must have responded
194.15 to 5,000 or fewer calls in the most recent calendar year.
194.16     Subd. 2. Reimbursement provisions Ambulance attendant criteria. Reimbursement
194.17 must be paid under provisions of this section when documentation is provided to the director
194.18 that the individual ambulance attendant:
194.19     (1) successfully completed an initial EMR or EMT education course approved by the
194.20 director under section 144E.285, a continuing education course for EMR or EMT care
194.21 approved by the director under section 144E.285, or both; and
194.22     (2) has served for one year from the date of the final certification exam as an active
194.23 member of a Minnesota licensed ambulance service.
194.24     Subd. 3. Discontinuance of reimbursement. If the state is unable to meet its financial
194.25 obligations under subdivision 1 as the obligations become due, the director must discontinue
194.26 reimbursing ambulance services for education costs until the state is again able to meet the
194.27 financial obligations under subdivision 1 as the obligations become due. An ambulance
194.28 service whose application is not approved due to lack of funding may resubmit the application
194.29 in the next fiscal year.
  Article 5 Section 1.  194
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
195.1    Sec. 2. [144E.55] RURAL EMS UNCOMPENSATED CARE POOL PAYMENT
195.2  PROGRAM.
195.3Subdivision 1. Definitions. (a) For purposes of this section, the following terms have
195.4  the meanings given.
195.5(b) "Eligible licensee" means a licensee that primarily provides ambulance services
195.6  outside the metropolitan counties listed in section 473.121, subdivision 4.
195.7(c) "Public safety answering point" has the meaning given in section 403.02, subdivision
195.8  19.
195.9Subd. 2. Payment program established. The director must establish and administer a
195.10 rural EMS uncompensated care pool payment program. Under the program, the director
195.11 must make payments to eligible licensees according to this section.
195.12Subd. 3. Excluded responses. The director must exclude EMS responses by specialized
195.13 life support, as described in section 144E.101, subdivision 9, in calculating payments under
195.14 this section.
195.15Subd. 4. Application process. (a) An eligible licensee seeking a payment under this
195.16 section must apply to the director each year by March 31, in the form and manner determined
195.17 by the director. In the application, the eligible licensee must specify the number of the
195.18 eligible licensee's EMS responses that meet the criteria in subdivision 5.
195.19(b) When an eligible licensee, an eligible licensee's parent company, a subsidiary of an
195.20 eligible licensee, or a subsidiary of an eligible licensee's parent company collectively hold
195.21 multiple licenses, the director must treat all such related licensees as a single eligible licensee.
195.22Subd. 5. Eligible EMS responses. In order for an EMS response to be an eligible EMS
195.23 response for purposes of subdivision 6, the EMS response must meet the following criteria:
195.24(1) the EMS response was initiated by a request for emergency medical services initially
195.25 received by a public safety answering point;
195.26(2) an ambulance responded to the scene;
195.27(3) the ambulance was not canceled while en route to the scene;
195.28(4) the ambulance did not transport a person from the scene to a hospital emergency
195.29 department;
195.30(5) the eligible licensee did not receive any payment for the EMS response from any
195.31 source; and
  Article 5 Sec. 2.  195
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
196.1(6) the EMS response was initiated between January 1 and December 31 of the year
196.2  prior to the year the application is submitted.
196.3Subd. 6. Calculations. (a) The director must calculate payments as provided in paragraphs
196.4  (b) and (c) for an eligible licensee that completes an application under subdivision 4.
196.5(b) The director must award points for eligible EMS responses as follows:
196.6(1) for eligible EMS responses one to 25, an eligible licensee is awarded ten points per
196.7  response;
196.8(2) for eligible EMS responses 26 to 50, an eligible licensee is awarded five points per
196.9  response;
196.10(3) for eligible EMS responses 51 to 100, an eligible licensee is awarded three points
196.11 per response;
196.12(4) for eligible EMS responses 101 to 200, an eligible licensee is awarded one point per
196.13 response; and
196.14(5) for eligible EMS responses exceeding 200, an eligible licensee is awarded zero points.
196.15(c) The director must total the number of all points awarded to all applying eligible
196.16 licensees under paragraph (b). The director must divide the amount appropriated for purposes
196.17 of this section by the total number of points awarded to determine a per-point amount. The
196.18 payment for each eligible licensee shall be calculated by multiplying the eligible licensee's
196.19 number of awarded points by the established per-point amount.
196.20Subd. 7. Payment. The director must certify the payment amount for each eligible
196.21 licensee and must make the full payment to each eligible licensee by May 30 each year.
196.22   Sec. 3. AMBULANCE SERVICE TRAINING AND STAFFING GRANT PROGRAM.
196.23Subdivision 1. Definitions. (a) For purposes of this section, the following terms have
196.24 the meanings given.
196.25(b) "Director" has the meaning given in Minnesota Statutes, section 144E.001, subdivision
196.26 16.
196.27(c) "Emergency medical technician" has the meaning given in Minnesota Statutes, section
196.28 144E.001, subdivision 5c.
196.29(d) "Employee" has the meaning given in Minnesota Statutes, section 181.960, subdivision
196.30 2.
  Article 5 Sec. 3.  196
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
197.1      Subd. 2. Grant program. The director must establish and administer a program to award
197.2  grants to eligible ambulance services for certain costs to train ambulance service employees
197.3  as emergency medical technicians and staff the ambulance service.
197.4      Subd. 3. Eligible ambulance services. To be eligible for a grant under this section, an
197.5  ambulance service must:
197.6      (1) be licensed under Minnesota Statutes, chapter 144E; and
197.7      (2) in the calendar year prior to the year in which the ambulance service first applies for
197.8  a grant under this section, have had at least 50 percent of its ambulance staffing provided
197.9  by emergency medical technicians.
197.10     Subd. 4. Application. An eligible ambulance service seeking a grant under this section
197.11 must apply to the director in a form and manner and according to a timeline specified by
197.12 the director. In its application, the eligible ambulance service must specify the number of
197.13 individuals it plans to hire using the grant money, the number of employee training hours
197.14 it plans to fund using the grant money, and other information required by the director.
197.15     Subd. 5. Allowable uses of grant money; maximum grant amount. (a) An ambulance
197.16 service must use grant money awarded under this section only for one or more of the
197.17 following:
197.18     (1) tuition for employees attending an emergency medical technician (EMT) education
197.19 program approved by the director;
197.20     (2) employee examination fees for EMT certification;
197.21     (3) fees for background studies for new EMT employees; and
197.22     (4) incurred wage and benefit costs of employees while attending an EMT education
197.23 program or program-related activities. Wage and benefit costs under this clause must be
197.24 commensurate with the wages and benefits the ambulance service provides to an entry-level
197.25 EMT and must not exceed $26 per hour.
197.26     (b) The grant amount awarded to an ambulance service must not exceed the amount
197.27 needed for the costs in paragraph (a).
197.28     Subd. 6. Grant program oversight. An ambulance service receiving a grant under this
197.29 section must provide the director with information necessary for the director to administer
197.30 and evaluate the grant program.
  Article 5 Sec. 3.  197
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
198.1    Sec. 4. AMBULANCE OPERATING DEFICIT GRANT PROGRAM.
198.2Subdivision 1. Definitions. (a) For the purposes of this section, the terms defined in this
198.3  subdivision have the meanings given.
198.4(b) "Capital expenses" means expenses incurred by a licensee for the purchase,
198.5  improvement, or maintenance of assets with an expected useful life of greater than five
198.6  years that improve the efficiency of provided ambulance services or the capabilities of the
198.7  licensee.
198.8(c) "Director" has the meaning given in Minnesota Statutes, section 144E.001, subdivision
198.9  16.
198.10(d) "Eligible applicant" or "eligible licensee" means any licensee who possessed a license
198.11 not excluded under subdivision 3 or 4 in the last completed state fiscal year for which data
198.12 was provided to the director, as provided in Minnesota Statutes, section 62J.49; who continues
198.13 to operate that same nonexcluded license at the time of application; and who provides
198.14 verifiable evidence of an operating deficit in the state fiscal year prior to submitting an
198.15 application.
198.16(e) "Government licensee" means any government entity, as defined in Minnesota
198.17 Statutes, section 118A.01, subdivision 2, including a Tribe, that is a licensee.
198.18(f) "Insurance revenue" means revenue from Medicare, medical assistance, private health
198.19 insurance, third-party liability insurance, and payments from individuals.
198.20(g) "Licensee" has the meaning given in Minnesota Statutes, section 144E.001,
198.21 subdivision 8.
198.22(h) "Operating deficit" means the sum of insurance revenue and other revenue is less
198.23 than the sum of operational expenses and capital expenses.
198.24(i) "Operational expenses" means costs related to the day-to-day operations of an
198.25 ambulance service, including but not limited to costs related to personnel, supplies and
198.26 equipment, fuel, vehicle maintenance, travel, education, and fundraising.
198.27(j) "Other revenue" means revenue from any revenue that is not insurance revenue,
198.28 including but not limited to grants, tax revenue, donations, fundraisers, or standby fees.
198.29 Grants awarded under this section and aid paid under Laws 2024, chapter 122, article 4,
198.30 section 1, must not be considered revenue.
  Article 5 Sec. 4.  198
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
199.1      Subd. 2. Program establishment. An ambulance operating deficit grant program is
199.2  established to award grants to applicants to address revenue shortfalls creating operating
199.3  deficits among eligible applicants.
199.4      Subd. 3. Licensee providing specialized life support services excluded. Licensees
199.5  providing specialized life support services as described in Minnesota Statutes, section
199.6  144E.101, subdivision 9, are not eligible for grants under this section.
199.7      Subd. 4. Other licensees excluded. Licensees whose individual primary service areas
199.8  are located mostly within a metropolitan county listed in Minnesota Statutes, section 473.121,
199.9  subdivision 4, or within the cities of Duluth, Mankato, St. Cloud, or Rochester are not
199.10 eligible for grants under this section.
199.11     Subd. 5. Application process. (a) An eligible licensee may apply to the director, in the
199.12 form and manner determined by the director, for a grant under this section.
199.13     (b) A grant application made by a government licensee must be accompanied by a
199.14 resolution of support from the governing body.
199.15     Subd. 6. Director calculations. The director shall award grants only to applicants who
199.16 provide verifiable evidence of an operating deficit in the last completed state fiscal year for
199.17 which data were provided to the director. The director may audit the financial data provided
199.18 to the director by applicants, as provided in Minnesota Statutes, section 62J.49. A grant
199.19 awarded must not be more than five percent more than any previous grant without special
199.20 permission from the director.
199.21     Subd. 7. Grant awards; limitations. (a) Grants awarded under this section to eligible
199.22 applicants may be proportionally distributed based on money available. Total amounts
199.23 awarded must not exceed the amount appropriated for purposes of this section.
199.24     (b) The director shall award grants in fiscal year 2026 and fiscal year 2027.
199.25     (c) The director must not award individual grants that exceed the amount of the grantee's
199.26 most recent verified operating deficit as reported to the director.
199.27     Subd. 8. Eligible expenditures. A grantee must spend grant money received under this
199.28 section on operational expenses and capital expenses incurred to provide ambulance services.
199.29     Subd. 9. Report. By February 15, 2026, and February 15, 2027, the director must submit
199.30 a report to the chairs and ranking minority members of the legislative committees with
199.31 jurisdiction over health finance and policy. The report must describe the number and amount
199.32 of grants awarded under this section and the uses made of grant money by grantees.
  Article 5 Sec. 4.  199
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
200.1ARTICLE 6
200.2HEALTH POLICY
200.3    Section 1. Minnesota Statutes 2024, section 144.98, subdivision 8, is amended to read:
200.4      Subd. 8. Exemption from national standards for quality control and personnel
200.5  requirements. Effective January 1, 2012, A laboratory that analyzes samples for compliance
200.6  with a permit issued under section 115.03, subdivision 5, may request exemption from the
200.7  personnel requirements and specific quality control provisions for microbiology and
200.8  chemistry stated in the national standards as incorporated by reference in subdivision 2a.
200.9  The commissioner shall grant the exemption if the laboratory:
200.10     (1) complies with the methodology and quality control requirements, where available,
200.11 in the most recent, approved edition of the Standard Methods for the Examination of Water
200.12 and Wastewater as published by the Water Environment Federation; and
200.13     (2) supplies the name of the person meeting the requirements in section 115.73, or the
200.14 personnel requirements in the national standard pursuant to subdivision 2a.
200.15     A laboratory applying for this exemption shall not apply for simultaneous accreditation
200.16 under the national standard.
200.17   Sec. 2. Minnesota Statutes 2024, section 144.98, subdivision 9, is amended to read:
200.18     Subd. 9. Exemption from national standards for proficiency testing frequency. (a)
200.19 Effective January 1, 2012, A laboratory applying for or requesting accreditation under the
200.20 exemption in subdivision 8 must obtain an acceptable proficiency test result for each of the
200.21 laboratory's accredited or requested fields of testing. The laboratory must analyze proficiency
200.22 samples selected from one of two annual proficiency testing studies scheduled by the
200.23 commissioner.
200.24     (b) If a laboratory fails to successfully complete the first scheduled proficiency study,
200.25 the laboratory shall:
200.26     (1) obtain and analyze a supplemental test sample within 15 days of receiving the test
200.27 report for the initial failed attempt; and
200.28     (2) participate in the second annual study as scheduled by the commissioner.
200.29     (c) If a laboratory does not submit results or fails two consecutive proficiency samples,
200.30 the commissioner will revoke the laboratory's accreditation for the affected fields of testing.
  Article 6 Sec. 2.  200
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
201.1(d) The commissioner may require a laboratory to analyze additional proficiency testing
201.2  samples beyond what is required in this subdivision if information available to the
201.3  commissioner indicates that the laboratory's analysis for the field of testing does not meet
201.4  the requirements for accreditation.
201.5(e) The commissioner may collect from laboratories accredited under the exemption in
201.6  subdivision 8 any additional costs required to administer this subdivision and subdivision
201.7  8.
201.8    Sec. 3. Minnesota Statutes 2024, section 145.901, subdivision 1, is amended to read:
201.9Subdivision 1. Purpose. Within the limits of available funding, the commissioner of
201.10 health may must conduct maternal death studies to assist the planning, implementation, and
201.11 evaluation of medical, health, and welfare service systems and to reduce the numbers of
201.12 preventable maternal deaths in Minnesota.
201.13   Sec. 4. Minnesota Statutes 2024, section 147A.02, is amended to read:
201.14147A.02 QUALIFICATIONS FOR LICENSURE.
201.15(a) The board may grant a license as a physician assistant to an applicant who:
201.16(1) submits an application on forms approved by the board;
201.17(2) pays the appropriate fee as determined by the board;
201.18(3) has current certification from the National Commission on Certification of Physician
201.19 Assistants, or its successor agency as approved by the board;
201.20(4) certifies that the applicant is mentally and physically able to engage safely in practice
201.21 as a physician assistant;
201.22(5) has no licensure, certification, or registration as a physician assistant under current
201.23 discipline, revocation, suspension, or probation for cause resulting from the applicant's
201.24 practice as a physician assistant, unless the board considers the condition and agrees to
201.25 licensure;
201.26(6) submits any other information the board deems necessary to evaluate the applicant's
201.27 qualifications; and
201.28(7) has been approved by the board.
  Article 6 Sec. 4.  201
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
202.1      (b) All persons registered as physician assistants as of June 30, 1995, are eligible for
202.2  continuing license renewal. All persons applying for licensure after that date shall be licensed
202.3  according to this chapter.
202.4      (c) A physician assistant who qualifies for licensure must practice for at least 2,080
202.5  hours, within the context of a collaborative agreement, within a hospital or integrated clinical
202.6  setting where physician assistants and physicians work together to provide patient care. The
202.7  physician assistant shall submit written evidence to the board with the application, or upon
202.8  completion of the required collaborative practice experience. For purposes of this paragraph,
202.9  a collaborative agreement is a mutually agreed upon plan for the overall working relationship
202.10 and collaborative arrangement between a physician assistant, and one or more physicians
202.11 licensed under chapter 147 or licensed in another state or United States territory, that
202.12 designates the scope of services that can be provided collaboration necessary to manage the
202.13 care of patients. The physician assistant and one of the collaborative physicians must have
202.14 experience in providing care to patients with the same or similar medical conditions. The
202.15 collaborating physician is not required to be physically present so long as the collaborating
202.16 physician and physician assistant are or can be easily in contact with each other by radio,
202.17 telephone, or other telecommunication device.
202.18   Sec. 5. Minnesota Statutes 2024, section 148.56, subdivision 1, is amended to read:
202.19     Subdivision 1. Optometry defined. (a) Any person shall be deemed to be practicing
202.20 optometry within the meaning of sections 148.52 to 148.62 who shall in any way:
202.21     (1) advertise as an optometrist;
202.22     (2) employ any means, including the use of autorefractors or other automated testing
202.23 devices, for the measurement of the powers of vision or the adaptation of lenses or prisms
202.24 for the aid thereof;
202.25     (3) possess testing appliances for the purpose of the measurement of the powers of vision;
202.26     (4) diagnose any disease, optical deficiency or deformity, or visual or muscular anomaly
202.27 of the visual system consisting of the human eye and its accessory or subordinate anatomical
202.28 parts;
202.29     (5) prescribe lenses, including plano or cosmetic contact lenses, or prisms for the
202.30 correction or the relief of same;
202.31     (6) employ or prescribe ocular exercises, orthoptics, or habilitative and rehabilitative
202.32 therapeutic vision care; or
  Article 6 Sec. 5.  202
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
203.1      (7) prescribe or administer legend drugs to aid in the diagnosis, cure, mitigation,
203.2  prevention, treatment, or management of disease, deficiency, deformity, or abnormality of
203.3  the human eye and adnexa included in the curricula of accredited schools or colleges of
203.4  optometry, and as limited by Minnesota statute and adopted rules by the Board of Optometry,
203.5  or who holds oneself out as being able to do so.
203.6      (b) In the course of treatment, nothing in this section shall allow:
203.7      (1) legend drugs to be administered intravenously, intramuscularly, or by injection,
203.8  except for treatment of anaphylaxis; by intraocular or sub-Tenon injection; by injection
203.9  posterior to the orbital septum; or by intramuscular injection, except as permitted under
203.10 paragraph (d);
203.11     (2) invasive surgery including, but not limited to, surgery using lasers;
203.12     (3) Schedule II and III oral legend drugs and oral steroids to be administered or
203.13 prescribed; or
203.14     (4) oral antivirals to be prescribed or administered for more than ten days; or steroids
203.15 to be administered or prescribed for more than 14 days without consultation with a physician.
203.16     (5) oral carbonic anhydrase inhibitors to be prescribed or administered for more than
203.17 seven days.
203.18     (c) Nothing in this section shall allow anesthetics to be administered by injection, except
203.19 that an optometrist may administer local anesthesia by injection:
203.20     (1) for excision of chalazia, except that recurrent chalazia must be referred to a physician;
203.21 and
203.22     (2) for excision of a single epidermal lesion that: (i) is without characteristics of
203.23 malignancy; (ii) is no larger than five millimeters in size; (iii) is no deeper than the dermal
203.24 layer of the skin; and (iv) is not a lesion involving the eyelid margin.
203.25     (d) An optometrist may inject Botulinum toxin, limited to the periocular muscles of
203.26 facial expression innervated by the first two branches of the facial nerve, including for
203.27 cosmetic purposes.
203.28   Sec. 6. Minnesota Statutes 2024, section 148.56, is amended by adding a subdivision to
203.29 read:
203.30     Subd. 1a. Injections. In order to perform injections permitted under subdivision 1, an
203.31 optometrist must receive approval from the board after demonstrating to the board that the
  Article 6 Sec. 6.  203
  06/07/25  REVISOR       DTT/LN  25-05697  as introduced
204.1  optometrist has sufficient educational or clinical training to perform injections. This
204.2  subdivision does not apply to injections for treatment of anaphylaxis.
204.3ARTICLE 7
204.4MINNESOTA HEALTH AND EDUCATION FACILITIES AUTHORITY
204.5    Section 1. Minnesota Statutes 2024, section 3.732, subdivision 1, is amended to read:
204.6      Subdivision 1. Definitions. As used in this section and section 3.736 the terms defined
204.7  in this section have the meanings given them.
204.8      (1) "State" includes each of the departments, boards, agencies, commissions, courts, and
204.9  officers in the executive, legislative, and judicial branches of the state of Minnesota and
204.10 includes but is not limited to the Housing Finance Agency, the Minnesota Office of Higher
204.11 Education, the Higher Health and Education Facilities Authority, the Health Technology
204.12 Advisory Committee, the Armory Building Commission, the Zoological Board, the
204.13 Department of Iron Range Resources and Rehabilitation, the Minnesota Historical Society,
204.14 the State Agricultural Society, the University of Minnesota, the Minnesota State Colleges
204.15 and Universities, state hospitals, and state penal institutions. It does not include a city, town,
204.16 county, school district, or other local governmental body corporate and politic.
204.17     (2) "Employee of the state" means all present or former officers, members, directors, or
204.18 employees of the state, members of the Minnesota National Guard, members of a bomb
204.19 disposal unit approved by the commissioner of public safety and employed by a municipality
204.20 defined in section 466.01 when engaged in the disposal or neutralization of bombs or other
204.21 similar hazardous explosives, as defined in section 299C.063, outside the jurisdiction of the
204.22 municipality but within the state, or persons acting on behalf of the state in an official
204.23 capacity, temporarily or permanently, with or without compensation. It does not include
204.24 either an independent contractor except, for purposes of this section and section 3.736 only,
204.25 a guardian ad litem acting under court appointment, or members of the Minnesota National
204.26 Guard while engaged in training or duty under United States Code, title 10, or title 32,
204.27 section 316, 502, 503, 504, or 505, as amended through December 31, 1983. Notwithstanding
204.28 sections 43A.02 and 611.263, for purposes of this section and section 3.736 only, "employee
204.29 of the state" includes a district public defender or assistant district public defender in the
204.30 Second or Fourth Judicial District, a member of the Health Technology Advisory Committee,
204.31 and any officer, agent, or employee of the state of Wisconsin performing work for the state
204.32 of Minnesota pursuant to a joint state initiative.
  Article 7 Section 1.  204
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205.1      (3) "Scope of office or employment" means that the employee was acting on behalf of
205.2  the state in the performance of duties or tasks lawfully assigned by competent authority.
205.3      (4) "Judicial branch" has the meaning given in section 43A.02, subdivision 25.
205.4    Sec. 2. Minnesota Statutes 2024, section 10A.01, subdivision 35, is amended to read:
205.5      Subd. 35. Public official. "Public official" means any:
205.6      (1) member of the legislature;
205.7      (2) individual employed by the legislature as secretary of the senate, legislative auditor,
205.8  director of the Legislative Budget Office, chief clerk of the house of representatives, revisor
205.9  of statutes, or researcher, legislative analyst, fiscal analyst, or attorney in the Office of
205.10 Senate Counsel, Research and Fiscal Analysis, House Research, or the House Fiscal Analysis
205.11 Department;
205.12     (3) constitutional officer in the executive branch and the officer's chief administrative
205.13 deputy;
205.14     (4) solicitor general or deputy, assistant, or special assistant attorney general;
205.15     (5) commissioner, deputy commissioner, or assistant commissioner of any state
205.16 department or agency as listed in section 15.01 or 15.06, or the state chief information
205.17 officer;
205.18     (6) member, chief administrative officer, or deputy chief administrative officer of a state
205.19 board or commission that has either the power to adopt, amend, or repeal rules under chapter
205.20 14, or the power to adjudicate contested cases or appeals under chapter 14;
205.21     (7) individual employed in the executive branch who is authorized to adopt, amend, or
205.22 repeal rules under chapter 14 or adjudicate contested cases under chapter 14;
205.23     (8) executive director of the State Board of Investment;
205.24     (9) deputy of any official listed in clauses (7) and (8);
205.25     (10) judge of the Workers' Compensation Court of Appeals;
205.26     (11) administrative law judge or compensation judge in the State Office of Administrative
205.27 Hearings or unemployment law judge in the Department of Employment and Economic
205.28 Development;
205.29     (12) member, regional administrator, division director, general counsel, or operations
205.30 manager of the Metropolitan Council;
  Article 7 Sec. 2.  205
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
206.1      (13) member or chief administrator of a metropolitan agency;
206.2      (14) director of the Division of Alcohol and Gambling Enforcement in the Department
206.3  of Public Safety;
206.4      (15) member or executive director of the Higher Health and Education Facilities
206.5  Authority;
206.6      (16) member of the board of directors or president of Enterprise Minnesota, Inc.;
206.7      (17) member of the board of directors or executive director of the Minnesota State High
206.8  School League;
206.9      (18) member of the Minnesota Ballpark Authority established in section 473.755;
206.10     (19) citizen member of the Legislative-Citizen Commission on Minnesota Resources;
206.11     (20) manager of a watershed district, or member of a watershed management organization
206.12 as defined under section 103B.205, subdivision 13;
206.13     (21) supervisor of a soil and water conservation district;
206.14     (22) director of Explore Minnesota Tourism;
206.15     (23) citizen member of the Lessard-Sams Outdoor Heritage Council established in section
206.16 97A.056;
206.17     (24) citizen member of the Clean Water Council established in section 114D.30;
206.18     (25) member or chief executive of the Minnesota Sports Facilities Authority established
206.19 in section 473J.07;
206.20     (26) district court judge, appeals court judge, or supreme court justice;
206.21     (27) county commissioner;
206.22     (28) member of the Greater Minnesota Regional Parks and Trails Commission;
206.23     (29) member of the Destination Medical Center Corporation established in section
206.24 469.41; or
206.25     (30) chancellor or member of the Board of Trustees of the Minnesota State Colleges
206.26 and Universities.
  Article 7 Sec. 2.  206
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207.1    Sec. 3. Minnesota Statutes 2024, section 136A.25, is amended to read:
207.2      136A.25 CREATION.
207.3      A state agency known as the Minnesota Higher Health and Education Facilities Authority
207.4  is hereby created.
207.5    Sec. 4. Minnesota Statutes 2024, section 136A.26, is amended to read:
207.6      136A.26 MEMBERSHIPS; OFFICERS; COMPENSATION; REMOVAL.
207.7      Subdivision 1. Membership. The Minnesota Higher Health and Education Facilities
207.8  Authority shall consist of eight nine members appointed by the governor with the advice
207.9  and consent of the senate, and a representative of the Office of Higher Education.
207.10     All members to be appointed by the governor shall be residents of the state. At least two
207.11 members must reside outside the metropolitan area as defined in section 473.121, subdivision
207.12 2. At least one of the members shall be a person having a favorable reputation for skill,
207.13 knowledge, and experience in the field of state and municipal finance; and at least one of
207.14 the members shall be a person having a favorable reputation for skill, knowledge, and
207.15 experience in the building construction field; and at least one of the members shall be a
207.16 trustee, director, officer, or employee of an institution of higher education; and at least one
207.17 of the members shall be a trustee, director, officer, or employee of a health care organization.
207.18     Subd. 1a. Private College Council member. The president of the Minnesota Private
207.19 College Council, or the president's designee, shall serve without compensation as an advisory,
207.20 nonvoting member of the authority.
207.21     Subd. 1b. Nonprofit health care association member. The chief executive officer of
207.22 a Minnesota nonprofit health care association whose members are primarily nonprofit health
207.23 care organizations, or the chief executive officer's designee, shall serve without compensation
207.24 as an advisory, nonvoting member of the authority. The identity of the Minnesota nonprofit
207.25 health care association shall be determined and may be changed from time to time by the
207.26 members of the authority in accordance with and as provided in the bylaws of the authority.
207.27     Subd. 2. Term; compensation; removal. The membership terms, compensation, removal
207.28 of members, and filling of vacancies for authority members other than the representative
207.29 of the office, and the president of the Private College Council, and the nonprofit health care
207.30 association member shall be as provided in section 15.0575.
  Article 7 Sec. 4.  207
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
208.1    Sec. 5. Minnesota Statutes 2024, section 136A.27, is amended to read:
208.2      136A.27 POLICY.
208.3      It is hereby declared that for the benefit of the people of the state, the increase of their
208.4  commerce, welfare and prosperity and the improvement of their health and living conditions
208.5  it is essential that health care organizations in Minnesota be provided with appropriate
208.6  additional means to establish, acquire, construct, improve, and expand health care facilities
208.7  in furtherance of their purposes; that this and future generations of youth be given the fullest
208.8  opportunity to learn and to develop their intellectual and mental capacities; that it is essential
208.9  that institutions of higher education within the state be provided with appropriate additional
208.10 means to assist such youth in achieving the required levels of learning and development of
208.11 their intellectual and mental capacities; and that health care organizations and institutions
208.12 of higher education be enabled to refinance outstanding indebtedness incurred to provide
208.13 existing facilities used for such those purposes in order to preserve and enhance the utilization
208.14 of facilities for purposes of health care and higher education, to extend or adjust maturities
208.15 in relation to the resources available for their payment, and to save interest costs and thereby
208.16 reduce health care costs or higher education tuition, fees, and charges; and. It is hereby
208.17 further declared that it is the purpose of sections 136A.25 to 136A.42 to provide a measure
208.18 of assistance and an alternative method to enable health care organizations and institutions
208.19 of higher education in the state to provide the facilities and structures which are sorely
208.20 needed to accomplish the purposes of sections 136A.25 to 136A.42, all to the public benefit
208.21 and good, to the extent and manner provided herein.
208.22   Sec. 6. Minnesota Statutes 2024, section 136A.28, is amended to read:
208.23     136A.28 DEFINITIONS.
208.24     Subdivision 1. Scope. In sections 136A.25 to 136A.42, the following words and terms
208.25 shall, unless the context otherwise requires, have the meanings ascribed to them.
208.26     Subd. 1a. Affiliate. "Affiliate" means an entity that directly or indirectly controls, is
208.27 controlled by, or is under common control with another entity. For purposes of this
208.28 subdivision, "control" means either the power to elect a majority of the members of the
208.29 governing body of an entity or the power, whether by contract or otherwise, to direct the
208.30 management and policies of the entity. Affiliate also means an entity whose business or
208.31 substantially all of whose property is operated under a lease, management agreement, or
208.32 operating agreement by another entity, or an entity who operates the business or substantially
208.33 all of the property of another entity under a lease, management agreement, or operating
208.34 agreement.
  Article 7 Sec. 6.  208
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
209.1      Subd. 2. Authority. "Authority" means the Higher Health and Education Facilities
209.2  Authority created by sections 136A.25 to 136A.42.
209.3      Subd. 3. Project. "Project" means a structure or structures available for use as a dormitory
209.4  or other student housing facility, a dining hall, student union, administration building,
209.5  academic building, library, laboratory, research facility, classroom, athletic facility, health
209.6  care facility, child care facility, and maintenance, storage, or utility facility and other
209.7  structures or facilities related thereto or required or useful for the instruction of students or
209.8  the conducting of research or the operation of an institution of higher education, whether
209.9  proposed, under construction, or completed, including parking and other facilities or
209.10 structures essential or convenient for the orderly conduct of such institution for higher
209.11 education, and shall also include landscaping, site preparation, furniture, equipment and
209.12 machinery, and other similar items necessary or convenient for the operation of a particular
209.13 facility or structure in the manner for which its use is intended but shall not include such
209.14 items as books, fuel, supplies, or other items the costs of which are customarily deemed to
209.15 result in a current operating charge, and shall a health care facility or an education facility
209.16 whether proposed, under construction, or completed, and includes land or interests in land,
209.17 appurtenances, site preparation, landscaping, buildings and structures, systems, fixtures,
209.18 furniture, machinery, equipment, and parking. Project also includes other structures, facilities,
209.19 improvements, machinery, equipment, and means of transport of a capital nature that are
209.20 necessary or convenient for the operation of the facility. Project does not include: (1) any
209.21 facility used or to be used for sectarian instruction or as a place of religious worship nor;
209.22 (2) any facility which is used or to be used primarily in connection with any part of the
209.23 program of a school or department of divinity for any religious denomination; or (3) any
209.24 books, supplies, medicine, medical supplies, fuel, or other items, the cost of which are
209.25 customarily deemed to result in a current operating charge.
209.26     Subd. 4. Cost. "Cost," as applied to a project or any portion thereof financed under the
209.27 provisions of sections 136A.25 to 136A.42, means all or any part of the cost of construction,
209.28 acquisition, alteration, enlargement, reconstruction and remodeling of a project including
209.29 all lands, structures, real or personal property, rights, rights-of-way, franchises, easements
209.30 and interests acquired or used for or in connection with a project, the cost of demolishing
209.31 or removing any buildings or structures on land so acquired, including the cost of acquiring
209.32 any lands to which such the buildings or structures may be moved, the cost of all machinery
209.33 and equipment, financing charges, interest prior to, during and for a period after completion
209.34 of such construction and acquisition, provisions for reserves for principal and interest and
209.35 for extensions, enlargements, additions and improvements, the cost of architectural,
  Article 7 Sec. 6.  209
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
210.1  engineering, financial and legal services, plans, specifications, studies, surveys, estimates
210.2  of cost and of revenues, administrative expenses, expenses necessary or incident to
210.3  determining the feasibility or practicability of constructing the project and such other
210.4  expenses as may be necessary or incident to the construction and acquisition of the project,
210.5  the financing of such construction and acquisition and the placing of the project in operation.
210.6      Subd. 5. Bonds. "Bonds," or "revenue bonds" means revenue bonds of the authority
210.7  issued under the provisions of sections 136A.25 to 136A.42, including revenue refunding
210.8  bonds, notwithstanding that the same may be secured by mortgage or the full faith and credit
210.9  of a participating institution for higher education or any other lawfully pledged security of
210.10 a participating institution for higher education.
210.11     Subd. 6. Institution of higher education. "Institution of higher education" means a
210.12 nonprofit educational institution within the state authorized to provide a program of education
210.13 beyond the high school level.
210.14     Subd. 6a. Health care organization. (a) "Health care organization" means a nonprofit
210.15 organization located within the state and authorized by law to operate a nonprofit health
210.16 care facility in the state. Health care organization also means a nonprofit affiliate of a health
210.17 care organization as defined under this paragraph, provided the affiliate is located within
210.18 the state or within a state that is geographically contiguous to Minnesota.
210.19     (b) Health care organization also means a nonprofit organization located in another state
210.20 that is geographically contiguous to Minnesota and authorized by law to operate a nonprofit
210.21 health care facility in that state, provided that the nonprofit organization located in the
210.22 contiguous state is an affiliate of a health care organization located in Minnesota.
210.23     Subd. 6b. Education facility. "Education facility" means a structure or structures
210.24 available for use as a dormitory or other student housing facility, dining hall, student union,
210.25 administration building, academic building, library, laboratory, research facility, classroom,
210.26 athletic facility, student health care facility, or child care facility, and includes other facilities
210.27 or structures related to the essential or convenient orderly conduct of an institution of higher
210.28 education.
210.29     Subd. 6c. Health care facility. (a) "Health care facility" means a structure or structures
210.30 available for use in Minnesota as a hospital, clinic, psychiatric residential treatment facility,
210.31 birth center, outpatient surgical center, comprehensive outpatient rehabilitation facility,
210.32 outpatient physical therapy or speech pathology facility, end-stage renal dialysis facility,
210.33 medical laboratory, pharmacy, radiation therapy facility, diagnostic imaging facility, medical
210.34 office building, residence for nurses or interns, nursing home, boarding care home, assisted
  Article 7 Sec. 6.  210
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
211.1  living facility, residential hospice, intermediate care facility for persons with developmental
211.2  disabilities, supervised living facility, board and lodging establishment with special services,
211.3  adult day care center, day services facility, prescribed pediatric extended care facility,
211.4  community residential setting, adult foster home, or other facility related to medical or
211.5  health care research, or the delivery or administration of health care services and includes
211.6  other structures or facilities related to the essential or convenient orderly conduct of a health
211.7  care organization.
211.8      (b) Health care facility also means a facility in a state that is geographically contiguous
211.9  to Minnesota operated by a health care organization that corresponds by purpose, function,
211.10 or use with a facility listed in paragraph (a).
211.11     Subd. 7. Participating institution of higher education. "Participating institution of
211.12 higher education" means a health care organization or an institution of higher education
211.13 that, under the provisions of sections 136A.25 to 136A.42, undertakes the financing and
211.14 construction or acquisition of a project or undertakes the refunding or refinancing of
211.15 obligations or of a mortgage or of advances as provided in sections 136A.25 to 136A.42.
211.16 Community colleges and technical colleges may be considered participating institutions of
211.17 higher education for the purpose of financing and constructing child care facilities and
211.18 parking facilities.
211.19   Sec. 7. Minnesota Statutes 2024, section 136A.29, subdivision 1, is amended to read:
211.20     Subdivision 1. Purpose. The purpose of the authority shall be to assist health care
211.21 organizations and institutions of higher education in the construction, financing, and
211.22 refinancing of projects. The exercise by the authority of the powers conferred by sections
211.23 136A.25 to 136A.42, shall be deemed and held to be the performance of an essential public
211.24 function. For the purpose of sections 136A.25 to 136A.42, the authority shall have the
211.25 powers and duties set forth in subdivisions 2 to 23.
211.26   Sec. 8. Minnesota Statutes 2024, section 136A.29, subdivision 3, is amended to read:
211.27     Subd. 3. Employees; office space. The authority is authorized and empowered to appoint
211.28 and employ employees as it may deem necessary to carry out its duties, determine the title
211.29 of the employees so employed, and fix the salary of said its employees. Employees of the
211.30 authority shall participate in retirement and other benefits in the same manner that employees
211.31 in the unclassified service of the office participate. The authority may maintain an office
211.32 space as it may designate.
  Article 7 Sec. 8.  211
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
212.1    Sec. 9. Minnesota Statutes 2024, section 136A.29, subdivision 6, is amended to read:
212.2      Subd. 6. Projects; generally. (a) The authority is authorized and empowered to determine
212.3  the location and character of any project to be financed under the provisions of sections
212.4  136A.25 to 136A.42, and to construct, reconstruct, remodel, maintain, manage, enlarge,
212.5  alter, add to, repair, operate, lease, as lessee or lessor, and regulate the same, to enter into
212.6  contracts for any or all of such these purposes, to enter into contracts for the management
212.7  and operation of a project, and to designate a participating institution of higher education
212.8  as its agent to determine the location and character of a project undertaken by such a
212.9  participating institution of higher education under the provisions of sections 136A.25 to
212.10 136A.42 and as the agent of the authority, to construct, reconstruct, remodel, maintain,
212.11 manage, enlarge, alter, add to, repair, operate, lease, as lessee or lessor, and regulate the
212.12 same, and as the agent of the authority, to enter into contracts for any or all of such these
212.13 purposes, including contracts for the management and operation of such the project.
212.14     (b) Notwithstanding paragraph (a), a project involving a health care facility in Minnesota
212.15 financed under sections 136A.25 to 136A.42 must comply with all applicable requirements
212.16 in state law related to authorizing construction of or modifications to a health care facility,
212.17 including the requirements in sections 144.5509, 144.551, 144A.071, and 252.291.
212.18     (c) Contracts of the authority or of a participating institution of higher education to
212.19 acquire or to construct, reconstruct, remodel, maintain, enlarge, alter, add to, or repair
212.20 projects shall not be subject to the provisions of chapter 16C or section 574.26, or any other
212.21 public contract or competitive bid law.
212.22   Sec. 10. Minnesota Statutes 2024, section 136A.29, subdivision 9, is amended to read:
212.23     Subd. 9. Revenue bonds; limit. (a) The authority is authorized and empowered to issue
212.24 revenue bonds whose aggregate principal amount at any time shall not exceed $2,000,000,000
212.25 $5,000,000,000 and to issue notes, bond anticipation notes, and revenue refunding bonds
212.26 of the authority under the provisions of sections 136A.25 to 136A.42, to provide funds for
212.27 acquiring, constructing, reconstructing, enlarging, remodeling, renovating, improving,
212.28 furnishing, or equipping one or more projects or parts thereof.
212.29     (b) Of the $5,000,000,000 limit in paragraph (a), the aggregate principal amount used
212.30 to fund education facilities may not exceed $2,250,000,000 at any time and the aggregate
212.31 principal amount used to fund health care facilities may not exceed $2,750,000,000 at any
212.32 time.
  Article 7 Sec. 10.  212
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
213.1    Sec. 11. Minnesota Statutes 2024, section 136A.29, subdivision 10, is amended to read:
213.2      Subd. 10. Revenue bonds; issuance, purpose, conditions. The authority is authorized
213.3  and empowered to issue revenue bonds to acquire projects from or to make loans to
213.4  participating institutions of higher education and thereby refinance outstanding indebtedness
213.5  incurred by participating institutions of higher education to provide funds for the acquisition,
213.6  construction or improvement of a facility before or after the enactment of sections 136A.25
213.7  to 136A.42, but otherwise eligible to be and being a project thereunder, whenever the
213.8  authority finds that such the refinancing will enhance or preserve such the participating
213.9  institutions and such the facilities or utilization thereof that is for health care or educational
213.10 purposes or extend or adjust maturities to correspond to the resources available for their
213.11 payment, or reduce charges or fees imposed on patients or occupants, or the tuition, charges,
213.12 or fees imposed on students for the use or occupancy of the facilities of such the participating
213.13 institutions of higher education or costs met by federal or state public funds, or enhance or
213.14 preserve health care or educational programs and research or the acquisition or improvement
213.15 of other facilities eligible to be a project or part thereof by the participating institution of
213.16 higher education. The amount of revenue bonds to be issued to refinance outstanding
213.17 indebtedness of a participating institution of higher education shall not exceed the lesser of
213.18 (a) the fair value of the project to be acquired by the authority from the institution or
213.19 mortgaged to the authority by the institution or (b) the amount of the outstanding indebtedness
213.20 including any premium thereon and any interest accrued or to accrue to the date of redemption
213.21 and any legal, fiscal and related costs in connection with such the refinancing and reasonable
213.22 reserves, as determined by the authority. The provisions of this subdivision do not prohibit
213.23 the authority from issuing revenue bonds within and charged against the limitations provided
213.24 in subdivision 9 to provide funds for improvements, alteration, renovation, or extension of
213.25 the project refinanced.
213.26   Sec. 12. Minnesota Statutes 2024, section 136A.29, subdivision 14, is amended to read:
213.27     Subd. 14. Rules for use of projects. The authority is authorized and empowered to
213.28 establish rules for the use of a project or any portion thereof and to designate a participating
213.29 institution of higher education as its agent to establish rules for the use of a project undertaken
213.30 for such a participating institution of higher education.
213.31   Sec. 13. Minnesota Statutes 2024, section 136A.29, subdivision 19, is amended to read:
213.32     Subd. 19. Surety. Before the issuance of any revenue bonds under the provisions of
213.33 sections 136A.25 to 136A.42, any member or officer of the authority authorized by resolution
  Article 7 Sec. 13.  213
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214.1  of the authority to handle funds or sign checks of the authority shall be covered under a
214.2  surety or fidelity bond in an amount to be determined by the authority. Each such bond shall
214.3  be conditioned upon the faithful performance of the duties of the office of the member or
214.4  officer, and shall be executed by a surety company authorized to transact business in the
214.5  state of Minnesota as surety. The cost of each such bond shall be paid by the authority.
214.6    Sec. 14. Minnesota Statutes 2024, section 136A.29, subdivision 20, is amended to read:
214.7      Subd. 20. Sale, lease, and disposal of property. The authority is authorized and
214.8  empowered to sell, lease, release, or otherwise dispose of real and personal property or
214.9  interests therein, or a combination thereof, acquired by the authority under authority of
214.10 sections 136A.25 to 136A.42 and no longer needed for the purposes of such this chapter or
214.11 of the authority, and grant such easements and other rights in, over, under, or across a project
214.12 as will not interfere with its use of such the property. Such The sale, lease, release,
214.13 disposition, or grant may be made without competitive bidding and in such the manner and
214.14 for such consideration as the authority in its judgment deems appropriate.
214.15   Sec. 15. Minnesota Statutes 2024, section 136A.29, subdivision 21, is amended to read:
214.16     Subd. 21. Loans. The authority is authorized and empowered to make loans to any
214.17 participating institution of higher education for the cost of a project in accordance with an
214.18 agreement between the authority and the participating institution of higher education;,
214.19 provided that no such loan shall exceed the total cost of the project as determined by the
214.20 participating institution of higher education and approved by the authority.
214.21   Sec. 16. Minnesota Statutes 2024, section 136A.29, subdivision 22, is amended to read:
214.22     Subd. 22. Costs, expenses, and other charges. The authority is authorized and
214.23 empowered to charge to and apportion among participating institutions of higher education
214.24 its administrative costs and expenses incurred in the exercise of the powers and duties
214.25 conferred by sections 136A.25 to 136A.42 in the manner as the authority in its judgment
214.26 deems appropriate.
214.27   Sec. 17. Minnesota Statutes 2024, section 136A.29, is amended by adding a subdivision
214.28 to read:
214.29     Subd. 24. Determination of affiliate status. The authority is authorized and empowered
214.30 to determine whether an entity is an affiliate. A determination by the authority of affiliate
214.31 status shall be deemed conclusive for the purposes of sections 136A.25 to 136A.42.
  Article 7 Sec. 17.  214
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
215.1    Sec. 18. Minnesota Statutes 2024, section 136A.32, subdivision 1, is amended to read:
215.2      Subdivision 1. Bonds; generally. (a) The authority may from time to time issue revenue
215.3  bonds for purposes of sections 136A.25 to 136A.42, and all such revenue bonds, notes,
215.4  bond anticipation notes or other obligations of the authority issued pursuant to sections
215.5  136A.25 to 136A.42 shall be and are hereby declared to be negotiable for all purposes
215.6  notwithstanding their payment from a limited source and without regard to any other law
215.7  or laws. In anticipation of the sale of such revenue bonds, the authority may issue negotiable
215.8  bond anticipation notes and may renew the same from time to time, but the maximum
215.9  maturity of any such note, including renewals thereof, shall not exceed five years from the
215.10 date of issue of the original note. Such Notes shall be paid from any revenues of the authority
215.11 available therefor and not otherwise pledged, or from the proceeds of sale of the revenue
215.12 bonds of the authority in anticipation of which they were issued. The notes shall be issued
215.13 in the same manner as the revenue bonds. Such The notes and the resolution or resolutions
215.14 authorizing the same may contain any provisions, conditions or limitations which a bond
215.15 resolution or the authority may contain.
215.16     (b) Before issuing revenue bonds, notes, or other obligations under paragraph (a) on
215.17 behalf of a health care organization to finance health care facilities, the authority must obtain
215.18 consent by resolution from each city or town where the project is located, except that consent
215.19 need not be obtained in the case of a city or town with a population of less than 100,000.
215.20 The consent by resolution requirement does not apply to financing under paragraph (a) on
215.21 behalf of a participating institution that is primarily an institution of higher education.
215.22   Sec. 19. Minnesota Statutes 2024, section 136A.32, subdivision 4, is amended to read:
215.23     Subd. 4. Provisions of resolution authorizing bonds. Any resolution or resolutions
215.24 authorizing any revenue bonds or any issue of revenue bonds may contain provisions, which
215.25 shall be a part of the contract with the holders of the revenue bonds to be authorized, as to:
215.26     (1) pledging all or any part of the revenues of a project or projects, any revenue producing
215.27 contract or contracts made by the authority with any individual partnership, corporation or
215.28 association or other body one or more partnerships, corporations or associations, or other
215.29 bodies, public or private, to secure the payment of the revenue bonds or of any particular
215.30 issue of revenue bonds, subject to such agreements with bondholders as may then exist;
215.31     (2) the rentals, fees and other charges to be charged, and the amounts to be raised in
215.32 each year thereby, and the use and disposition of the revenues;
  Article 7 Sec. 19.  215
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
216.1      (3) the setting aside of reserves or sinking funds, and the regulation and disposition
216.2  thereof of them;
216.3      (4) limitations on the right of the authority or its agent to restrict and regulate the use of
216.4  the project;
216.5      (5) limitations on the purpose to which the proceeds of sale of any issue of revenue
216.6  bonds then or thereafter to be issued may be applied and pledging such the proceeds to
216.7  secure the payment of the revenue bonds or any issue of the revenue bonds;
216.8      (6) limitations on the issuance of additional bonds, the terms upon which additional
216.9  bonds may be issued and secured and the refunding of outstanding bonds;
216.10     (7) the procedure, if any, by which the terms of any contract with bondholders may be
216.11 amended or abrogated, the amount of bonds the holders of which must consent thereto to,
216.12 and the manner in which such consent may be given;
216.13     (8) limitations on the amount of moneys derived from the project to be expended for
216.14 operating, administrative or other expenses of the authority;
216.15     (9) defining the acts or omissions to act which shall constitute a default in the duties of
216.16 the authority to holders of its obligations and providing the rights and remedies of such the
216.17 holders in the event of a default; or
216.18     (10) the mortgaging of a project and the site thereof for the purpose of securing the
216.19 bondholders.
216.20   Sec. 20. Minnesota Statutes 2024, section 136A.32, is amended by adding a subdivision
216.21 to read:
216.22     Subd. 4a. Health care certification. Health care organizations must provide the authority
216.23 with a signed certificate from the health care organization stating that so long as authority
216.24 financing for the health care organization remains outstanding, none of the proceeds of the
216.25 bonds to the health care organization may be directly or indirectly used to benefit a private
216.26 party or private equity-funded entity.
216.27   Sec. 21. Minnesota Statutes 2024, section 136A.33, is amended to read:
216.28     136A.33 TRUST AGREEMENT.
216.29     In the discretion of the authority any revenue bonds issued under the provisions of
216.30 sections 136A.25 to 136A.42, may be secured by a trust agreement by and between the
216.31 authority and a corporate trustee or trustees, which may be any trust company or bank having
  Article 7 Sec. 21.  216
  06/07/25  REVISOR        DTT/LN  25-05697  as introduced
217.1  the powers of a trust company within the state. Such The trust agreement or the resolution
217.2  providing for the issuance of such revenue bonds may pledge or assign the revenues to be
217.3  received or proceeds of any contract or contracts pledged and may convey or mortgage the
217.4  project or any portion thereof of the project. Such The trust agreement or resolution providing
217.5  for the issuance of such revenue bonds may contain such provisions for protecting and
217.6  enforcing the rights and remedies of the bondholders as may be reasonable and proper and
217.7  not in violation of laws, including particularly such particular provisions as have hereinabove
217.8  that have been specifically authorized to be included in any resolution or resolutions of the
217.9  authority authorizing revenue bonds thereof. Any bank or trust company incorporated under
217.10 the laws of the state which that may act as depository of the proceeds of bonds or of revenues
217.11 or other moneys may furnish such indemnifying bonds or pledges such pledge securities as
217.12 may be required by the authority. Any such trust agreement may set forth the rights and
217.13 remedies of the bondholders and of the trustee or trustees and may restrict the individual
217.14 right of action by bondholders. In addition to the foregoing, any such trust agreement or
217.15 resolution may contain such other provisions as the authority may deem reasonable and
217.16 proper for the security of the bondholders. All expenses incurred in carrying out the
217.17 provisions of such the trust agreement or resolution may be treated as a part of the cost of
217.18 the operation of a project.
217.19   Sec. 22. Minnesota Statutes 2024, section 136A.34, subdivision 3, is amended to read:
217.20     Subd. 3. Investment. Any such escrowed proceeds, pending such use, may be invested
217.21 and reinvested in direct obligations of the United States of America, or in certificates of
217.22 deposit or time deposits secured by direct obligations of the United States of America, or
217.23 in shares or units in any money market mutual fund whose investment portfolio consists
217.24 solely of direct obligations of the United States of America, maturing at such a time or times
217.25 as shall be appropriate to assure the prompt payment, as to principal, interest and redemption
217.26 premium, if any, of the outstanding revenue bonds to be so refunded. The interest, income
217.27 and profits, if any, earned or realized on any such investment may also be applied to the
217.28 payment of the outstanding revenue bonds to be so refunded. After the terms of the escrow
217.29 have been fully satisfied and carried out, any balance of such the proceeds and interest,
217.30 income and profits, if any, earned or realized on the investments thereof may be returned
217.31 to the authority for use by it in any lawful manner.
217.32   Sec. 23. Minnesota Statutes 2024, section 136A.34, subdivision 4, is amended to read:
217.33     Subd. 4. Additional purpose; improvements. The portion of the proceeds of any such
217.34 revenue bonds issued for the additional purpose of paying all or any part of the cost of
  Article 7 Sec. 23.  217
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
218.1  constructing and acquiring additions, improvements, extensions or enlargements of a project
218.2  may be invested or deposited in time deposits as provided in section 136A.32, subdivision
218.3  7.
218.4    Sec. 24. Minnesota Statutes 2024, section 136A.36, is amended to read:
218.5136A.36 REVENUES.
218.6The authority may fix, revise, charge and collect rates, rents, fees and charges for the
218.7  use of and for the services furnished or to be furnished by each project and to may contract
218.8  with any person, partnership, association or corporation, or other body, public or private,
218.9  in respect thereof. Such The rates, rents, fees, and charges may vary between projects
218.10 involving an education facility and projects involving a health care facility and shall be
218.11 fixed and adjusted in respect of the aggregate of rates, rents, fees, and charges from such
218.12 the project so as to provide funds sufficient with other revenues, if any:
218.13(1) to pay the cost of maintaining, repairing and operating the project and each and every
218.14 portion thereof of the project, to the extent that the payment of such the cost has not otherwise
218.15 been adequately provided for;
218.16(2) to pay the principal of and the interest on outstanding revenue bonds of the authority
218.17 issued in respect of such the project as the same shall become due and payable; and
218.18(3) to create and maintain reserves required or provided for in any resolution authorizing,
218.19 or trust agreement securing, such revenue bonds of the authority. Such The rates, rents, fees
218.20 and charges shall not be subject to supervision or regulation by any department, commission,
218.21 board, body, bureau or agency of this state other than the authority. A sufficient amount of
218.22 the revenues derived in respect of a project, except such part of such the revenues as may
218.23 be necessary to pay the cost of maintenance, repair and operation and to provide reserves
218.24 and for renewals, replacements, extensions, enlargements and improvements as may be
218.25 provided for in the resolution authorizing the issuance of any revenue bonds of the authority
218.26 or in the trust agreement securing the same, shall be set aside at such regular intervals as
218.27 may be provided in such the resolution or trust agreement in a sinking or other similar fund
218.28 which that is hereby pledged to, and charged with, the payment of the principal of and the
218.29 interest on such revenue bonds as the same shall become due, and the redemption price or
218.30 the purchase price of bonds retired by call or purchase as therein provided. Such The pledge
218.31 shall be valid and binding from the time when the pledge is made; the rates, rents, fees and
218.32 charges and other revenues or other moneys so pledged and thereafter received by the
218.33 authority shall immediately be subject to the lien of such the pledge without physical delivery
218.34 thereof or further act, and the lien of any such pledge shall be valid and binding as against
  Article 7 Sec. 24.  218
  06/07/25  REVISOR        DTT/LN  25-05697  as introduced
219.1  all parties having claims of any kind against the authority, irrespective of whether such the
219.2  parties have notice thereof of the pledge. Neither the resolution nor any trust agreement by
219.3  which a pledge is created need be filed or recorded except in the records of the authority.
219.4  The use and disposition of moneys to the credit of such a sinking or other similar fund shall
219.5  be subject to the provisions of the resolution authorizing the issuance of such bonds or of
219.6  such a trust agreement. Except as may otherwise be provided in such the resolution or such
219.7  trust agreement, such the sinking or other similar fund shall be a fund for all such revenue
219.8  bonds issued to finance a project or projects at one or more participating institutions of
219.9  higher education without distinction or priority of one over another; provided the authority
219.10 in any such resolution or trust agreement may provide that such the sinking or other similar
219.11 fund shall be the fund for a particular project at an a participating institution of higher
219.12 education and for the revenue bonds issued to finance a particular project and may,
219.13 additionally, permit and provide for the issuance of revenue bonds having a subordinate
219.14 lien in respect of the security herein authorized to other revenue bonds of the authority and,
219.15 in such case, the authority may create separate or other similar funds in respect of such the
219.16 subordinate lien bonds.
219.17   Sec. 25. Minnesota Statutes 2024, section 136A.38, is amended to read:
219.18     136A.38 BONDS ELIGIBLE FOR INVESTMENT.
219.19     Bonds issued by the authority under the provisions of sections 136A.25 to 136A.42, are
219.20 hereby made securities in which all public officers and public bodies of the state and its
219.21 political subdivisions, all insurance companies, trust companies, banking associations,
219.22 investment companies, executors, administrators, trustees and other fiduciaries may properly
219.23 and legally invest funds, including capital in their control or belonging to them; it being the
219.24 purpose of this section to authorize the investment in such bonds of all sinking, insurance,
219.25 retirement, compensation, pension and trust funds, whether owned or controlled by private
219.26 or public persons or officers; provided, however, that nothing contained in this section may
219.27 be construed as relieving any person, firm, or corporation from any duty of exercising due
219.28 care in selecting securities for purchase or investment; and provide further, that in no event
219.29 shall assets of pension funds of public employees of the state of Minnesota or any of its
219.30 agencies, boards or subdivisions, whether publicly or privately administered, be invested
219.31 in bonds issued under the provisions of sections 136A.25 to 136A.42. Such The bonds are
219.32 hereby constituted "authorized securities" within the meaning and for the purposes of
219.33 Minnesota Statutes 1969, section 50.14. Such The bonds are hereby made securities which
219.34 that may properly and legally be deposited with and received by any state or municipal
  Article 7 Sec. 25.  219
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
220.1  officer or any agency or political subdivision of the state for any purpose for which the
220.2  deposit of bonds or obligations of the state now or may hereafter be authorized by law.
220.3    Sec. 26. Minnesota Statutes 2024, section 136A.41, is amended to read:
220.4      136A.41 CONFLICT OF INTEREST.
220.5      Notwithstanding any other law to the contrary it shall not be or constitute a conflict of
220.6  interest for a trustee, director, officer or employee of any participating institution of higher
220.7  education, financial institution, investment banking firm, brokerage firm, commercial bank
220.8  or trust company, architecture firm, insurance company, construction company, or any other
220.9  firm, person or corporation to serve as a member of the authority, provided such the trustee,
220.10 director, officer or employee shall abstain from deliberation, action and vote by the authority
220.11 in each instance where the business affiliation of any such trustee, director, officer or
220.12 employee is involved.
220.13   Sec. 27. Minnesota Statutes 2024, section 136A.42, is amended to read:
220.14     136A.42 ANNUAL REPORT.
220.15     The authority shall keep an accurate account of all of its activities and all of its receipts
220.16 and expenditures and shall annually report to the office. Each year, the authority shall submit
220.17 to the Minnesota Historical Society and the Legislative Reference Library a report of the
220.18 authority's activities in the previous year, including all financial activities.
220.19   Sec. 28. Minnesota Statutes 2024, section 136F.67, subdivision 1, is amended to read:
220.20     Subdivision 1. Authorization. A technical college or a community college must not
220.21 seek financing for child care facilities or parking facilities through the Higher Health and
220.22 Education Facilities Authority, as provided in section 136A.28, subdivision 7, without the
220.23 explicit authorization of the board.
220.24   Sec. 29. Minnesota Statutes 2024, section 354B.20, subdivision 7, is amended to read:
220.25     Subd. 7. Employing unit. "Employing unit," if the agency employs any persons covered
220.26 by the individual retirement account plan under section 354B.211, means:
220.27     (1) the board;
220.28     (2) the Minnesota Office of Higher Education; and
220.29     (3) the Higher Health and Education Facilities Authority.
  Article 7 Sec. 29.  220
  06/07/25  REVISOR       DTT/LN  25-05697  as introduced
221.1    Sec. 30. REVISOR INSTRUCTION.
221.2      The revisor of statutes shall renumber the law establishing and governing the Minnesota
221.3  Higher Education Facilities Authority, renamed the Minnesota Health and Education
221.4  Facilities Authority in this act, as Minnesota Statutes, chapter 15D, coded in Minnesota
221.5  Statutes, sections 136A.25 to 136A.42, as amended or repealed in this act. The revisor of
221.6  statutes shall also duplicate any required definitions from Minnesota Statutes, chapter 136A;
221.7  revise any statutory cross-references consistent with the recoding; and report the history in
221.8  Minnesota Statutes, chapter 15D. The revisor of statutes shall change "Minnesota Higher
221.9  Education Facilities Authority" to "Minnesota Health and Higher Education Facilities
221.10 Authority" where it appears in Minnesota Statutes.
221.11   Sec. 31. REPEALER.
221.12     Minnesota Statutes 2024, section 136A.29, subdivision 4, is repealed.
221.13ARTICLE 8
221.14HUMAN SERVICES HEALTH CARE FINANCE
221.15   Section 1. Minnesota Statutes 2024, section 62A.673, subdivision 2, is amended to read:
221.16     Subd. 2. Definitions. (a) For purposes of this section, the terms defined in this subdivision
221.17 have the meanings given.
221.18     (b) "Distant site" means a site at which a health care provider is located while providing
221.19 health care services or consultations by means of telehealth.
221.20     (c) "Health care provider" means a health care professional who is licensed or registered
221.21 by the state to perform health care services within the provider's scope of practice and in
221.22 accordance with state law. A health care provider includes a mental health professional
221.23 under section 245I.04, subdivision 2; a mental health practitioner under section 245I.04,
221.24 subdivision 4; a clinical trainee under section 245I.04, subdivision 6; a treatment coordinator
221.25 under section 245G.11, subdivision 7; an alcohol and drug counselor under section 245G.11,
221.26 subdivision 5; and a recovery peer under section 245G.11, subdivision 8.
221.27     (d) "Health carrier" has the meaning given in section 62A.011, subdivision 2.
221.28     (e) "Health plan" has the meaning given in section 62A.011, subdivision 3. Health plan
221.29 includes dental plans as defined in section 62Q.76, subdivision 3, but does not include dental
221.30 plans that provide indemnity-based benefits, regardless of expenses incurred, and are designed
221.31 to pay benefits directly to the policy holder.
  Article 8 Section 1.  221
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
222.1      (f) "Originating site" means a site at which a patient is located at the time health care
222.2  services are provided to the patient by means of telehealth. For purposes of store-and-forward
222.3  technology, the originating site also means the location at which a health care provider
222.4  transfers or transmits information to the distant site.
222.5      (g) "Store-and-forward technology" means the asynchronous electronic transfer or
222.6  transmission of a patient's medical information or data from an originating site to a distant
222.7  site for the purposes of diagnostic and therapeutic assistance in the care of a patient.
222.8      (h) "Telehealth" means the delivery of health care services or consultations through the
222.9  use of real time two-way interactive audio and visual communications to provide or support
222.10 health care delivery and facilitate the assessment, diagnosis, consultation, treatment,
222.11 education, and care management of a patient's health care. Telehealth includes the application
222.12 of secure video conferencing, store-and-forward technology, and synchronous interactions
222.13 between a patient located at an originating site and a health care provider located at a distant
222.14 site. Until July 1, 2025 2027, telehealth also includes audio-only communication between
222.15 a health care provider and a patient in accordance with subdivision 6, paragraph (b) if the
222.16 communication is a scheduled appointment and the standard of care for that particular
222.17 service can be met through the use of audio-only communication or if, for substance use
222.18 disorder treatment services and mental health care services delivered through telehealth by
222.19 means of audio-only communication, the communication was initiated by the enrollee while
222.20 in an emergency or crisis situation and a scheduled appointment was not possible due to
222.21 the need of an immediate response. Telehealth does not include communication between
222.22 health care providers that consists solely of a telephone conversation, email, or facsimile
222.23 transmission. Telehealth does not include communication between a health care provider
222.24 and a patient that consists solely of an email or facsimile transmission. Telehealth does not
222.25 include telemonitoring services as defined in paragraph (i).
222.26     (i) "Telemonitoring services" means the remote monitoring of clinical data related to
222.27 the enrollee's vital signs or biometric data by a monitoring device or equipment that transmits
222.28 the data electronically to a health care provider for analysis. Telemonitoring is intended to
222.29 collect an enrollee's health-related data for the purpose of assisting a health care provider
222.30 in assessing and monitoring the enrollee's medical condition or status.
222.31     EFFECTIVE DATE. This section is effective July 1, 2025.
222.32   Sec. 2. Minnesota Statutes 2024, section 62M.17, subdivision 2, is amended to read:
222.33     Subd. 2. Effect of change in prior authorization clinical criteria. (a) If, during a plan
222.34 year, or a calendar year for fee-for-service providers under chapters 256B and 256L, a
  Article 8 Sec. 2.  222
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
223.1  utilization review organization changes coverage terms for a health care service or the
223.2  clinical criteria used to conduct prior authorizations for a health care service, the change in
223.3  coverage terms or change in clinical criteria shall not apply until the next plan year, or the
223.4  next calendar year for fee-for-service providers under chapters 256B and 256L, for any
223.5  enrollee who received prior authorization for a health care service using the coverage terms
223.6  or clinical criteria in effect before the effective date of the change.
223.7      (b) Paragraph (a) does not apply if a utilization review organization changes coverage
223.8  terms for a drug or device that has been deemed unsafe by the United States Food and Drug
223.9  Administration (FDA); that has been withdrawn by either the FDA or the product
223.10 manufacturer; or when an independent source of research, clinical guidelines, or
223.11 evidence-based standards has issued drug- or device-specific warnings or recommended
223.12 changes in drug or device usage.
223.13     (c) Paragraph (a) does not apply if a utilization review organization changes coverage
223.14 terms for a service or the clinical criteria used to conduct prior authorizations for a service
223.15 when an independent source of research, clinical guidelines, or evidence-based standards
223.16 has recommended changes in usage of the service for reasons related to patient harm. This
223.17 paragraph expires December 31, 2025, for health benefit plans offered, sold, issued, or
223.18 renewed on or after that date.
223.19     (d) Effective January 1, 2026, and applicable to health benefit plans offered, sold, issued,
223.20 or renewed on or after that date, paragraph (a) does not apply if a utilization review
223.21 organization changes coverage terms for a service or the clinical criteria used to conduct
223.22 prior authorizations for a service when an independent source of research, clinical guidelines,
223.23 or evidence-based standards has recommended changes in usage of the service for reasons
223.24 related to previously unknown and imminent patient harm.
223.25     (e) Paragraph (a) does not apply if a utilization review organization removes a brand
223.26 name drug from its formulary or places a brand name drug in a benefit category that increases
223.27 the enrollee's cost, provided the utilization review organization (1) adds to its formulary a
223.28 generic or multisource brand name drug rated as therapeutically equivalent according to
223.29 the FDA Orange Book, or a biologic drug rated as interchangeable according to the FDA
223.30 Purple Book, at a lower cost to the enrollee, and (2) provides at least a 60-day notice to
223.31 prescribers, pharmacists, and affected enrollees.
223.32   Sec. 3. Minnesota Statutes 2024, section 174.30, subdivision 3, is amended to read:
223.33     Subd. 3. Other standards; wheelchair securement; protected transport. (a) A special
223.34 transportation service that transports individuals occupying wheelchairs is subject to the
  Article 8 Sec. 3.  223
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
224.1  provisions of sections 299A.11 to 299A.17 concerning wheelchair securement devices. The
224.2  commissioners of transportation and public safety shall cooperate in the enforcement of
224.3  this section and sections 299A.11 to 299A.17 so that a single inspection is sufficient to
224.4  ascertain compliance with sections 299A.11 to 299A.17 and with the standards adopted
224.5  under this section. Representatives of the Department of Transportation may inspect
224.6  wheelchair securement devices in vehicles operated by special transportation service
224.7  providers to determine compliance with sections 299A.11 to 299A.17 and to issue certificates
224.8  under section 299A.14, subdivision 4.
224.9      (b) In place of a certificate issued under section 299A.14, the commissioner may issue
224.10 a decal under subdivision 4 for a vehicle equipped with a wheelchair securement device if
224.11 the device complies with sections 299A.11 to 299A.17 and the decal displays the information
224.12 in section 299A.14, subdivision 4.
224.13     (c) For vehicles designated as protected transport under section 256B.0625, subdivision
224.14 17, paragraph (l) (n), the commissioner of transportation, during the commissioner's
224.15 inspection, shall check to ensure the safety provisions contained in that paragraph are in
224.16 working order.
224.17   Sec. 4. Minnesota Statutes 2024, section 256.9657, is amended by adding a subdivision
224.18 to read:
224.19     Subd. 2b. Hospital assessment. (a) For purposes of this subdivision, the following terms
224.20 have the meanings given:
224.21     (1) "eligible hospital" means:
224.22     (i) PrairieCare psychiatric hospital; or
224.23     (ii) a hospital licensed under section 144.50, located in Minnesota, and with a Medicare
224.24 cost report filed and showing in the Healthcare Cost Report Information System (HCRIS),
224.25 except for the following:
224.26     (A) federal Indian Health Service facilities;
224.27     (B) state-owned or state-operated regional treatment centers and all state-operated
224.28 services;
224.29     (C) federal Veterans Administration Medical Centers; and
224.30     (D) long-term acute care hospitals;
224.31     (2) "net outpatient revenue" means total outpatient revenue less Medicare revenue as
224.32 calculated from:
  Article 8 Sec. 4.  224
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
225.1      (i) values on Worksheet G of the hospital's Medicare cost report; or
225.2      (ii) for PrairieCare psychiatric hospital, data available to the commissioner; and
225.3      (3) "total patient days" means total hospital inpatient days as reported on:
225.4      (i) Worksheet S-3 of the hospital's Medicare cost report; or
225.5      (ii) for PrairieCare psychiatric hospital, data available to the commissioner.
225.6      (b) Subject to paragraphs (m) to (o), each eligible hospital must pay assessments to the
225.7  hospital directed payment program account in the special revenue fund, with an aggregate
225.8  annual assessment amount equal to the sum of the following:
225.9      (1) $120.22 multiplied by total patient days; and
225.10     (2) 5.96 percent of the hospital's net outpatient revenue.
225.11     (c) The assessment amount for calendar years 2026 and 2027 must be based on the total
225.12 patient days and net outpatient revenue reflected on an eligible hospital's Medicare cost
225.13 report as follows:
225.14     (1) an eligible hospital with a fiscal year ending on March 31 or June 30 must use data
225.15 from a cost report from the hospital's fiscal year 2022; and
225.16     (2) an eligible hospital with a fiscal year ending on September 30 or December 31 must
225.17 use data from a cost report from the hospital's fiscal year 2021.
225.18     (d) The annual assessment amount for calendar years after 2027 must be set for a two-year
225.19 period and must be based on the total patient days and net outpatient revenue reflected on
225.20 an eligible hospital's most recent Medicare cost report filed and showing in HCRIS as of
225.21 August 1 of the year prior to the subsequent two-year period.
225.22     (e) The commissioner may, after consultation with the Minnesota Hospital Association,
225.23 modify the rates of assessment in paragraph (b) as necessary to comply with federal law,
225.24 obtain or maintain a waiver under Code of Federal Regulations, title 42, section 433.72, or
225.25 otherwise maximize under this section federal financial participation for medical assistance.
225.26 Notwithstanding the foregoing authorization to maximize federal financial participation for
225.27 medical assistance, the commissioner must reduce the rates of assessment in paragraph (b)
225.28 as necessary to ensure:
225.29     (1) the state's aggregated health care-related taxes on inpatient hospital services do not
225.30 exceed 5.75 percent of the net patient revenue attributable to those services; and
  Article 8 Sec. 4.  225
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226.1      (2) the state's aggregated health care-related taxes on outpatient hospital services do not
226.2  exceed 5.75 percent of the net patient revenue attributable to those services.
226.3      (f) Eligible hospitals must pay the annual assessment amount under paragraph (b) to the
226.4  commissioner by paying four equal, quarterly assessments. Eligible hospitals must pay the
226.5  quarterly assessments by January 1, April 1, July 1, and October 1 each year. Assessments
226.6  must be paid in the form and manner specified by the commissioner. An eligible hospital
226.7  is prohibited from paying a quarterly assessment until the eligible hospital has received the
226.8  applicable invoice under paragraph (g).
226.9      (g) The commissioner must provide eligible hospitals with an invoice by December 1
226.10 for the assessment due January 1, March 1 for the assessment due April 1, June 1 for the
226.11 assessment due July 1, and September 1 for the assessment due October 1 each year.
226.12     (h) The commissioner must notify each eligible hospital of the hospital's estimated annual
226.13 assessment amount for the subsequent calendar year by October 15 each year.
226.14     (i) If any of the dates for assessments or invoices in paragraphs (f) to (h) fall on a holiday,
226.15 the applicable date is the next business day.
226.16     (j) A hospital that has merged with another hospital must have the surviving hospital's
226.17 assessment revised at the start of the hospital's first full fiscal year after the merger is
226.18 complete. A closed hospital is retroactively responsible for assessments owed for services
226.19 provided through the final date of operations.
226.20     (k) If the commissioner determines that a hospital has underpaid or overpaid an
226.21 assessment, the commissioner must notify the hospital of the unpaid assessment or of any
226.22 refund due. The commissioner must refund a hospital's overpayment from the hospital
226.23 directed payment program account created in section 256B.1975, subdivision 1.
226.24     (l) Revenue from an assessment under this subdivision must only be used by the
226.25 commissioner to pay the nonfederal share of the directed payment program under section
226.26 256B.1974.
226.27     (m) The commissioner is prohibited from collecting any assessment under this subdivision
226.28 during any period of time when:
226.29     (1) federal financial participation is unavailable or disallowed, or if the approved
226.30 aggregate federal financial participation for the directed payment under section 256B.1974
226.31 is less than 51 percent; or
226.32     (2) a directed payment under section 256B.1974 is not approved by the Centers for
226.33 Medicare and Medicaid Services.
  Article 8 Sec. 4.  226
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227.1      (n) The commissioner must make the following discounts from the inpatient portion of
227.2  the assessment under paragraph (b), clause (1), in the stated amount or as necessary to
227.3  achieve federal approval of the assessment in this section:
227.4      (1) Hennepin Healthcare, with a discount of 25 percent;
227.5      (2) Mayo Rochester, with a discount of ten percent;
227.6      (3) Gillette Children's Hospital, with a discount of 90 percent;
227.7      (4) each hospital not included in another discount category, and with greater than
227.8  $200,000,000 in total medical assistance inpatient and outpatient revenue in fee-for-service
227.9  and managed care, as reported in state fiscal year 2022 medical assistance fee-for-service
227.10 and managed care claims data, with a discount of five percent; and
227.11     (5) any hospital responsible for greater than 12 percent of the total assessment annually
227.12 collected statewide, with a discount in the amount necessary such that the hospital is
227.13 responsible for 12 percent of the total assessment annually collected statewide.
227.14     (o) The commissioner must make the following discounts from the outpatient portion
227.15 of the assessment under paragraph (b), clause (2), in the stated amount or as necessary to
227.16 achieve federal approval of the assessment in this section:
227.17     (1) each critical access hospital or independent hospital located outside a city of the first
227.18 class and paid under the Medicare prospective payment system, with a discount of 40 percent;
227.19     (2) Gillette Children's Hospital, with a discount of 90 percent;
227.20     (3) Hennepin Healthcare, with a discount of 60 percent;
227.21     (4) Mayo Rochester, with a discount of 20 percent; and
227.22     (5) each hospital not included in another discount category, and with greater than
227.23 $200,000,000 in total medical assistance inpatient and outpatient revenue in fee-for-service
227.24 and managed care, as reported in state fiscal year 2022 medical assistance fee-for-service
227.25 and managed care claims data, with a discount of ten percent.
227.26     (p) If the federal share of the hospital directed payment program under section 256B.1974
227.27 is increased as the result of an increase to the federal medical assistance percentage, the
227.28 commissioner must reduce the assessment on a uniform percentage basis across eligible
227.29 hospitals on which the assessment is imposed, such that the aggregate amount collected
227.30 from hospitals under this subdivision does not exceed the total amount needed to maintain
227.31 the same aggregate state and federal funding level for the directed payments authorized by
227.32 section 256B.1974.
  Article 8 Sec. 4.  227
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228.1      (q) Eligible hospitals must submit to the commissioner on an annual basis, in the form
228.2  and manner specified by the commissioner in consultation with the Minnesota Hospital
228.3  Association, all documentation necessary to determine the assessment amounts under this
228.4  subdivision.
228.5      EFFECTIVE DATE. (a) This section is effective the later of January 1, 2026, or federal
228.6  approval of all of the following:
228.7      (1) the waiver for the assessment required under this section; and
228.8      (2) the hospital directed payment program under Minnesota Statutes, section 256B.1974,
228.9  and any conforming changes made to the directed payment program under Minnesota
228.10 Statutes, section 256B.1973.
228.11     (b) The commissioner of human services shall notify the revisor of statutes when federal
228.12 approval is obtained.
228.13   Sec. 5. Minnesota Statutes 2024, section 256.969, subdivision 2f, is amended to read:
228.14     Subd. 2f. Alternate inpatient payment rate. (a) Effective January 1, 2022, for a hospital
228.15 eligible to receive disproportionate share hospital payments under subdivision 9, paragraph
228.16 (d), clause (6), the commissioner shall reduce the amount calculated under subdivision 9,
228.17 paragraph (d), clause (6), by 99 percent and compute an alternate inpatient payment rate.
228.18 The alternate payment rate shall be structured to target a total aggregate reimbursement
228.19 amount equal to what the hospital would have received for providing fee-for-service inpatient
228.20 services under this section to patients enrolled in medical assistance had the hospital received
228.21 the entire amount calculated under subdivision 9, paragraph (d), clause (6). This paragraph
228.22 expires when paragraph (b) becomes effective.
228.23     (b) For hospitals eligible to receive payment under section 256B.1973 or 256B.1974
228.24 and meeting the criteria in subdivision 9, paragraph (d), the commissioner must reduce the
228.25 amount calculated under subdivision 9, paragraph (d), by one percent and compute an
228.26 alternate inpatient payment rate. The alternate payment rate must be structured to target a
228.27 total aggregate reimbursement amount equal to the amount that the hospital would have
228.28 received for providing fee-for-service inpatient services under this section to patients enrolled
228.29 in medical assistance had the hospital received 99 percent of the entire amount calculated
228.30 under subdivision 9, paragraph (d). Hospitals that do not meet federal requirements for
228.31 Medicaid disproportionate share hospitals are not eligible for the alternate payment rate.
228.32     EFFECTIVE DATE. (a) Paragraph (b) of this section is effective the later of January
228.33 1, 2026, or federal approval of all of the following:
  Article 8 Sec. 5.  228
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229.1      (1) the waiver for the assessment required under Minnesota Statutes, section 256.9657,
229.2  subdivision 2b; and
229.3      (2) the hospital directed payment program under Minnesota Statutes, section 256B.1974,
229.4  and any conforming changes made to the directed payment program under Minnesota
229.5  Statutes, section 256B.1973.
229.6      (b) The commissioner of human services shall notify the revisor of statutes when federal
229.7  approval is obtained.
229.8    Sec. 6. Minnesota Statutes 2024, section 256B.0371, subdivision 3, is amended to read:
229.9      Subd. 3. Contingent contract with dental administrator. (a) The commissioner shall
229.10 determine the extent to which managed care and county-based purchasing plans in the
229.11 aggregate meet the performance benchmark specified in subdivision 1 for coverage year
229.12 2024. If managed care and county-based purchasing plans in the aggregate fail to meet the
229.13 performance benchmark, the commissioner, after issuing a request for information followed
229.14 by a request for proposals, shall contract with a dental administrator to administer dental
229.15 services beginning January 1, 2026 2028, for all recipients of medical assistance and
229.16 MinnesotaCare, including persons who are served under fee-for-service and persons receiving
229.17 services through managed care and county-based purchasing plans.
229.18     (b) The dental administrator must provide administrative services, including but not
229.19 limited to:
229.20     (1) provider recruitment, contracting, and assistance;
229.21     (2) recipient outreach and assistance;
229.22     (3) utilization management and reviews of medical necessity for dental services;
229.23     (4) dental claims processing;
229.24     (5) coordination of dental care with other services;
229.25     (6) management of fraud and abuse;
229.26     (7) monitoring access to dental services statewide;
229.27     (8) performance measurement;
229.28     (9) quality improvement and evaluation; and
229.29     (10) management of third-party liability requirements.; and
  Article 8 Sec. 6.  229
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230.1      (11) establishment of grievance and appeals processes for providers and enrollees that
230.2  the commissioner can monitor.
230.3      (c) Dental administrator payments to contracted dental providers must be at the based
230.4  on rates established under sections 256B.76 and 256L.11 recommended by the dental access
230.5  working group. If the recommended rates are not established in law prior to July 1, 2027,
230.6  dental administrator payments to contracted dental providers must be at the rates established
230.7  under sections 256B.76 and 256L.11.
230.8      (d) Recipients must be given a choice of dental provider, including any provider who
230.9  agrees to provider participation requirements and payment rates established by the
230.10 commissioner and dental administrator. The dental administrator must comply with the
230.11 network adequacy and geographic access requirements that apply to managed care and
230.12 county-based purchasing plans for dental services under section 62K.14.
230.13     (e) The contract with the dental administrator must include a provision that states that
230.14 if the dental administrator fails to meet, by calendar year 2029, a performance benchmark
230.15 under which at least 55 percent of children and adults who were continuously enrolled for
230.16 at least 11 months in either medical assistance or MinnesotaCare received at least one dental
230.17 visit during the calendar year, the contract must be terminated and the commissioner must
230.18 enter into a contract with a new dental administrator as soon as practicable performance
230.19 benchmarks, accountability measures, and progress rewards based on the recommendations
230.20 from the dental access working group.
230.21     (f) The commissioner shall implement this subdivision in consultation with representatives
230.22 of providers who provide dental services to patients enrolled in medical assistance or
230.23 MinnesotaCare, including but not limited to providers serving primarily low-income and
230.24 socioeconomically complex populations, and with representatives of managed care plans
230.25 and county-based purchasing plans.
230.26     (f) Notwithstanding the contract term limits under section 16C.06, subdivision 3b, the
230.27 commissioner may extend the implementation contract for the single dental administrator
230.28 under paragraph (a) up to three years from the date of execution and may contract with the
230.29 same contractor as the single dental administrator for up to five years, beginning in 2028.
230.30   Sec. 7. Minnesota Statutes 2024, section 256B.04, subdivision 12, is amended to read:
230.31     Subd. 12. Limitation on services. (a) The commissioner shall place limits on the types
230.32 of services covered by medical assistance, the frequency with which the same or similar
230.33 services may be covered by medical assistance for an individual recipient, and the amount
  Article 8 Sec. 7.  230
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
231.1  paid for each covered service. The state agency shall promulgate rules establishing maximum
231.2  reimbursement rates for emergency and nonemergency transportation.
231.3      The rules shall provide:
231.4      (1) an opportunity for all recognized transportation providers to be reimbursed for
231.5  nonemergency transportation consistent with the maximum rates established by the agency;
231.6  and
231.7      (2) reimbursement of public and private nonprofit providers serving the population with
231.8  a disability generally at reasonable maximum rates that reflect the cost of providing the
231.9  service regardless of the fare that might be charged by the provider for similar services to
231.10 individuals other than those receiving medical assistance or medical care under this chapter.
231.11 This paragraph expires July 1, 2026, for medical assistance fee-for-service and January 1,
231.12 2027, for prepaid medical assistance.
231.13     (b) The commissioner shall encourage providers reimbursed under this chapter to
231.14 coordinate their operation with similar services that are operating in the same community.
231.15 To the extent practicable, the commissioner shall encourage eligible individuals to utilize
231.16 less expensive providers capable of serving their needs. This paragraph expires July 1, 2026,
231.17 for medical assistance fee-for-service and January 1, 2027, for prepaid medical assistance.
231.18     (c) For the purpose of this subdivision and section 256B.02, subdivision 8, and effective
231.19 on January 1, 1981, "recognized provider of transportation services" means an operator of
231.20 special transportation service as defined in section 174.29 that has been issued a current
231.21 certificate of compliance with operating standards of the commissioner of transportation
231.22 or, if those standards do not apply to the operator, that the agency finds is able to provide
231.23 the required transportation in a safe and reliable manner. Until January 1, 1981, "recognized
231.24 transportation provider" includes an operator of special transportation service that the agency
231.25 finds is able to provide the required transportation in a safe and reliable manner. This
231.26 paragraph expires July 1, 2026, for medical assistance fee-for-service and January 1, 2027,
231.27 for prepaid medical assistance.
231.28     (d) Effective July 1, 2026, for medical assistance fee-for-service and January 1, 2027,
231.29 for prepaid medical assistance, the commissioner shall place limits on the types of services
231.30 covered by medical assistance, the frequency with which the same or similar services may
231.31 be covered by medical assistance for an individual recipient, and the amount paid for each
231.32 covered service.
231.33     EFFECTIVE DATE. This section is effective the day following final enactment.
  Article 8 Sec. 7.  231
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232.1    Sec. 8. Minnesota Statutes 2024, section 256B.04, subdivision 14, is amended to read:
232.2      Subd. 14. Competitive bidding. (a) When determined to be effective, economical, and
232.3  feasible, the commissioner may utilize volume purchase through competitive bidding and
232.4  negotiation under the provisions of chapter 16C, to provide items under the medical assistance
232.5  program including but not limited to the following:
232.6      (1) eyeglasses;
232.7      (2) oxygen. The commissioner shall provide for oxygen needed in an emergency situation
232.8  on a short-term basis, until the vendor can obtain the necessary supply from the contract
232.9  dealer;
232.10     (3) hearing aids and supplies;
232.11     (4) durable medical equipment, including but not limited to:
232.12     (i) hospital beds;
232.13     (ii) commodes;
232.14     (iii) glide-about chairs;
232.15     (iv) patient lift apparatus;
232.16     (v) wheelchairs and accessories;
232.17     (vi) oxygen administration equipment;
232.18     (vii) respiratory therapy equipment;
232.19     (viii) electronic diagnostic, therapeutic and life-support systems; and
232.20     (ix) allergen-reducing products as described in section 256B.0625, subdivision 67,
232.21 paragraph (c) or (d);
232.22     (5) nonemergency medical transportation level of need determinations, disbursement of
232.23 public transportation passes and tokens, and volunteer and recipient mileage and parking
232.24 reimbursements;
232.25     (6) drugs; and
232.26     (7) quitline services as described in section 256B.0625, subdivision 68, paragraph (c).
232.27 This paragraph expires July 1, 2026, for medical assistance fee-for-service and January 1,
232.28 2027, for prepaid medical assistance.
232.29     (b) Effective July 1, 2026, for medical assistance fee-for-service and January 1, 2027,
232.30 for prepaid medical assistance, when determined to be effective, economical, and feasible,
  Article 8 Sec. 8.  232
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
233.1  the commissioner may utilize volume purchase through competitive bidding and negotiation
233.2  under the provisions of chapter 16C to provide items under the medical assistance program,
233.3  including but not limited to the following:
233.4      (1) eyeglasses;
233.5      (2) oxygen. The commissioner shall provide for oxygen needed in an emergency situation
233.6  on a short-term basis, until the vendor can obtain the necessary supply from the contract
233.7  dealer;
233.8      (3) hearing aids and supplies;
233.9      (4) durable medical equipment, including but not limited to:
233.10     (i) hospital beds;
233.11     (ii) commodes;
233.12     (iii) glide-about chairs;
233.13     (iv) patient lift apparatus;
233.14     (v) wheelchairs and accessories;
233.15     (vi) oxygen administration equipment;
233.16     (vii) respiratory therapy equipment; and
233.17     (viii) electronic diagnostic, therapeutic, and life-support systems;
233.18     (5) nonemergency medical transportation; and
233.19     (6) drugs.
233.20     (b) (c) Rate changes and recipient cost-sharing under this chapter and chapter 256L do
233.21 not affect contract payments under this subdivision unless specifically identified.
233.22     (c) (d) The commissioner may not utilize volume purchase through competitive bidding
233.23 and negotiation under the provisions of chapter 16C for special transportation services or
233.24 incontinence products and related supplies. This paragraph expires July 1, 2026, for medical
233.25 assistance fee-for-service and January 1, 2027, for prepaid medical assistance.
233.26     (e) Effective July 1, 2026, for medical assistance fee-for-service and January 1, 2027,
233.27 for prepaid medical assistance, the commissioner must not utilize volume purchase through
233.28 competitive bidding and negotiation under the provisions of chapter 16C for incontinence
233.29 products and related supplies.
233.30     EFFECTIVE DATE. This section is effective the day following final enactment.
  Article 8 Sec. 8.  233
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
234.1    Sec. 9. Minnesota Statutes 2024, section 256B.0625, subdivision 3b, is amended to read:
234.2      Subd. 3b. Telehealth services. (a) Medical assistance covers medically necessary services
234.3  and consultations delivered by a health care provider through telehealth in the same manner
234.4  as if the service or consultation was delivered through in-person contact. Services or
234.5  consultations delivered through telehealth shall be paid at the full allowable rate.
234.6      (b) The commissioner may establish criteria that a health care provider must attest to in
234.7  order to demonstrate the safety or efficacy of delivering a particular service through
234.8  telehealth. The attestation may include that the health care provider:
234.9      (1) has identified the categories or types of services the health care provider will provide
234.10 through telehealth;
234.11     (2) has written policies and procedures specific to services delivered through telehealth
234.12 that are regularly reviewed and updated;
234.13     (3) has policies and procedures that adequately address patient safety before, during,
234.14 and after the service is delivered through telehealth;
234.15     (4) has established protocols addressing how and when to discontinue telehealth services;
234.16 and
234.17     (5) has an established quality assurance process related to delivering services through
234.18 telehealth.
234.19     (c) As a condition of payment, a licensed health care provider must document each
234.20 occurrence of a health service delivered through telehealth to a medical assistance enrollee.
234.21 Health care service records for services delivered through telehealth must meet the
234.22 requirements set forth in Minnesota Rules, part 9505.2175, subparts 1 and 2, and must
234.23 document:
234.24     (1) the type of service delivered through telehealth;
234.25     (2) the time the service began and the time the service ended, including an a.m. and p.m.
234.26 designation;
234.27     (3) the health care provider's basis for determining that telehealth is an appropriate and
234.28 effective means for delivering the service to the enrollee;
234.29     (4) the mode of transmission used to deliver the service through telehealth and records
234.30 evidencing that a particular mode of transmission was utilized;
234.31     (5) the location of the originating site and the distant site;
  Article 8 Sec. 9.  234
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
235.1      (6) if the claim for payment is based on a physician's consultation with another physician
235.2  through telehealth, the written opinion from the consulting physician providing the telehealth
235.3  consultation; and
235.4      (7) compliance with the criteria attested to by the health care provider in accordance
235.5  with paragraph (b).
235.6      (d) Telehealth visits provided through audio and visual communication or accessible
235.7  video-based platforms may be used to satisfy the face-to-face requirement for reimbursement
235.8  under the payment methods that apply to a federally qualified health center, rural health
235.9  clinic, Indian health service, 638 tribal clinic, and certified community behavioral health
235.10 clinic, if the service would have otherwise qualified for payment if performed in person.
235.11     (e) For purposes of this subdivision, unless otherwise covered under this chapter:
235.12     (1) "telehealth" means the delivery of health care services or consultations using real-time
235.13 two-way interactive audio and visual communication or accessible telehealth video-based
235.14 platforms to provide or support health care delivery and facilitate the assessment, diagnosis,
235.15 consultation, treatment, education, and care management of a patient's health care. Telehealth
235.16 includes: the application of secure video conferencing consisting of a real-time, full-motion
235.17 synchronized video; store-and-forward technology; and synchronous interactions, between
235.18 a patient located at an originating site and a health care provider located at a distant site.
235.19 Telehealth does not include communication between health care providers, or between a
235.20 health care provider and a patient that consists solely of an audio-only communication,
235.21 email, or facsimile transmission or as specified by law, except that from July 1, 2025, to
235.22 July 1, 2027, telehealth includes communication between a health care provider and a patient
235.23 that solely consists of audio-only communication;
235.24     (2) "health care provider" means a health care provider as defined under section 62A.673;
235.25 a community paramedic as defined under section 144E.001, subdivision 5f; a community
235.26 health worker who meets the criteria under subdivision 49, paragraph (a); a mental health
235.27 certified peer specialist under section 245I.04, subdivision 10; a mental health certified
235.28 family peer specialist under section 245I.04, subdivision 12; a mental health rehabilitation
235.29 worker under section 245I.04, subdivision 14; a mental health behavioral aide under section
235.30 245I.04, subdivision 16; a treatment coordinator under section 245G.11, subdivision 7; an
235.31 alcohol and drug counselor under section 245G.11, subdivision 5; or a recovery peer under
235.32 section 245G.11, subdivision 8; and
235.33     (3) "originating site," "distant site," and "store-and-forward technology" have the
235.34 meanings given in section 62A.673, subdivision 2.
  Article 8 Sec. 9.  235
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236.1      EFFECTIVE DATE. This section is effective July 1, 2025, or upon federal approval,
236.2  whichever is later. The commissioner of human services shall notify the revisor of statutes
236.3  when federal approval is obtained.
236.4    Sec. 10. Minnesota Statutes 2024, section 256B.0625, subdivision 8, is amended to read:
236.5      Subd. 8. Physical therapy. (a) Medical assistance covers physical therapy and related
236.6  services. Specialized maintenance therapy is covered for recipients age 20 and under.
236.7      (b) Services provided by a physical therapy assistant shall be reimbursed at the same
236.8  rate as services performed by a physical therapist when the services of the physical therapy
236.9  assistant are provided under the direction of a physical therapist who is on the premises.
236.10 Services provided by a physical therapy assistant that are provided under the direction of a
236.11 physical therapist who is not on the premises shall be reimbursed at 65 percent of the physical
236.12 therapist rate.
236.13     (c) Payment for physical therapy and related services is limited to 14 visits per year
236.14 unless prior authorization of a greater number of visits is obtained.
236.15     EFFECTIVE DATE. This section is effective January 1, 2026, or upon federal approval,
236.16 whichever is later. The commissioner must notify the revisor of statutes when federal
236.17 approval is obtained.
236.18   Sec. 11. Minnesota Statutes 2024, section 256B.0625, subdivision 8a, is amended to read:
236.19     Subd. 8a. Occupational therapy. (a) Medical assistance covers occupational therapy
236.20 and related services. Specialized maintenance therapy is covered for recipients age 20 and
236.21 under.
236.22     (b) Services provided by an occupational therapy assistant shall be reimbursed at the
236.23 same rate as services performed by an occupational therapist when the services of the
236.24 occupational therapy assistant are provided under the direction of the occupational therapist
236.25 who is on the premises. Services provided by an occupational therapy assistant that are
236.26 provided under the direction of an occupational therapist who is not on the premises shall
236.27 be reimbursed at 65 percent of the occupational therapist rate.
236.28     (c) Payment for occupational therapy and related services is limited to 24 visits per year
236.29 unless prior authorization of a greater number of visits is obtained.
236.30     EFFECTIVE DATE. This section is effective January 1, 2026, or upon federal approval,
236.31 whichever is later. The commissioner must notify the revisor of statutes when federal
236.32 approval is obtained.
  Article 8 Sec. 11.  236
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
237.1    Sec. 12. Minnesota Statutes 2024, section 256B.0625, subdivision 8e, is amended to read:
237.2      Subd. 8e. Chiropractic services. Payment for chiropractic services is limited to
237.3  individuals under the age of 21. Coverage for individuals under the age of 21 is limited to
237.4  one annual evaluation and 24 visits per year unless prior authorization of a greater number
237.5  of visits is obtained.
237.6      EFFECTIVE DATE. This section is effective January 1, 2026, or upon federal approval,
237.7  whichever is later. The commissioner of human services shall notify the revisor of statutes
237.8  when federal approval is obtained.
237.9    Sec. 13. Minnesota Statutes 2024, section 256B.0625, subdivision 17, is amended to read:
237.10     Subd. 17. Transportation costs. (a) "Nonemergency medical transportation service"
237.11 means motor vehicle transportation provided by a public or private person that serves
237.12 Minnesota health care program beneficiaries who do not require emergency ambulance
237.13 service, as defined in section 144E.001, subdivision 3, to obtain covered medical services.
237.14     (b) For purposes of this subdivision, "rural urban commuting area" or "RUCA" means
237.15 a census-tract based classification system under which a geographical area is determined
237.16 to be urban, rural, or super rural. This paragraph expires July 1, 2026, for medical assistance
237.17 fee-for-service and January 1, 2027, for prepaid medical assistance.
237.18     (c) Medical assistance covers medical transportation costs incurred solely for obtaining
237.19 emergency medical care or transportation costs incurred by eligible persons in obtaining
237.20 emergency or nonemergency medical care when paid directly to an ambulance company,
237.21 nonemergency medical transportation company, or other recognized providers of
237.22 transportation services. Medical transportation must be provided by:
237.23     (1) nonemergency medical transportation providers who meet the requirements of this
237.24 subdivision;
237.25     (2) ambulances, as defined in section 144E.001, subdivision 2;
237.26     (3) taxicabs that meet the requirements of this subdivision;
237.27     (4) public transportation, within the meaning of "public transportation" as defined in
237.28 section 174.22, subdivision 7; or
237.29     (5) not-for-hire vehicles, including volunteer drivers, as defined in section 65B.472,
237.30 subdivision 1, paragraph (p).
237.31     (d) Medical assistance covers nonemergency medical transportation provided by
237.32 nonemergency medical transportation providers enrolled in the Minnesota health care
  Article 8 Sec. 13.  237
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238.1  programs. All nonemergency medical transportation providers must comply with the
238.2  operating standards for special transportation service as defined in sections 174.29 to 174.30
238.3  and Minnesota Rules, chapter 8840, and all drivers must be individually enrolled with the
238.4  commissioner and reported on the claim as the individual who provided the service. All
238.5  nonemergency medical transportation providers shall bill for nonemergency medical
238.6  transportation services in accordance with Minnesota health care programs criteria. Publicly
238.7  operated transit systems, volunteers, and not-for-hire vehicles are exempt from the
238.8  requirements outlined in this paragraph.
238.9      (e) An organization may be terminated, denied, or suspended from enrollment if:
238.10     (1) the provider has not initiated background studies on the individuals specified in
238.11 section 174.30, subdivision 10, paragraph (a), clauses (1) to (3); or
238.12     (2) the provider has initiated background studies on the individuals specified in section
238.13 174.30, subdivision 10, paragraph (a), clauses (1) to (3), and:
238.14     (i) the commissioner has sent the provider a notice that the individual has been
238.15 disqualified under section 245C.14; and
238.16     (ii) the individual has not received a disqualification set-aside specific to the special
238.17 transportation services provider under sections 245C.22 and 245C.23.
238.18     (f) The administrative agency of nonemergency medical transportation must:
238.19     (1) adhere to the policies defined by the commissioner;
238.20     (2) pay nonemergency medical transportation providers for services provided to
238.21 Minnesota health care programs beneficiaries to obtain covered medical services;
238.22     (3) provide data monthly to the commissioner on appeals, complaints, no-shows, canceled
238.23 trips, and number of trips by mode; and
238.24     (4) by July 1, 2016, in accordance with subdivision 18e, utilize a web-based single
238.25 administrative structure assessment tool that meets the technical requirements established
238.26 by the commissioner, reconciles trip information with claims being submitted by providers,
238.27 and ensures prompt payment for nonemergency medical transportation services. This
238.28 paragraph expires July 1, 2026, for medical assistance fee-for-service and January 1, 2027,
238.29 for prepaid medical assistance.
238.30     (g) Effective July 1, 2026, for medical fee-for-service and January 1, 2027, for prepaid
238.31 medical assistance, the administrative agency of nonemergency medical transportation must:
238.32     (1) adhere to the policies defined by the commissioner;
  Article 8 Sec. 13.  238
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
239.1      (2) pay nonemergency medical transportation providers for services provided to
239.2  Minnesota health care program beneficiaries to obtain covered medical services; and
239.3      (3) provide data monthly to the commissioner on appeals, complaints, no-shows, canceled
239.4  trips, and number of trips by mode.
239.5      (g) (h) Until the commissioner implements the single administrative structure and delivery
239.6  system under subdivision 18e, clients shall obtain their level-of-service certificate from the
239.7  commissioner or an entity approved by the commissioner that does not dispatch rides for
239.8  clients using modes of transportation under paragraph (l) (n), clauses (4), (5), (6), and (7).
239.9  This paragraph expires July 1, 2026, for medical assistance fee-for-service and January 1,
239.10 2027, for prepaid medical assistance.
239.11     (h) (i) The commissioner may use an order by the recipient's attending physician,
239.12 advanced practice registered nurse, physician assistant, or a medical or mental health
239.13 professional to certify that the recipient requires nonemergency medical transportation
239.14 services. Nonemergency medical transportation providers shall perform driver-assisted
239.15 services for eligible individuals, when appropriate. Driver-assisted service includes passenger
239.16 pickup at and return to the individual's residence or place of business, assistance with
239.17 admittance of the individual to the medical facility, and assistance in passenger securement
239.18 or in securing of wheelchairs, child seats, or stretchers in the vehicle.
239.19     (i) (j) Nonemergency medical transportation providers must take clients to the health
239.20 care provider using the most direct route, and must not exceed 30 miles for a trip to a primary
239.21 care provider or 60 miles for a trip to a specialty care provider, unless the client receives
239.22 authorization from the local agency. This paragraph expires July 1, 2026, for medical
239.23 assistance fee-for-service and January 1, 2027, for prepaid medical assistance.
239.24     (k) Effective July 1, 2026, for medical assistance fee-for-service and January 1, 2027,
239.25 for prepaid medical assistance, nonemergency medical transportation providers must take
239.26 clients to the health care provider using the most direct route and must not exceed 30 miles
239.27 for a trip to a primary care provider or 60 miles for a trip to a specialty care provider, unless
239.28 the client receives authorization from the administrator.
239.29     (j) (l) Nonemergency medical transportation providers may not bill for separate base
239.30 rates for the continuation of a trip beyond the original destination. Nonemergency medical
239.31 transportation providers must maintain trip logs, which include pickup and drop-off times,
239.32 signed by the medical provider or client, whichever is deemed most appropriate, attesting
239.33 to mileage traveled to obtain covered medical services. Clients requesting client mileage
  Article 8 Sec. 13.  239
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
240.1  reimbursement must sign the trip log attesting mileage traveled to obtain covered medical
240.2  services.
240.3      (k) (m) The administrative agency shall use the level of service process established by
240.4  the commissioner to determine the client's most appropriate mode of transportation. If public
240.5  transit or a certified transportation provider is not available to provide the appropriate service
240.6  mode for the client, the client may receive a onetime service upgrade.
240.7      (l) (n) The covered modes of transportation are:
240.8      (1) client reimbursement, which includes client mileage reimbursement provided to
240.9  clients who have their own transportation, or to family or an acquaintance who provides
240.10 transportation to the client;
240.11     (2) volunteer transport, which includes transportation by volunteers using their own
240.12 vehicle;
240.13     (3) unassisted transport, which includes transportation provided to a client by a taxicab
240.14 or public transit. If a taxicab or public transit is not available, the client can receive
240.15 transportation from another nonemergency medical transportation provider;
240.16     (4) assisted transport, which includes transport provided to clients who require assistance
240.17 by a nonemergency medical transportation provider;
240.18     (5) lift-equipped/ramp transport, which includes transport provided to a client who is
240.19 dependent on a device and requires a nonemergency medical transportation provider with
240.20 a vehicle containing a lift or ramp;
240.21     (6) protected transport, which includes transport provided to a client who has received
240.22 a prescreening that has deemed other forms of transportation inappropriate and who requires
240.23 a provider: (i) with a protected vehicle that is not an ambulance or police car and has safety
240.24 locks, a video recorder, and a transparent thermoplastic partition between the passenger and
240.25 the vehicle driver; and (ii) who is certified as a protected transport provider; and
240.26     (7) stretcher transport, which includes transport for a client in a prone or supine position
240.27 and requires a nonemergency medical transportation provider with a vehicle that can transport
240.28 a client in a prone or supine position.
240.29     (m) (o) The local agency shall be the single administrative agency and shall administer
240.30 and reimburse for modes defined in paragraph (l) (n) according to paragraphs (p) and (q)
240.31 (r) to (t) when the commissioner has developed, made available, and funded the web-based
240.32 single administrative structure, assessment tool, and level of need assessment under
240.33 subdivision 18e. The local agency's financial obligation is limited to funds provided by the
  Article 8 Sec. 13.  240
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
241.1  state or federal government. This paragraph expires July 1, 2026, for medical assistance
241.2  fee-for-service and January 1, 2027, for prepaid medical assistance.
241.3      (n) (p) The commissioner shall:
241.4      (1) verify that the mode and use of nonemergency medical transportation is appropriate;
241.5      (2) verify that the client is going to an approved medical appointment; and
241.6      (3) investigate all complaints and appeals.
241.7      (o) (q) The administrative agency shall pay for the services provided in this subdivision
241.8  and seek reimbursement from the commissioner, if appropriate. As vendors of medical care,
241.9  local agencies are subject to the provisions in section 256B.041, the sanctions and monetary
241.10 recovery actions in section 256B.064, and Minnesota Rules, parts 9505.2160 to 9505.2245.
241.11 This paragraph expires July 1, 2026, for medical assistance fee-for-service and January 1,
241.12 2027, for prepaid medical assistance.
241.13     (p) (r) Payments for nonemergency medical transportation must be paid based on the
241.14 client's assessed mode under paragraph (k) (m), not the type of vehicle used to provide the
241.15 service. The medical assistance reimbursement rates for nonemergency medical transportation
241.16 services that are payable by or on behalf of the commissioner for nonemergency medical
241.17 transportation services are:
241.18     (1) $0.22 per mile for client reimbursement;
241.19     (2) up to 100 percent of the Internal Revenue Service business deduction rate for volunteer
241.20 transport;
241.21     (3) equivalent to the standard fare for unassisted transport when provided by public
241.22 transit, and $12.10 for the base rate and $1.43 per mile when provided by a nonemergency
241.23 medical transportation provider;
241.24     (4) $14.30 for the base rate and $1.43 per mile for assisted transport;
241.25     (5) $19.80 for the base rate and $1.70 per mile for lift-equipped/ramp transport;
241.26     (6) $75 for the base rate and $2.40 per mile for protected transport; and
241.27     (7) $60 for the base rate and $2.40 per mile for stretcher transport, and $9 per trip for
241.28 an additional attendant if deemed medically necessary. This paragraph expires July 1, 2026,
241.29 for medical assistance fee-for-service and January 1, 2027, for prepaid medical assistance.
241.30     (s) Effective July 1, 2026, for medical assistance fee-for-service and January 1, 2027,
241.31 for prepaid medical assistance, payments for nonemergency medical transportation must
  Article 8 Sec. 13.  241
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
242.1  be paid based on the client's assessed mode under paragraph (m), not the type of vehicle
242.2  used to provide the service.
242.3      (q) (t) The base rate for nonemergency medical transportation services in areas defined
242.4  under RUCA to be super rural is equal to 111.3 percent of the respective base rate in
242.5  paragraph (p) (r), clauses (1) to (7). The mileage rate for nonemergency medical
242.6  transportation services in areas defined under RUCA to be rural or super rural areas is:
242.7      (1) for a trip equal to 17 miles or less, equal to 125 percent of the respective mileage
242.8  rate in paragraph (p) (r), clauses (1) to (7); and
242.9      (2) for a trip between 18 and 50 miles, equal to 112.5 percent of the respective mileage
242.10 rate in paragraph (p) (r), clauses (1) to (7). This paragraph expires July 1, 2026, for medical
242.11 assistance fee-for-service and January 1, 2027, for prepaid medical assistance.
242.12     (r) (u) For purposes of reimbursement rates for nonemergency medical transportation
242.13 services under paragraphs (p) and (q) (r) to (t), the zip code of the recipient's place of
242.14 residence shall determine whether the urban, rural, or super rural reimbursement rate applies.
242.15 This paragraph expires July 1, 2026, for medical assistance fee-for-service and January 1,
242.16 2027, for prepaid medical assistance.
242.17     (s) (v) The commissioner, when determining reimbursement rates for nonemergency
242.18 medical transportation under paragraphs (p) and (q), shall exempt all modes of transportation
242.19 listed under paragraph (l) (n) from Minnesota Rules, part 9505.0445, item R, subitem (2).
242.20     (t) (w) Effective for the first day of each calendar quarter in which the price of gasoline
242.21 as posted publicly by the United States Energy Information Administration exceeds $3.00
242.22 per gallon, the commissioner shall adjust the rate paid per mile in paragraph (p) (r) by one
242.23 percent up or down for every increase or decrease of ten cents for the price of gasoline. The
242.24 increase or decrease must be calculated using a base gasoline price of $3.00. The percentage
242.25 increase or decrease must be calculated using the average of the most recently available
242.26 price of all grades of gasoline for Minnesota as posted publicly by the United States Energy
242.27 Information Administration. This paragraph expires July 1, 2026, for medical assistance
242.28 fee-for-service and January 1, 2027, for prepaid medical assistance.
242.29     EFFECTIVE DATE. This section is effective the day following final enactment.
242.30   Sec. 14. Minnesota Statutes 2024, section 256B.0625, is amended by adding a subdivision
242.31 to read:
242.32     Subd. 18i. Administration of nonemergency medical transportation. Effective July
242.33 1, 2026, for medical assistance fee-for-service and January 1, 2027, for prepaid medical
  Article 8 Sec. 14.  242
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
243.1  assistance, the commissioner must contract either statewide or regionally for the
243.2  administration of the nonemergency medical transportation program in compliance with
243.3  the provisions of this chapter. The contract must include the administration of the
243.4  nonemergency medical transportation benefit for those enrolled in managed care as described
243.5  in section 256B.69.
243.6      EFFECTIVE DATE. This section is effective the day following final enactment.
243.7    Sec. 15. Minnesota Statutes 2024, section 256B.0625, subdivision 30, is amended to read:
243.8      Subd. 30. Other clinic services. (a) Medical assistance covers rural health clinic services,
243.9  federally qualified health center services, nonprofit community health clinic services, and
243.10 public health clinic services. Rural health clinic services and federally qualified health center
243.11 services mean services defined in United States Code, title 42, section 1396d(a)(2)(B) and
243.12 (C). Payment for rural health clinic and federally qualified health center services shall be
243.13 made according to applicable federal law and regulation.
243.14     (b) A federally qualified health center (FQHC) that is beginning initial operation shall
243.15 submit an estimate of budgeted costs and visits for the initial reporting period in the form
243.16 and detail required by the commissioner. An FQHC that is already in operation shall submit
243.17 an initial report using actual costs and visits for the initial reporting period. Within 90 days
243.18 of the end of its reporting period, an FQHC shall submit, in the form and detail required by
243.19 the commissioner, a report of its operations, including allowable costs actually incurred for
243.20 the period and the actual number of visits for services furnished during the period, and other
243.21 information required by the commissioner. FQHCs that file Medicare cost reports shall
243.22 provide the commissioner with a copy of the most recent Medicare cost report filed with
243.23 the Medicare program intermediary for the reporting year which support the costs claimed
243.24 on their cost report to the state.
243.25     (c) In order to continue cost-based payment under the medical assistance program
243.26 according to paragraphs (a) and (b), an FQHC or rural health clinic must apply for designation
243.27 as an essential community provider within six months of final adoption of rules by the
243.28 Department of Health according to section 62Q.19, subdivision 7. For those FQHCs and
243.29 rural health clinics that have applied for essential community provider status within the
243.30 six-month time prescribed, medical assistance payments will continue to be made according
243.31 to paragraphs (a) and (b) for the first three years after application. For FQHCs and rural
243.32 health clinics that either do not apply within the time specified above or who have had
243.33 essential community provider status for three years, medical assistance payments for health
243.34 services provided by these entities shall be according to the same rates and conditions
  Article 8 Sec. 15.  243
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
244.1  applicable to the same service provided by health care providers that are not FQHCs or rural
244.2  health clinics.
244.3      (d) Effective July 1, 1999, the provisions of paragraph (c) requiring an FQHC or a rural
244.4  health clinic to make application for an essential community provider designation in order
244.5  to have cost-based payments made according to paragraphs (a) and (b) no longer apply.
244.6      (e) Effective January 1, 2000, payments made according to paragraphs (a) and (b) shall
244.7  be limited to the cost phase-out schedule of the Balanced Budget Act of 1997.
244.8      (f) Effective January 1, 2001, through December 31, 2020, each FQHC and rural health
244.9  clinic may elect to be paid either under the prospective payment system established in United
244.10 States Code, title 42, section 1396a(aa), or under an alternative payment methodology
244.11 consistent with the requirements of United States Code, title 42, section 1396a(aa), and
244.12 approved by the Centers for Medicare and Medicaid Services. The alternative payment
244.13 methodology shall be 100 percent of cost as determined according to Medicare cost
244.14 principles.
244.15     (g) Effective for services provided on or after January 1, 2021, all claims for payment
244.16 of clinic services provided by FQHCs and rural health clinics shall be paid by the
244.17 commissioner, according to an annual election by the FQHC or rural health clinic, under
244.18 the current prospective payment system described in paragraph (f) or the alternative payment
244.19 methodology described in paragraph (l), or, upon federal approval, for FQHCs that are also
244.20 urban Indian organizations under Title V of the federal Indian Health Improvement Act, as
244.21 provided under paragraph (k).
244.22     (h) For purposes of this section, "nonprofit community clinic" is a clinic that:
244.23     (1) has nonprofit status as specified in chapter 317A;
244.24     (2) has tax exempt status as provided in Internal Revenue Code, section 501(c)(3);
244.25     (3) is established to provide health services to low-income population groups, uninsured,
244.26 high-risk and special needs populations, underserved and other special needs populations;
244.27     (4) employs professional staff at least one-half of which are familiar with the cultural
244.28 background of their clients;
244.29     (5) charges for services on a sliding fee scale designed to provide assistance to
244.30 low-income clients based on current poverty income guidelines and family size; and
244.31     (6) does not restrict access or services because of a client's financial limitations or public
244.32 assistance status and provides no-cost care as needed.
  Article 8 Sec. 15.  244
  06/07/25  REVISOR        DTT/LN  25-05697  as introduced
245.1      (i) Effective for services provided on or after January 1, 2015, all claims for payment
245.2  of clinic services provided by FQHCs and rural health clinics shall be paid by the
245.3  commissioner. the commissioner shall determine the most feasible method for paying claims
245.4  from the following options:
245.5      (1) FQHCs and rural health clinics submit claims directly to the commissioner for
245.6  payment, and the commissioner provides claims information for recipients enrolled in a
245.7  managed care or county-based purchasing plan to the plan, on a regular basis; or
245.8      (2) FQHCs and rural health clinics submit claims for recipients enrolled in a managed
245.9  care or county-based purchasing plan to the plan, and those claims are submitted by the
245.10 plan to the commissioner for payment to the clinic.
245.11     (j) For clinic services provided prior to January 1, 2015, the commissioner shall calculate
245.12 and pay monthly the proposed managed care supplemental payments to clinics, and clinics
245.13 shall conduct a timely review of the payment calculation data in order to finalize all
245.14 supplemental payments in accordance with federal law. Any issues arising from a clinic's
245.15 review must be reported to the commissioner by January 1, 2017. Upon final agreement
245.16 between the commissioner and a clinic on issues identified under this subdivision, and in
245.17 accordance with United States Code, title 42, section 1396a(bb), no supplemental payments
245.18 for managed care plan or county-based purchasing plan claims for services provided prior
245.19 to January 1, 2015, shall be made after June 30, 2017. If the commissioner and clinics are
245.20 unable to resolve issues under this subdivision, the parties shall submit the dispute to the
245.21 arbitration process under section 14.57.
245.22     (k) The commissioner shall establish an encounter payment rate that is equivalent to the
245.23 all inclusive rate (AIR) payment established by the Indian Health Service and published in
245.24 the Federal Register. The encounter rate must be updated annually and must reflect the
245.25 changes in the AIR established by the Indian Health Service each calendar year. FQHCs
245.26 that are also urban Indian organizations under Title V of the federal Indian Health
245.27 Improvement Act may elect to be paid: (1) at the encounter rate established under this
245.28 paragraph; (2) under the alternative payment methodology described in paragraph (l); or
245.29 (3) under the federally required prospective payment system described in paragraph (f).
245.30 FQHCs that elect to be paid at the encounter rate established under this paragraph must
245.31 continue to meet all state and federal requirements related to FQHCs and urban Indian
245.32 organizations, and must maintain their statuses as FQHCs and urban Indian organizations.
  Article 8 Sec. 15.  245
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
246.1      (l) All claims for payment of clinic services provided by FQHCs and rural health clinics,
246.2  that have elected to be paid under this paragraph, shall be paid by the commissioner according
246.3  to the following requirements:
246.4      (1) the commissioner shall establish a single medical and single dental organization
246.5  encounter rate for each FQHC and rural health clinic when applicable;
246.6      (2) each FQHC and rural health clinic is eligible for same day reimbursement of one
246.7  medical and one dental organization encounter rate if eligible medical and dental visits are
246.8  provided on the same day;
246.9      (3) the commissioner shall reimburse FQHCs and rural health clinics, in accordance
246.10 with current applicable Medicare cost principles, their allowable costs, including direct
246.11 patient care costs and patient-related support services. Nonallowable costs include, but are
246.12 not limited to:
246.13     (i) general social services and administrative costs;
246.14     (ii) retail pharmacy;
246.15     (iii) patient incentives, food, housing assistance, and utility assistance;
246.16     (iv) external lab and x-ray;
246.17     (v) navigation services;
246.18     (vi) health care taxes;
246.19     (vii) advertising, public relations, and marketing;
246.20     (viii) office entertainment costs, food, alcohol, and gifts;
246.21     (ix) contributions and donations;
246.22     (x) bad debts or losses on awards or contracts;
246.23     (xi) fines, penalties, damages, or other settlements;
246.24     (xii) fundraising, investment management, and associated administrative costs;
246.25     (xiii) research and associated administrative costs;
246.26     (xiv) nonpaid workers;
246.27     (xv) lobbying;
246.28     (xvi) scholarships and student aid; and
246.29     (xvii) nonmedical assistance covered services;
  Article 8 Sec. 15.  246
  06/07/25  REVISOR        DTT/LN  25-05697  as introduced
247.1      (4) the commissioner shall review the list of nonallowable costs in the years between
247.2  the rebasing process established in clause (5), in consultation with the Minnesota Association
247.3  of Community Health Centers, FQHCs, and rural health clinics. The commissioner shall
247.4  publish the list and any updates in the Minnesota health care programs provider manual;
247.5      (5) the initial applicable base year organization encounter rates for FQHCs and rural
247.6  health clinics shall be computed for services delivered on or after January 1, 2021, and:
247.7      (i) must be determined using each FQHC's and rural health clinic's Medicare cost reports
247.8  from 2017 and 2018;
247.9      (ii) must be according to current applicable Medicare cost principles as applicable to
247.10 FQHCs and rural health clinics without the application of productivity screens and upper
247.11 payment limits or the Medicare prospective payment system FQHC aggregate mean upper
247.12 payment limit;
247.13     (iii) must be subsequently rebased every two years thereafter using the Medicare cost
247.14 reports that are three and four years prior to the rebasing year. Years in which organizational
247.15 cost or claims volume is reduced or altered due to a pandemic, disease, or other public health
247.16 emergency shall not be used as part of a base year when the base year includes more than
247.17 one year. The commissioner may use the Medicare cost reports of a year unaffected by a
247.18 pandemic, disease, or other public health emergency, or previous two consecutive years,
247.19 inflated to the base year as established under item (iv);
247.20     (iv) must be inflated to the base year using the inflation factor described in clause (6);
247.21 and
247.22     (v) the commissioner must provide for a 60-day appeals process under section 14.57;
247.23     (6) the commissioner shall annually inflate the applicable organization encounter rates
247.24 for FQHCs and rural health clinics from the base year payment rate to the effective date by
247.25 using the CMS FQHC Market Basket inflator established under United States Code, title
247.26 42, section 1395m(o), less productivity;
247.27     (7) FQHCs and rural health clinics that have elected the alternative payment methodology
247.28 under this paragraph shall submit all necessary documentation required by the commissioner
247.29 to compute the rebased organization encounter rates no later than six months following the
247.30 date the applicable Medicare cost reports are due to the Centers for Medicare and Medicaid
247.31 Services;
  Article 8 Sec. 15.  247
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
248.1      (8) the commissioner shall reimburse FQHCs and rural health clinics an additional
248.2  amount relative to their medical and dental organization encounter rates that is attributable
248.3  to the tax required to be paid according to section 295.52, if applicable;
248.4      (9) FQHCs and rural health clinics may submit change of scope requests to the
248.5  commissioner if the change of scope would result in an increase or decrease of 2.5 percent
248.6  or higher in the medical or dental organization encounter rate currently received by the
248.7  FQHC or rural health clinic;
248.8      (10) for FQHCs and rural health clinics seeking a change in scope with the commissioner
248.9  under clause (9) that requires the approval of the scope change by the federal Health
248.10 Resources Services Administration:
248.11     (i) FQHCs and rural health clinics shall submit the change of scope request, including
248.12 the start date of services, to the commissioner within seven business days of submission of
248.13 the scope change to the federal Health Resources Services Administration;
248.14     (ii) the commissioner shall establish the effective date of the payment change as the
248.15 federal Health Resources Services Administration date of approval of the FQHC's or rural
248.16 health clinic's scope change request, or the effective start date of services, whichever is
248.17 later; and
248.18     (iii) within 45 days of one year after the effective date established in item (ii), the
248.19 commissioner shall conduct a retroactive review to determine if the actual costs established
248.20 under clause (3) or encounters result in an increase or decrease of 2.5 percent or higher in
248.21 the medical or dental organization encounter rate, and if this is the case, the commissioner
248.22 shall revise the rate accordingly and shall adjust payments retrospectively to the effective
248.23 date established in item (ii);
248.24     (11) for change of scope requests that do not require federal Health Resources Services
248.25 Administration approval, the FQHC and rural health clinic shall submit the request to the
248.26 commissioner before implementing the change, and the effective date of the change is the
248.27 date the commissioner received the FQHC's or rural health clinic's request, or the effective
248.28 start date of the service, whichever is later. The commissioner shall provide a response to
248.29 the FQHC's or rural health clinic's request within 45 days of submission and provide a final
248.30 approval within 120 days of submission. This timeline may be waived at the mutual
248.31 agreement of the commissioner and the FQHC or rural health clinic if more information is
248.32 needed to evaluate the request;
248.33     (12) the commissioner, when establishing organization encounter rates for new FQHCs
248.34 and rural health clinics, shall consider the patient caseload of existing FQHCs and rural
  Article 8 Sec. 15.  248
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
249.1  health clinics in a 60-mile radius for organizations established outside of the seven-county
249.2  metropolitan area, and in a 30-mile radius for organizations in the seven-county metropolitan
249.3  area. If this information is not available, the commissioner may use Medicare cost reports
249.4  or audited financial statements to establish base rates;
249.5(13) the commissioner, when establishing organization encounter rates under this section
249.6  for FQHCs and rural health clinics resulting from a merger of existing clinics or the
249.7  acquisition of an existing clinic by another existing clinic, must use the combined costs and
249.8  caseloads from the clinics participating in the merger or acquisition to set the encounter rate
249.9  for the new clinic organization resulting from the merger or acquisition. The scope of services
249.10 for the newly formed clinic must be inclusive of the scope of services of the clinics
249.11 participating in the merger or acquisition;
249.12(13) (14) the commissioner shall establish a quality measures workgroup that includes
249.13 representatives from the Minnesota Association of Community Health Centers, FQHCs,
249.14 and rural health clinics, to evaluate clinical and nonclinical measures; and
249.15(14) (15) the commissioner shall not disallow or reduce costs that are related to an
249.16 FQHC's or rural health clinic's participation in health care educational programs to the extent
249.17 that the costs are not accounted for in the alternative payment methodology encounter rate
249.18 established in this paragraph.
249.19(m) Effective July 1, 2023, an enrolled Indian health service facility or a Tribal health
249.20 center operating under a 638 contract or compact may elect to also enroll as a Tribal FQHC.
249.21 Requirements that otherwise apply to an FQHC covered in this subdivision do not apply to
249.22 a Tribal FQHC enrolled under this paragraph, except that any requirements necessary to
249.23 comply with federal regulations do apply to a Tribal FQHC. The commissioner shall establish
249.24 an alternative payment method for a Tribal FQHC enrolled under this paragraph that uses
249.25 the same method and rates applicable to a Tribal facility or health center that does not enroll
249.26 as a Tribal FQHC.
249.27(n) FQHC reimbursement for mental health targeted case management services is limited
249.28 to:
249.29(1) only those services described under subdivision 20 and provided in accordance with
249.30 contracts executed with counties authorized to subcontract for mental health targeted case
249.31 management services; and
249.32(2) an FQHC's actual incurred costs as separately reported on the cost report submitted
249.33 to the Centers for Medicare and Medicaid Services and further identified in reports submitted
249.34 to the commissioner.
  Article 8 Sec. 15.  249
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
250.1      (o) Counties contracting with FQHCs for mental health targeted case management remain
250.2  responsible for the nonfederal share of the cost of the provided mental health targeted case
250.3  management services. The commissioner must bill each county for the nonfederal share of
250.4  the mental health targeted case management costs as reported by the FQHC.
250.5      EFFECTIVE DATE. This section is effective the day following final enactment.
250.6    Sec. 16. Minnesota Statutes 2024, section 256B.0625, subdivision 54, is amended to read:
250.7      Subd. 54. Services provided in birth centers. (a) Medical assistance covers services
250.8  provided in a licensed birth center by a licensed health professional if the service would
250.9  otherwise be covered if provided in a hospital.
250.10     (b) Facility services provided by a birth center shall be paid at the lower of billed charges
250.11 or 70 100 percent of the statewide average for a facility payment rate made to a hospital
250.12 hospital facility fee cost trended to current for an uncomplicated vaginal birth as determined
250.13 using the most recent calendar year for which complete claims data is available. If a recipient
250.14 is transported from a birth center to a hospital prior to the delivery, the payment for facility
250.15 services to the birth center shall be the lower of billed charges or 15 100 percent of the
250.16 average hospital facility payment made to a hospital for the services provided fee cost
250.17 trended to current for an uncomplicated vaginal delivery as determined using the most recent
250.18 calendar year for which complete claims data is available.
250.19     (c) Nursery care Facility services provided to a newborn by a birth center shall be paid
250.20 the lower of billed charges or 70 100 percent of the statewide average for a payment rate
250.21 paid to a hospital for nursery care as determined by using the most recent calendar year for
250.22 which complete claims data is available the hospital facility fee for a normal newborn as
250.23 determined using the most recent calendar year for which complete claims data is available,
250.24 cost trended to current.
250.25     (d) Professional services provided by traditional midwives licensed under chapter 147D
250.26 shall be paid at the lower of billed charges or 100 percent of the rate paid to a physician
250.27 performing the same services. If a recipient is transported from a birth center to a hospital
250.28 prior to the delivery, a licensed traditional midwife who does not perform the delivery may
250.29 not bill for any delivery services. Services are not covered if provided by an unlicensed
250.30 traditional midwife.
250.31     (e) Licensed health professionals working in licensed birth centers shall be reimbursed
250.32 for the full range of maternity care and newborn care services within their scope of practice,
250.33 regardless of place of service. The commissioner shall review current birth center
  Article 8 Sec. 16.  250
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
251.1  reimbursement and, in consultation with birth centers currently licensed in the state, develop
251.2  revisions to current payment practices in order to ensure reimbursement for the full range
251.3  of maternity care and newborn care services, including but not limited to:
251.4      (1) professional services for intrapartum care when a recipient is transferred from a birth
251.5  center to a hospital prior to delivery;
251.6      (2) professional services billed with a home place of service code by a licensed health
251.7  professional within their scope of practice;
251.8      (3) professional services when a licensed health professional provides any
251.9  Minnesota-mandated newborn screening, including but not limited to the newborn metabolic
251.10 screen, CCHD screening, hearing screen, or any other medically necessary newborn
251.11 screening, test, or assessment; and
251.12     (4) telehealth services provided by any licensed health professional working in a birth
251.13 center.
251.14     (f) Managed care organizations and county-based purchasing plans contracted to provide
251.15 medical assistance coverage under section 256B.69 shall reimburse licensed birth centers
251.16 and licensed health professionals working in licensed birth centers for the full range of
251.17 maternity care services within their scope of practice, regardless of place of service, as
251.18 determined in paragraph (e) at no less than the medical assistance fee for service fee schedule
251.19 for the year in which the service is provided. If, for any contract year, federal approval is
251.20 not received for this paragraph, the commissioner must adjust the capitation rates paid to
251.21 managed care plans and county-based purchasing plans for that contract year to reflect the
251.22 removal of this paragraph. Contracts between managed care plans and county-based
251.23 purchasing plans and providers to whom this paragraph applies must allow recovery of
251.24 payments from those providers if capitation rates are adjusted in accordance with this
251.25 paragraph. Payment recoveries must not exceed the amount equal to any increase in rates
251.26 that results from this paragraph. This paragraph expires if federal approval is not received
251.27 for this paragraph at any time.
251.28     (e) (g) The commissioner shall apply for any necessary waivers from the Centers for
251.29 Medicare and Medicaid Services to allow birth centers and birth center providers to be
251.30 reimbursed.
251.31     EFFECTIVE DATE. This section is effective January 1, 2026, or upon federal approval,
251.32 whichever is later. The commissioner of human services shall notify the revisor of statutes
251.33 when federal approval is obtained.
  Article 8 Sec. 16.  251
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
252.1    Sec. 17. Minnesota Statutes 2024, section 256B.0625, is amended by adding a subdivision
252.2  to read:
252.3      Subd. 54a. Home birth. (a) For purposes of this subdivision, the following terms have
252.4  the meanings given:
252.5      (1) "birth services" means prenatal, labor, birth, and postpartum services;
252.6      (2) "eligible provider" means a licensed or certified health care professional eligible for
252.7  reimbursement under the medical assistance program; and
252.8      (3) "low-risk patient for birth services" means a person undergoing a normal,
252.9  uncomplicated prenatal course as determined by documentation of adequate prenatal care
252.10 whose treating provider anticipates a normal, uncomplicated labor and birth, as defined by
252.11 reasonable and generally accepted criteria adopted by professional groups for maternal,
252.12 fetal, and neonatal health care.
252.13     (b) Medical assistance covers birth services provided at home when the following
252.14 conditions are met:
252.15     (1) the birth services are provided by an eligible provider whose scope of practice and
252.16 experience includes home birth;
252.17     (2) the recipient is a low-risk patient for birth services; and
252.18     (3) the recipient has a plan of care that includes:
252.19     (i) a consent form detailing the risks and benefits of home birth signed by the recipient;
252.20     (ii) sufficient visits, test results, and follow-up consultations as needed to establish that
252.21 the recipient is a low-risk patient for birth services; and
252.22     (iii) a plan for transfer to a hospital as needed.
252.23     (c) Services provided under this subdivision by an eligible provider must be paid at a
252.24 rate at least equal to 100 percent of the rate paid to a physician performing the same services.
252.25 An eligible provider who does not perform the delivery must not bill for any delivery
252.26 services.
252.27     (d) Supplies used for birth services under this subdivision must be paid at 70 percent of
252.28 the statewide average for a facility payment rate made to a hospital for an uncomplicated
252.29 vaginal delivery as determined using the most recent calendar year for which complete
252.30 claims data are available. If a recipient is transported from a home to a hospital prior to the
252.31 delivery, the payment for the supplies used for birth services under this subdivision must
252.32 be the lower of billed charges or 15 percent of the statewide average for a facility payment
  Article 8 Sec. 17.  252
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
253.1  rate made to a hospital for the services provided for an uncomplicated vaginal delivery as
253.2  determined using the most recent calendar year for which complete claims data are available.
253.3      EFFECTIVE DATE. This section is effective January 1, 2026, or upon federal approval,
253.4  whichever is later. The commissioner of human services shall notify the revisor of statutes
253.5  when federal approval is obtained.
253.6    Sec. 18. Minnesota Statutes 2024, section 256B.0757, subdivision 5, is amended to read:
253.7      Subd. 5. Payments. (a) The commissioner shall make payments to each designated
253.8  provider for the provision of health home services described in subdivision 3 to each eligible
253.9  individual under subdivision 2 that selects the health home as a provider. This paragraph
253.10 expires on the date that paragraph (b) becomes effective.
253.11     (b) Effective January 1, 2026, or upon federal approval, whichever is later, the
253.12 commissioner shall make payments to each designated provider for the provision of health
253.13 home services described in subdivision 3, except for behavioral health services, to each
253.14 eligible individual under subdivision 2 who selects the health home as a provider.
253.15   Sec. 19. Minnesota Statutes 2024, section 256B.0757, is amended by adding a subdivision
253.16 to read:
253.17     Subd. 5a. Payments for behavioral health home services. (a) For services rendered
253.18 on or after January 1, 2026, or on or after the date of federal approval, whichever is later,
253.19 and notwithstanding subdivision 5, the commissioner must implement a single statewide
253.20 reimbursement rate for behavioral health home services under this section. The rate must
253.21 be no less than $425 per member per month. The commissioner must adjust the
253.22 reimbursement rate for behavioral health home services annually according to the change
253.23 from the midpoint of the previous rate year to the midpoint of the rate year for which the
253.24 rate is being determined using the Centers for Medicare and Medicaid Services Medicare
253.25 Economic Index as forecasted in the fourth quarter of the calendar year before the rate year.
253.26     (b) The commissioner must review and update the behavioral health home services rate
253.27 under paragraph (a) at least every four years. The updated rate must account for the average
253.28 hours required for behavioral health home team members spent providing services and the
253.29 Department of Labor prevailing wage for required behavioral health home team members.
253.30 The updated rate must ensure that behavioral health home services rates are sufficient to
253.31 allow providers to meet required certifications, training, and practice transformation
253.32 standards; staff qualification requirements; and service delivery standards.
  Article 8 Sec. 19.  253
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
254.1      (c) Managed care plans and county-based purchasing plans must reimburse providers
254.2  at an amount that is at least equal to the fee-for-service rate for services under this
254.3  subdivision. The commissioner must monitor the effect of this rate increase on enrollee
254.4  access to services under this subdivision. If for any contract year federal approval is not
254.5  received for this paragraph, the commissioner must adjust the capitation rates paid to managed
254.6  care plans and county-based purchasing plans for that contract year to reflect the removal
254.7  of this paragraph. Contracts between managed care plans and county-based purchasing
254.8  plans and providers to whom this paragraph applies must allow recovery of payments from
254.9  those providers if capitation rates are adjusted in accordance with this paragraph. Payment
254.10 recoveries must not exceed the amount equal to any increase in rates that results from this
254.11 paragraph.
254.12     EFFECTIVE DATE. This section is effective on the latest of the following: (1) January
254.13 1, 2026; (2) federal approval of the medical assistance program changes in this section; or
254.14 (3) federal approval of all necessary federal waivers to implement the managed care
254.15 organization assessment in Minnesota Statutes, section 295.525. The commissioner of
254.16 human services shall notify the revisor of statutes when federal approval is obtained.
254.17   Sec. 20. Minnesota Statutes 2024, section 256B.1973, subdivision 5, is amended to read:
254.18     Subd. 5. Commissioner's duties; state-directed fee schedule requirement. (a) For
254.19 each federally approved directed payment arrangement under this section that is a
254.20 state-directed fee schedule requirement, the commissioner shall determine a uniform
254.21 adjustment factor to be applied to each claim submitted by an eligible provider to a health
254.22 plan. The uniform adjustment factor shall be determined using the average commercial
254.23 payer rate or using another method acceptable to the Centers for Medicare and Medicaid
254.24 Services if the average commercial payer rate is not approved, minus the amount necessary
254.25 for the plan to satisfy tax liabilities under sections 256.9657 and 297I.05 attributable to the
254.26 directed payment arrangement. The commissioner shall ensure that the application of the
254.27 uniform adjustment factor maximizes the allowable directed payments and does not result
254.28 in payments exceeding federal limits, and may use an annual settle-up process. The directed
254.29 payment shall may be specific to each health plan and prospectively incorporated into
254.30 capitation payments for that plan.
254.31     (b) For each federally approved directed payment arrangement that is a state-directed
254.32 fee schedule requirement, the commissioner shall develop a plan for the initial
254.33 implementation of the state-directed fee schedule requirement to ensure that the eligible
254.34 provider receives the entire permissible value of the federally approved directed payment
  Article 8 Sec. 20.  254
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
255.1  arrangement. If federal approval of a directed payment arrangement under this subdivision
255.2  is retroactive, the commissioner shall make a onetime pro rata increase to the uniform
255.3  adjustment factor and the initial payments in order to include claims submitted between the
255.4  retroactive federal approval date and the period captured by the initial payments.
255.5    Sec. 21. Minnesota Statutes 2024, section 256B.1973, is amended by adding a subdivision
255.6  to read:
255.7      Subd. 9. Interaction with other directed payments. An eligible provider under
255.8  subdivision 3 may participate in the hospital directed payment program under section
255.9  256B.1974 for inpatient hospital services, outpatient hospital services, or both. A provider
255.10 participating in the hospital directed payment program must not receive a directed payment
255.11 under this section for any provider classes paid via the hospital directed payment program.
255.12 A hospital subject to this section must notify the commissioner in writing no later than 30
255.13 days after enactment of this subdivision of the hospital's intention to participate in the
255.14 hospital directed payment program under section 256B.1974 for inpatient hospital services,
255.15 outpatient hospital services, or both. The election under this subdivision is a onetime election,
255.16 except that if an eligible provider elects to participate in the hospital directed payment
255.17 program, and the hospital directed payment program expires or is not federally approved,
255.18 the eligible provider may subsequently elect to participate in the directed payment under
255.19 this section.
255.20     EFFECTIVE DATE. (a) This section is effective on the later of January 1, 2026, or
255.21 federal approval of all of the following:
255.22     (1) the waiver for the assessment required under Minnesota Statutes, section 256.9657,
255.23 subdivision 2b; and
255.24     (2) the hospital directed payment program under Minnesota Statutes, section 256B.1974.
255.25     (b) The commissioner of human services shall notify the revisor of statutes when federal
255.26 approval is obtained.
255.27   Sec. 22. [256B.1974] HOSPITAL DIRECTED PAYMENT PROGRAM.
255.28     Subdivision 1. Definitions. (a) For the purposes of this section, the following terms have
255.29 the meanings given.
255.30     (b) "Eligible hospital" has the meaning given in section 256.9657, subdivision 2b,
255.31 paragraph (a), clause (1).
  Article 8 Sec. 22.  255
  06/07/25  REVISOR        DTT/LN  25-05697  as introduced
256.1      (c) "Health plan" means a managed care plan or county-based purchasing plan that is
256.2  under contract with the commissioner to deliver services to medical assistance enrollees
256.3  under section 256B.69 or 256B.692.
256.4      Subd. 2. Required conditions for program. The hospital directed payment program
256.5  must conform with the requirements for permissible directed managed care organization
256.6  expenditures under section 256B.6928, subdivision 5.
256.7      Subd. 3. Commissioner's duties; state-directed fee schedule requirement. (a) For
256.8  each federally approved directed payment program that is a state-directed fee schedule
256.9  requirement that includes a quarterly payment amount to be submitted by each health plan
256.10 to each eligible hospital, the commissioner must determine the quarterly payment amount
256.11 using the statewide average commercial payer rate, or using another method acceptable to
256.12 the Centers for Medicare and Medicaid Services if the statewide average commercial payer
256.13 rate is not approved. The commissioner must ensure that the application of the quarterly
256.14 payment amounts maximizes the amount generated by the hospital assessment in section
256.15 256.9657, subdivision 2b, for allowable directed payments and does not result in payments
256.16 exceeding federal limits.
256.17     (b) The commissioner must use an annual settle-up process to determine the accuracy
256.18 of the amounts paid by the commissioner to health plans for directed payments to hospitals
256.19 under this section. The commissioner's settle-up determination must occur within one year
256.20 of the payment of the applicable amounts to health plans. If the commissioner determines
256.21 the amount paid to a health plan exceeds or is less than the amount required under this
256.22 section, the commissioner must pay an additional amount to the health plan for directed
256.23 payments to hospitals or require a refund from the health plan for an overpayment. Any
256.24 additional amount required to be paid by the commissioner to a health plan, or any refund
256.25 to the commissioner from a health plan, must be paid by the immediately following April
256.26 1. Additional amounts received by a health plan under this paragraph must be paid to the
256.27 eligible hospital in accordance with this section. Any refund amount the commissioner
256.28 determines is owed by a health plan under this paragraph must be paid back by the eligible
256.29 hospital in accordance with this section.
256.30     (c) On and after January 1, 2028, if the federal regulations set forth in Code of Federal
256.31 Regulations, title 42, parts 430, 438, and 457, and applicable to this section remain effective,
256.32 the hospital directed payment program may be specific to each health plan and prospectively
256.33 incorporated into capitation payments for that plan.
  Article 8 Sec. 22.  256
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
257.1      (d) For each federally approved directed payment program under this section that is a
257.2  state-directed fee schedule requirement, the commissioner must develop a plan for the initial
257.3  implementation of the state-directed fee schedule requirement to ensure that eligible hospitals
257.4  receive the entire permissible value of the federally approved directed payment.
257.5      (e) Directed payments under this section must only be used to supplement, and not
257.6  supplant, medical assistance reimbursement to eligible hospitals. The directed payment
257.7  program must not modify, reduce, or offset the medical assistance payment rates determined
257.8  for each eligible hospital as required by section 256.969.
257.9      (f) The commissioner must require health plans to make quarterly directed payments
257.10 according to this section.
257.11     (g) Health plans must make quarterly directed payments using electronic funds transfers,
257.12 if the eligible hospital provides the information necessary to process such transfers, and in
257.13 accordance with directions provided by the commissioner. Health plans must make quarterly
257.14 directed payments:
257.15     (1) for the first two quarters for which such payments are due, within 30 calendar days
257.16 of the date the commissioner issued sufficient payments to the health plan to make the
257.17 directed payments according to this section; and
257.18     (2) for all subsequent quarters, within ten calendar days of the date the commissioner
257.19 issued sufficient payments to the health plan to make the directed payments according to
257.20 this section.
257.21     (h) The commissioner of human services must publish on the Department of Human
257.22 Services website, on a quarterly basis, the dates that the health plans completed their required
257.23 quarterly payments under this section.
257.24     (i) Payments to health plans that would be paid consistent with actuarial certification
257.25 and enrollment in the absence of the increased capitation payments under this section must
257.26 not be reduced as a result of this section.
257.27     (j) The commissioner must publish all directed payments resulting from this section
257.28 owed to each eligible hospital from each health plan on the Department of Human Services
257.29 website for at least two years. All calculations and reports must be posted no later than the
257.30 first day of the quarter for which the payments are to be issued.
257.31     (k) By December 1 each year, the commissioner must notify each eligible hospital of
257.32 any changes to the payment methodologies in this section, including but not limited to
257.33 changes in the directed payment rates, the aggregate directed payment amount for all eligible
  Article 8 Sec. 22.  257
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
258.1  hospitals, and the eligible hospital's directed payment amount for the upcoming calendar
258.2  year.
258.3      (l) The commissioner must pay the amounts to be used for the directed payments to
258.4  health plans under contract no later than January 1, April 1, July 1, and October 1 each year.
258.5      (m) A hospital is not entitled to payments under this section unless it is an eligible
258.6  hospital. An eligible hospital that has merged with another hospital must have the surviving
258.7  hospital's payments under this section revised at the start of the hospital's first full fiscal
258.8  year after the merger is complete. A closed eligible hospital is entitled to the payments under
258.9  this section for services provided through the final date of operations.
258.10     Subd. 4. Health plan duties; submission of claims. Each health plan must submit to
258.11 the commissioner, in accordance with its contract with the commissioner to serve as a
258.12 managed care organization in medical assistance, payment information for each claim paid
258.13 to an eligible hospital for services provided to a medical assistance enrollee. Health plans
258.14 must allow each eligible hospital to review the health plan's own paid claims detail to enable
258.15 proper validation that the medical assistance managed care claims volume and content is
258.16 consistent with the eligible hospital's internal records. To support the validation process for
258.17 the directed payment program, health plans must permit the commissioner to share inpatient
258.18 and outpatient claims-level details with eligible hospitals identifying only those claims
258.19 where the prepaid medical assistance program under section 256B.69 or 256B.692 is the
258.20 payer source. Eligible hospitals may request claims-level detail once annually and must
258.21 provide notice of discrepancies in claims paid to the commissioner in a form determined
258.22 by the commissioner. The commissioner is authorized to determine the final disposition of
258.23 the validation process for disputed claims.
258.24     Subd. 5. Health plan duties; directed payment add-on. (a) Each health plan must
258.25 make, in accordance with its contract with the commissioner to serve as a managed care
258.26 organization in medical assistance, a directed payment to each eligible hospital. The amount
258.27 of the directed payment to the eligible hospital must be equal to the payment amounts the
258.28 plan received from the commissioner for the hospital under this section.
258.29     (b) Health plans are prohibited from:
258.30     (1) setting, establishing, or negotiating reimbursement rates with an eligible hospital in
258.31 a manner that directly or indirectly takes into account a directed payment that a hospital
258.32 receives under this section;
258.33     (2) unnecessarily delaying a directed payment to an eligible hospital; or
  Article 8 Sec. 22.  258
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
259.1      (3) recouping or offsetting a directed payment for any reason, except as expressly
259.2  authorized by the commissioner.
259.3      Subd. 6. Hospital duties; quarterly supplemental directed payment add-on. (a) An
259.4  eligible hospital receiving a directed payment under this section is prohibited from:
259.5      (1) setting, establishing, or negotiating reimbursement rates with a managed care
259.6  organization in a manner that directly or indirectly takes into account a directed payment
259.7  that an eligible hospital receives under this section; or
259.8      (2) directly passing on the cost of an assessment to patients or nonmedical assistance
259.9  payers, including as a fee or rate increase.
259.10     (b) An eligible hospital that violates this subdivision is prohibited from receiving a
259.11 directed payment under this section for the remainder of the calendar year. This subdivision
259.12 does not prohibit an eligible hospital from negotiating with a payer for a rate increase.
259.13     Subd. 7. State minimum policy goals established. (a) The effect of the directed
259.14 payments under this section must align with the state's policy goals for medical assistance
259.15 enrollees. The directed payments must be used to maintain quality and access to a full range
259.16 of health care delivery mechanisms for medical assistance enrollees, and specifically provide
259.17 improvement for one of the following quality measures:
259.18     (1) overall well child visit rates;
259.19     (2) maternal depression screening rates; or
259.20     (3) colon cancer screening rates.
259.21     (b) The commissioner, in consultation with the Minnesota Hospital Association, must
259.22 submit to the Centers for Medicare and Medicaid Services quality measures performance
259.23 evaluation criteria and a methodology to regularly measure access to care and the
259.24 achievement of state policy goals described in this subdivision.
259.25     (c) The quality measures evaluation data, as determined by paragraph (b), must be
259.26 reported to the Centers for Medicare and Medicaid Services after at least 12 months of
259.27 directed payments to hospitals.
259.28     Subd. 8. Administrative review. Before making the payments required under this
259.29 section, and on at least an annual basis, the commissioner must consult with and provide
259.30 for review of the payment amounts by a permanent select committee established by the
259.31 Minnesota Hospital Association. Any data or information reviewed by members of the
  Article 8 Sec. 22.  259
  06/07/25  REVISOR        DTT/LN  25-05697  as introduced
260.1  committee are data not on individuals, as defined in section 13.02. The committee's members
260.2  may not include any current employee or paid consultant of any hospital.
260.3      EFFECTIVE DATE. (a) This section is effective the later of January 1, 2026, or federal
260.4  approval of all of the following:
260.5      (1) the waiver for the assessment required under Minnesota Statutes, section 256.9657,
260.6  subdivision 2b; and
260.7      (2) the hospital directed payment program under this section and any conforming changes
260.8  to the directed payment program under Minnesota Statutes, section 256B.1973.
260.9      (b) The commissioner of human services shall notify the revisor of statutes when federal
260.10 approval is obtained.
260.11   Sec. 23. [256B.1975] HOSPITAL DIRECTED PAYMENT PROGRAM ACCOUNT.
260.12     Subdivision 1. Account established; appropriation. (a) The hospital directed payment
260.13 program account is created in the special revenue fund in the state treasury.
260.14     (b) Money in the account, including interest earned, is annually appropriated to the
260.15 commissioner of human services for the purposes specified in section 256B.1974.
260.16     (c) Transfers from this account to another fund are prohibited, except as necessary to
260.17 make the payments required under section 256B.1974.
260.18     Subd. 2. Reports to the legislature. By January 15, 2027, and each January 15 thereafter,
260.19 the commissioner must submit a report to the chairs and ranking minority members of the
260.20 legislative committees with jurisdiction over health and human services policy and finance
260.21 that details the activities and uses of money in the hospital directed payment program
260.22 account, including the metrics and outcomes of the policy goals established by section
260.23 256B.1974, subdivision 7.
260.24     EFFECTIVE DATE. (a) This section is effective on the later of January 1, 2026, or
260.25 federal approval of all of the following:
260.26     (1) the waiver for the assessment required under Minnesota Statutes, section 256.9657,
260.27 subdivision 2b; and
260.28     (2) the hospital directed payment program under Minnesota Statutes, section 256B.1974,
260.29 and any conforming changes to the directed payment program under Minnesota Statutes,
260.30 section 256B.1973.
  Article 8 Sec. 23.  260
  06/07/25  REVISOR        DTT/LN  25-05697  as introduced
261.1      (b) The commissioner of human services shall notify the revisor of statutes when federal
261.2  approval is obtained.
261.3    Sec. 24. Minnesota Statutes 2024, section 256B.69, subdivision 3a, is amended to read:
261.4      Subd. 3a. County authority. (a) The commissioner, when implementing the medical
261.5  assistance prepayment program within a county, must include the county board in the process
261.6  of development, approval, and issuance of the request for proposals to provide services to
261.7  eligible individuals within the proposed county. County boards must be given reasonable
261.8  opportunity to make recommendations regarding the development, issuance, review of
261.9  responses, and changes needed in the request for proposals. The commissioner must provide
261.10 county boards the opportunity to review each proposal based on the identification of
261.11 community needs under chapters 142F and 145A and county advocacy activities. If a county
261.12 board finds that a proposal does not address certain community needs, the county board and
261.13 commissioner shall continue efforts for improving the proposal and network prior to the
261.14 approval of the contract. The county board shall make recommendations regarding the
261.15 approval of local networks and their operations to ensure adequate availability and access
261.16 to covered services. The provider or health plan must respond directly to county advocates
261.17 and the state prepaid medical assistance ombudsperson regarding service delivery and must
261.18 be accountable to the state regarding contracts with medical assistance funds. The county
261.19 board may recommend a maximum number of participating health plans after considering
261.20 the size of the enrolling population; ensuring adequate access and capacity; considering the
261.21 client and county administrative complexity; and considering the need to promote the
261.22 viability of locally developed health plans. The county board or a single entity representing
261.23 a group of county boards and the commissioner shall mutually select health plans for
261.24 participation at the time of initial implementation of the prepaid medical assistance program
261.25 in that county or group of counties and at the time of contract renewal. The commissioner
261.26 shall also seek input for contract requirements from the county or single entity representing
261.27 a group of county boards at each contract renewal and incorporate those recommendations
261.28 into the contract negotiation process.
261.29     (b) At the option of the county board, the board may develop contract requirements
261.30 related to the achievement of local public health goals to meet the health needs of medical
261.31 assistance enrollees. These requirements must be reasonably related to the performance of
261.32 health plan functions and within the scope of the medical assistance benefit set. If the county
261.33 board and the commissioner mutually agree to such requirements, the department shall
261.34 include such requirements in all health plan contracts governing the prepaid medical
261.35 assistance program in that county at initial implementation of the program in that county
  Article 8 Sec. 24.  261
  06/07/25  REVISOR        DTT/LN  25-05697  as introduced
262.1  and at the time of contract renewal. The county board may participate in the enforcement
262.2  of the contract provisions related to local public health goals.
262.3      (c) For counties in which a prepaid medical assistance program has not been established,
262.4  the commissioner shall not implement that program if a county board submits an acceptable
262.5  and timely preliminary and final proposal under section 256B.692, until county-based
262.6  purchasing is no longer operational in that county. For counties in which a prepaid medical
262.7  assistance program is in existence on or after September 1, 1997, the commissioner must
262.8  terminate contracts with health plans according to section 256B.692, subdivision 5, if the
262.9  county board submits and the commissioner accepts a preliminary and final proposal
262.10 according to that subdivision. The commissioner is not required to terminate contracts that
262.11 begin on or after September 1, 1997, according to section 256B.692 until two years have
262.12 elapsed from the date of initial enrollment. This paragraph expires upon the effective date
262.13 of paragraph (d).
262.14     (d) For counties in which a prepaid medical assistance program is in existence on or
262.15 after September 1, 1997, the commissioner must terminate contracts with health plans
262.16 according to section 256B.692, subdivision 5, if the county board submits and the
262.17 commissioner accepts a preliminary and final proposal according to that subdivision. This
262.18 paragraph is effective January 1, 2027, or upon federal approval, whichever is later. The
262.19 commissioner of human services shall notify the revisor of statutes when federal approval
262.20 is obtained.
262.21     (d) (e) In the event that a county board or a single entity representing a group of county
262.22 boards and the commissioner cannot reach agreement regarding: (i) the selection of
262.23 participating health plans in that county; (ii) contract requirements; or (iii) implementation
262.24 and enforcement of county requirements including provisions regarding local public health
262.25 goals, the commissioner shall resolve all disputes after taking into account the
262.26 recommendations of a three-person mediation panel. The panel shall be composed of one
262.27 designee of the president of the association of Minnesota counties, one designee of the
262.28 commissioner of human services, and one person selected jointly by the designee of the
262.29 commissioner of human services and the designee of the Association of Minnesota Counties.
262.30 Within a reasonable period of time before the hearing, the panelists must be provided all
262.31 documents and information relevant to the mediation. The parties to the mediation must be
262.32 given 30 days' notice of a hearing before the mediation panel.
262.33     (e) (f) If a county which elects to implement county-based purchasing ceases to implement
262.34 county-based purchasing, it is prohibited from assuming the responsibility of county-based
262.35 purchasing for a period of five years from the date it discontinues purchasing.
  Article 8 Sec. 24.  262
  06/07/25  REVISOR        DTT/LN  25-05697  as introduced
263.1      (f) (g) The commissioner shall not require that contractual disputes between county-based
263.2  purchasing entities and the commissioner be mediated by a panel that includes a
263.3  representative of the Minnesota Council of Health Plans.
263.4      (g) (h) At the request of a county-purchasing entity, the commissioner shall adopt a
263.5  contract reprocurement or renewal schedule under which all counties included in the entity's
263.6  service area are reprocured or renewed at the same time.
263.7      (h) (i) The commissioner shall provide a written report under section 3.195 to the chairs
263.8  of the legislative committees having jurisdiction over human services in the senate and the
263.9  house of representatives describing in detail the activities undertaken by the commissioner
263.10 to ensure full compliance with this section. The report must also provide an explanation for
263.11 any decisions of the commissioner not to accept the recommendations of a county or group
263.12 of counties required to be consulted under this section. The report must be provided at least
263.13 30 days prior to the effective date of a new or renewed prepaid or managed care contract
263.14 in a county.
263.15     EFFECTIVE DATE. This section is effective the day following final enactment.
263.16   Sec. 25. [256B.695] COUNTY-ADMINISTERED RURAL MEDICAL ASSISTANCE
263.17 PROGRAM.
263.18     Subdivision 1. Definitions. (a) For the purposes of this section, the following terms have
263.19 the meanings given.
263.20     (b) "CARMA" means the county-administered rural medical assistance program
263.21 established under this section.
263.22     (c) "Commissioner" means the commissioner of human services.
263.23     (d) "Eligible individual" means an individual who is:
263.24     (1) residing in a county administering CARMA; and
263.25     (2) eligible for medical assistance, MinnesotaCare, Minnesota Senior Health Options
263.26 (MSHO), Minnesota Senior Care Plus (MSC+), or Special Needs Basic Care (SNBC).
263.27     (e) "Enrollee" means an individual enrolled in CARMA.
263.28     (f) "PMAP" means the prepaid medical assistance program under section 256B.69.
263.29     (g) "Rural county" has the meaning given to "rural area" in Code of Federal Regulations,
263.30 title 42, section 438.52.
263.31     Subd. 2. Program established. CARMA is established to:
  Article 8 Sec. 25.  263
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
264.1      (1) provide a county-owned and county-administered alternative to PMAP;
264.2      (2) facilitate integration of health care, public health, and social services to address
264.3  health-related social needs in rural communities;
264.4      (3) account for the fewer enrollees and local providers of health care and community
264.5  services in rural communities; and
264.6      (4) promote accountability for health outcomes, health equity, customer service,
264.7  community outreach, and cost of care.
264.8      Subd. 3. County participation. Each county or group of counties authorized under
264.9  section 256B.692 may administer CARMA for any or all eligible individuals as an alternative
264.10 to PMAP, MinnesotaCare, MSHO, MSC+, or SNBC programs. Counties choosing and
264.11 authorized to administer CARMA are exempt from the procurement process as required
264.12 under section 256B.69.
264.13     Subd. 4. Oversight and regulation. CARMA is governed by sections 256B.69 and
264.14 256B.692, unless otherwise provided for under this section. The commissioner must develop
264.15 and implement a procurement process requiring applications from county-based purchasing
264.16 plans interested in offering CARMA. The procurement process must require county-based
264.17 purchasing plans to demonstrate compliance with federal and state regulatory requirements
264.18 and the ability to meet the goals of the program set forth in subdivision 2. The commissioner
264.19 must review and approve or disapprove applications.
264.20     Subd. 5. CARMA enrollment. (a) Subject to paragraphs (d) and (e), eligible individuals
264.21 must be automatically enrolled in CARMA, but may decline enrollment. Eligible individuals
264.22 may enroll in fee-for-service medical assistance. Eligible individuals may change their
264.23 CARMA elections on an annual basis.
264.24     (b) Eligible individuals must be able to enroll in CARMA through the selection process
264.25 in accordance with the election period established in section 256B.69, subdivision 4,
264.26 paragraph (e).
264.27     (c) Enrollees who were not previously enrolled in the medical assistance program or
264.28 MinnesotaCare can change their selection once within the first year after enrollment in
264.29 CARMA. Enrollees who were not previously enrolled in CARMA have 90 days to make a
264.30 change and changes are allowed for additional special circumstances.
264.31     (d) The commissioner may offer a second health plan other than, and in addition to,
264.32 CARMA to eligible individuals when another health plan is required by federal law or rule.
264.33 The commissioner may offer a replacement plan to eligible individuals, as determined by
  Article 8 Sec. 25.  264
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
265.1  the commissioner, when counties administering CARMA have their contract terminated
265.2  for cause.
265.3      (e) The commissioner may, on a county-by-county basis, offer a health plan other than,
265.4  and in addition to, CARMA to individuals who are eligible for both Medicare and medical
265.5  assistance due to age or disability if the commissioner deems it necessary for enrollees to
265.6  have another choice of health plan. Factors the commissioner must consider when
265.7  determining if the other health plan is necessary include the number of available Medicare
265.8  Advantage Plan options that are not special needs plans in the county, the size of the enrolling
265.9  population, the additional administrative burden placed on providers and counties by multiple
265.10 health plan options in a county, the need to ensure the viability and success of the CARMA
265.11 program, and the impact to the medical assistance program.
265.12     (f) In counties where the commissioner is required by federal law or elects to offer a
265.13 second health plan other than CARMA pursuant to paragraphs (d) and (e), eligible enrollees
265.14 who do not select a health plan at the time of enrollment must automatically be enrolled in
265.15 CARMA.
265.16     (g) This subdivision supersedes section 256B.694.
265.17     Subd. 6. Benefits and services. (a) Counties or groups of counties administering CARMA
265.18 must cover all benefits and services required to be covered by medical assistance under
265.19 section 256B.0625.
265.20     (b) Counties or groups of counties administering CARMA may reimburse enrollees
265.21 directly for out-of-pocket costs incurred obtaining assessed HRSN services provided by
265.22 nontraditional providers who are unable to accept payment via traditional health insurance
265.23 methods. Enrollees must not be reimbursed for out-of-pocket costs paid to providers eligible
265.24 to enroll.
265.25     Subd. 7. Payment. (a) The commissioner, in consultation with counties and groups of
265.26 counties administering CARMA, must develop a mechanism for making payments to
265.27 counties and groups of counties that administer CARMA. The payment mechanism must:
265.28     (1) be governed by contracts with terms, including but not limited to payment rates,
265.29 amended on an as-needed basis;
265.30     (2) pay a full-risk monthly capitation payment for services included in CARMA, including
265.31 the cost for administering CARMA benefits and services;
265.32     (3) include risk corridors based on minimum loss ratio, total cost of care, or other metrics;
  Article 8 Sec. 25.  265
  06/07/25  REVISOR        DTT/LN  25-05697  as introduced
266.1      (4) include a settle-up process tied to the risk corridor arrangement allowing a county
266.2  or group of counties administering CARMA to retain savings for reinvestment in health
266.3  care activities and operations to protect against significant losses that a county or group of
266.4  counties administering CARMA or the state might realize, beginning no sooner than after
266.5  a county's or group of counties' third year of CARMA operations;
266.6      (5) include a collaborative rate-setting process accounting for CARMA experience,
266.7  regional experience, and the Department of Human Services fee-for-service experience;
266.8  and
266.9      (6) be exempt from section 256B.69, subdivisions 5a, paragraphs (c) and (f), and 5d,
266.10 and payment for Medicaid services provided under section 256B.69, subdivision 28,
266.11 paragraph (b), no sooner than three years after CARMA implementation.
266.12     (b) Payments for benefits and services under subdivision 6, paragraph (a), must not
266.13 exceed payments that otherwise would have been paid to health plans under medical
266.14 assistance for that county or region.
266.15     Subd. 8. Quality measures. (a) The commissioner and counties and groups of counties
266.16 administering CARMA must collaborate to establish quality measures for CARMA not to
266.17 exceed the extent of quality measures required under sections 256B.69 and 256B.692. The
266.18 measures must include:
266.19     (1) enrollee experience and outcomes;
266.20     (2) population health;
266.21     (3) health equity; and
266.22     (4) the value of health care spending.
266.23     (b) The commissioner and counties and groups of counties administering CARMA must
266.24 collaborate to define a quality improvement model for CARMA. The model must include
266.25 a focus on locally specified measures based on counties' unique needs. The locally specified
266.26 measures for the county or group of counties administering CARMA must be determined
266.27 before the commissioner enters into any contract with a county or group of counties.
266.28     Subd. 9. Data and systems integration. The commissioner and counties and groups of
266.29 counties administering CARMA must collaborate to:
266.30     (1) identify and address barriers that prevent counties and groups of counties
266.31 administering CARMA from reviewing individual enrollee eligibility information to identify
266.32 eligibility and to help enrollees apply for other appropriate programs and resources;
  Article 8 Sec. 25.  266
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
267.1      (2) identify and address barriers preventing counties and groups of counties administering
267.2  CARMA from more readily communicating with and educating potential and current
267.3  enrollees regarding other program opportunities, including helping enrollees apply for those
267.4  programs and navigate transitions between programs;
267.5      (3) develop and test, in counties participating in CARMA, a universal public assistance
267.6  application form to reduce the administrative barriers associated with applying for and
267.7  participating in various public programs;
267.8      (4) identify and address regulatory and system barriers that may prohibit counties and
267.9  groups of counties administering CARMA, agencies, and other partners from working
267.10 together to identify and address an individual's needs;
267.11     (5) facilitate greater interoperability between counties and groups of counties
267.12 administering CARMA, agencies, and other partners to send and receive the data necessary
267.13 to support CARMA, counties, and local health system efforts to improve the health and
267.14 welfare of prospective and enrolled populations;
267.15     (6) support efforts of counties and groups of counties administering CARMA to
267.16 incorporate the necessary automation and interoperability to eliminate manual processes
267.17 when related to the data exchanged; and
267.18     (7) support the creation and maintenance by counties and groups of counties administering
267.19 CARMA of an updated electronic inventory of community resources available to assist the
267.20 enrollee in the enrollee's HRSN, including an electronic closed-loop referral system.
267.21     EFFECTIVE DATE. This section is effective January 1, 2027, or upon federal approval,
267.22 whichever is later. The commissioner of human services shall notify the revisor of statutes
267.23 when federal approval is obtained.
267.24   Sec. 26. Minnesota Statutes 2024, section 256B.76, subdivision 1, is amended to read:
267.25     Subdivision 1. Physician and professional services reimbursement adjustments. (a)
267.26 Effective for services rendered on or after October 1, 1992, the commissioner shall make
267.27 payments for physician services as follows:
267.28     (1) payment for level one Centers for Medicare and Medicaid Services' common
267.29 procedural coding system codes titled "office and other outpatient services," "preventive
267.30 medicine new and established patient," "delivery, antepartum, and postpartum care," "critical
267.31 care," cesarean delivery and pharmacologic management provided to psychiatric patients,
267.32 and level three codes for enhanced services for prenatal high risk, shall be paid at the lower
267.33 of (i) submitted charges, or (ii) 25 percent above the rate in effect on June 30, 1992;
  Article 8 Sec. 26.  267
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
268.1      (2) payments for all other services shall be paid at the lower of (i) submitted charges,
268.2  or (ii) 15.4 percent above the rate in effect on June 30, 1992; and
268.3      (3) all physician rates shall be converted from the 50th percentile of 1982 to the 50th
268.4  percentile of 1989, less the percent in aggregate necessary to equal the above increases
268.5  except that payment rates for home health agency services shall be the rates in effect on
268.6  September 30, 1992.
268.7      (b) Effective for services rendered on or after January 1, 2000, payment rates for physician
268.8  and professional services shall be increased by three percent over the rates in effect on
268.9  December 31, 1999, except for home health agency and family planning agency services.
268.10 The increases in this paragraph shall be implemented January 1, 2000, for managed care.
268.11     (c) Effective for services rendered on or after July 1, 2009, payment rates for physician
268.12 and professional services shall be reduced by five percent, except that for the period July
268.13 1, 2009, through June 30, 2010, payment rates shall be reduced by 6.5 percent for the medical
268.14 assistance and general assistance medical care programs, over the rates in effect on June
268.15 30, 2009. This reduction and the reductions in paragraph (d) do not apply to office or other
268.16 outpatient visits, preventive medicine visits and family planning visits billed by physicians,
268.17 advanced practice registered nurses, or physician assistants in a family planning agency or
268.18 in one of the following primary care practices: general practice, general internal medicine,
268.19 general pediatrics, general geriatrics, and family medicine. This reduction and the reductions
268.20 in paragraph (d) do not apply to federally qualified health centers, rural health centers, and
268.21 Indian health services. Effective October 1, 2009, payments made to managed care plans
268.22 and county-based purchasing plans under sections 256B.69, 256B.692, and 256L.12 shall
268.23 reflect the payment reduction described in this paragraph.
268.24     (d) Effective for services rendered on or after July 1, 2010, payment rates for physician
268.25 and professional services shall be reduced an additional seven percent over the five percent
268.26 reduction in rates described in paragraph (c). This additional reduction does not apply to
268.27 physical therapy services, occupational therapy services, and speech pathology and related
268.28 services provided on or after July 1, 2010. This additional reduction does not apply to
268.29 physician services billed by a psychiatrist or an advanced practice registered nurse with a
268.30 specialty in mental health. Effective October 1, 2010, payments made to managed care plans
268.31 and county-based purchasing plans under sections 256B.69, 256B.692, and 256L.12 shall
268.32 reflect the payment reduction described in this paragraph.
268.33     (e) Effective for services rendered on or after September 1, 2011, through June 30, 2013,
268.34 payment rates for physician and professional services shall be reduced three percent from
  Article 8 Sec. 26.  268
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
269.1  the rates in effect on August 31, 2011. This reduction does not apply to physical therapy
269.2  services, occupational therapy services, and speech pathology and related services.
269.3      (f) Effective for services rendered on or after September 1, 2014, payment rates for
269.4  physician and professional services, including physical therapy, occupational therapy, speech
269.5  pathology, and mental health services shall be increased by five percent from the rates in
269.6  effect on August 31, 2014. In calculating this rate increase, the commissioner shall not
269.7  include in the base rate for August 31, 2014, the rate increase provided under section
269.8  256B.76, subdivision 7. This increase does not apply to federally qualified health centers,
269.9  rural health centers, and Indian health services. Payments made to managed care plans and
269.10 county-based purchasing plans shall not be adjusted to reflect payments under this paragraph.
269.11     (g) Effective for services rendered on or after July 1, 2015, payment rates for physical
269.12 therapy, occupational therapy, and speech pathology and related services provided by a
269.13 hospital meeting the criteria specified in section 62Q.19, subdivision 1, paragraph (a), clause
269.14 (4), shall be increased by 90 percent from the rates in effect on June 30, 2015. Payments
269.15 made to managed care plans and county-based purchasing plans shall not be adjusted to
269.16 reflect payments under this paragraph.
269.17     (h) Any ratables effective before July 1, 2015, do not apply to early intensive
269.18 developmental and behavioral intervention (EIDBI) benefits described in section 256B.0949.
269.19     (i) The commissioner may reimburse physicians and other licensed professionals for
269.20 costs incurred to pay the fee for testing newborns who are medical assistance enrollees for
269.21 heritable and congenital disorders under section 144.125, subdivision 1, paragraph (c), when
269.22 the sample is collected outside of an inpatient hospital or freestanding birth center and the
269.23 cost is not recognized by another payment source.
269.24     EFFECTIVE DATE. This section is effective January 1, 2026, or upon federal approval
269.25 of the amendments in this act to Minnesota Statutes, section 256B.0625, subdivision 54,
269.26 whichever is later. The commissioner of human services shall notify the revisor of statutes
269.27 when federal approval is obtained.
269.28   Sec. 27. Minnesota Statutes 2024, section 256B.76, is amended by adding a subdivision
269.29 to read:
269.30     Subd. 1a. Certain long-term ambulatory electrocardiogram monitoring services. (a)
269.31 For the purpose of this subdivision, "long-term ambulatory electrocardiogram monitoring
269.32 services" means the provision of external cardiac patch monitoring devices to patients to
269.33 wear for 48 hours or greater and the interpretation of data gathered by such devices to detect
  Article 8 Sec. 27.  269
  06/07/25  REVISOR        DTT/LN  25-05697  as introduced
270.1  heart arrhythmias that can lead to stroke, cardiac arrest, or other comorbidities or medical
270.2  complications if not correctly diagnosed.
270.3      (b) Effective January 1, 2026, or upon federal approval, whichever is later, the
270.4  commissioner must reimburse diagnostic testing facilities providing long-term ambulatory
270.5  electrocardiogram monitoring services at 100 percent of the Medicare Physician Fee Schedule
270.6  rate for such services or higher.
270.7      EFFECTIVE DATE. This section is effective the day following final enactment.
270.8    Sec. 28. Minnesota Statutes 2024, section 256B.76, subdivision 6, is amended to read:
270.9      Subd. 6. Medicare relative value units. (a) Effective for services rendered on or after
270.10 January 1, 2007, the commissioner shall make payments for physician and professional
270.11 services based on the Medicare relative value units (RVUs). This change shall be budget
270.12 neutral and the cost of implementing RVUs will be incorporated in the established conversion
270.13 factor.
270.14     (b) Notwithstanding any other provision in this chapter modifying rates for the mental
270.15 health services reimbursed under this paragraph, effective for services rendered on or after
270.16 January 1, 2025 2026, or on or after the date of federal approval, whichever is later, rates
270.17 for mental health services reimbursed under the resource-based relative value scale (RBRVS)
270.18 must be equal to 83 100 percent of the Medicare Physician Fee Schedule.
270.19     (c) Effective for services rendered on or after January 1, 2025, the commissioner shall
270.20 increase capitation payments made to managed care plans and county-based purchasing
270.21 plans to reflect the rate increases provided under this subdivision. Managed care plans and
270.22 county-based purchasing plans must use the capitation rate increase provided under this
270.23 paragraph to increase payment rates to the providers corresponding to the rate increases.
270.24 The commissioner must monitor the effect of this rate increase on enrollee access to services
270.25 under this subdivision. If for any contract year federal approval is not received for this
270.26 paragraph, the commissioner must adjust the capitation rates paid to managed care plans
270.27 and county-based purchasing plans for that contract year to reflect the removal of this
270.28 paragraph. Contracts between managed care plans and county-based purchasing plans and
270.29 providers to whom this paragraph applies must allow recovery of payments from those
270.30 providers if capitation rates are adjusted in accordance with this paragraph. Payment
270.31 recoveries must not exceed the amount equal to any increase in rates that results from this
270.32 paragraph.
  Article 8 Sec. 28.  270
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
271.1      EFFECTIVE DATE. This section is effective on the latest of the following: (1) January
271.2  1, 2026; (2) federal approval of the medical assistance program changes in this section; or
271.3  (3) federal approval of all necessary federal waivers to implement the managed care
271.4  organization assessment in Minnesota Statutes, section 295.525. The commissioner of
271.5  human services shall notify the revisor of statutes when federal approval is obtained.
271.6    Sec. 29. Minnesota Statutes 2024, section 256B.761, is amended to read:
271.7      256B.761 REIMBURSEMENT FOR MENTAL HEALTH SERVICES.
271.8      Subdivision 1. Rates effective 2026. (a) Effective for services rendered on or after July
271.9  1, 2001, payment for medication management provided to psychiatric patients, outpatient
271.10 mental health services, day treatment services, home-based mental health services, and
271.11 family community support services shall be paid at the lower of (1) submitted charges, or
271.12 (2) 75.6 percent of the 50th percentile of 1999 charges.
271.13     (b) Effective July 1, 2001, the medical assistance rates for outpatient mental health
271.14 services provided by an entity that operates: (1) a Medicare-certified comprehensive
271.15 outpatient rehabilitation facility; and (2) a facility that was certified prior to January 1, 1993,
271.16 with at least 33 percent of the clients receiving rehabilitation services in the most recent
271.17 calendar year who are medical assistance recipients, will be increased by 38 percent, when
271.18 those services are provided within the comprehensive outpatient rehabilitation facility and
271.19 provided to residents of nursing facilities owned by the entity.
271.20     (c) In addition to rate increases otherwise provided, the commissioner may restructure
271.21 coverage policy and rates to improve access to adult rehabilitative mental health services
271.22 under section 256B.0623 and related mental health support services under section 256B.021,
271.23 subdivision 4, paragraph (f), clause (2). For state fiscal years 2015 and 2016, the projected
271.24 state share of increased costs due to this paragraph is transferred from adult mental health
271.25 grants under sections 245.4661 and 256K.10. The transfer for fiscal year 2016 is a permanent
271.26 base adjustment for subsequent fiscal years. Payments made to managed care plans and
271.27 county-based purchasing plans under sections 256B.69, 256B.692, and 256L.12 shall reflect
271.28 the rate changes described in this paragraph.
271.29     (d) Any ratables effective before July 1, 2015, do not apply to early intensive
271.30 developmental and behavioral intervention (EIDBI) benefits described in section 256B.0949.
271.31     (e) Effective for services rendered on or after January 1, 2024, payment rates for
271.32 behavioral health services included in the rate analysis required by Laws 2021, First Special
271.33 Session chapter 7, article 17, section 18, except for adult day treatment services under section
  Article 8 Sec. 29.  271
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
272.1  256B.0671, subdivision 3; early intensive developmental and behavioral intervention services
272.2  under section 256B.0949; and substance use disorder services under chapter 254B, must be
272.3  increased by three percent from the rates in effect on December 31, 2023. Effective for
272.4  services rendered on or after January 1, 2025, payment rates for behavioral health services
272.5  included in the rate analysis required by Laws 2021, First Special Session chapter 7, article
272.6  17, section 18; early intensive developmental behavioral intervention services under section
272.7  256B.0949; and substance use disorder services under chapter 254B, must be annually
272.8  adjusted according to the change from the midpoint of the previous rate year to the midpoint
272.9  of the rate year for which the rate is being determined using the Centers for Medicare and
272.10 Medicaid Services Medicare Economic Index as forecasted in the fourth quarter of the
272.11 calendar year before the rate year. For payments made in accordance with this paragraph,
272.12 if and to the extent that the commissioner identifies that the state has received federal
272.13 financial participation for behavioral health services in excess of the amount allowed under
272.14 United States Code, title 42, section 447.321, the state shall repay the excess amount to the
272.15 Centers for Medicare and Medicaid Services with state money and maintain the full payment
272.16 rate under this paragraph. This paragraph does not apply to federally qualified health centers,
272.17 rural health centers, Indian health services, certified community behavioral health clinics,
272.18 cost-based rates, and rates that are negotiated with the county. This paragraph expires upon
272.19 legislative implementation of the new rate methodology resulting from the rate analysis
272.20 required by Laws 2021, First Special Session chapter 7, article 17, section 18.
272.21     (f) Effective January 1, 2024, the commissioner shall increase capitation payments made
272.22 to managed care plans and county-based purchasing plans to reflect the behavioral health
272.23 service rate increase provided in paragraph (e). Managed care and county-based purchasing
272.24 plans must use the capitation rate increase provided under this paragraph to increase payment
272.25 rates to behavioral health services providers. The commissioner must monitor the effect of
272.26 this rate increase on enrollee access to behavioral health services. If for any contract year
272.27 federal approval is not received for this paragraph, the commissioner must adjust the
272.28 capitation rates paid to managed care plans and county-based purchasing plans for that
272.29 contract year to reflect the removal of this provision. Contracts between managed care plans
272.30 and county-based purchasing plans and providers to whom this paragraph applies must
272.31 allow recovery of payments from those providers if capitation rates are adjusted in accordance
272.32 with this paragraph. Payment recoveries must not exceed the amount equal to any increase
272.33 in rates that results from this provision.
  Article 8 Sec. 29.  272
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
273.1      (a) Effective for services rendered on or after January 1, 2026, or on or after the date of
273.2  federal approval, whichever is later, the commissioner must establish and pay market-based
273.3  payment rates for the following services:
273.4      (1) children's therapeutic services and supports under section 256B.0943;
273.5      (2) child and family psychoeducation services under section 256B.0671, subdivision 5;
273.6      (3) clinical care consultation services under section 256B.0671, subdivision 7;
273.7      (4) mental health certified family peer specialist services under section 256B.0616;
273.8      (5) adult day treatment services under section 256B.0671, subdivision 3;
273.9      (6) adult rehabilitative mental health services under section 256B.0623;
273.10     (7) adult mental health peer support specialist services under section 256B.0615;
273.11     (8) dialectical behavioral therapy under section 256B.0671, subdivision 6;
273.12     (9) explanation of findings under section 256B.0671, subdivision 4;
273.13     (10) mental health crisis response services under section 256B.0624;
273.14     (11) mental health provider travel time under section 256B.0625, subdivision 43;
273.15     (12) neuropsychological testing under section 256B.0671, subdivision 9;
273.16     (13) partial hospitalization services under section 256B.0671, subdivision 12; and
273.17     (14) psychotherapy services under section 256B.0671, subdivision 11, incorporating
273.18 biofeedback.
273.19     (b) Rates established under paragraph (a) must:
273.20     (1) be based on the costs of the following factors:
273.21     (i) direct staff worker wages and benefits;
273.22     (ii) direct staff worker productivity;
273.23     (iii) program-related expenses; and
273.24     (iv) administrative costs; and
273.25     (2) must not be lower than:
273.26     (i) the payment rates recommended in the rate analysis required by Laws 2021, First
273.27 Special Session chapter 7, article 17, section 18, and published by the Department of Human
273.28 Services on January 22, 2024; or
  Article 8 Sec. 29.  273
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
274.1      (ii) the payment rates in effect on December 31, 2025.
274.2      Subd. 2. Capitation payments. Managed care and county-based purchasing plans must
274.3  reimburse providers at an amount that is at least equal to the fee-for-service rate for services
274.4  under this section. The commissioner must monitor the effect of this rate adjustment on
274.5  enrollee access to behavioral health services. If for any contract year federal approval is not
274.6  received for this subdivision, the commissioner must adjust the capitation rates paid to
274.7  managed care plans and county-based purchasing plans for that contract year to reflect the
274.8  removal of this provision. Contracts between managed care plans and county-based
274.9  purchasing plans and providers to whom this subdivision applies must allow recovery of
274.10 payments from those providers if capitation rates are adjusted in accordance with this
274.11 subdivision. Payment recoveries must not exceed the amount equal to any increase in rates
274.12 that results from this subdivision.
274.13     Subd. 3. Inflation adjustment. The commissioner must adjust the reimbursement rate
274.14 for services under this section annually according to the change from the midpoint of the
274.15 previous rate year to the midpoint of the rate year for which the rate is being determined
274.16 using the Centers for Medicare and Medicaid Services Medicare Economic Index as
274.17 forecasted in the fourth quarter of the calendar year before the rate year.
274.18     Subd. 4. Exceptions. This section does not apply to federally qualified health centers,
274.19 rural health centers, Indian health services, or certified community behavioral health clinics
274.20 or to cost-based rates or rates that are negotiated with the county.
274.21     EFFECTIVE DATE. (a) This section is effective on the latest of the following: (1)
274.22 January 1, 2026; (2) federal approval of the medical assistance program changes in this
274.23 section; or (3) federal approval of all necessary federal waivers to implement the managed
274.24 care organization assessment in Minnesota Statutes, section 295.525. The commissioner
274.25 shall notify the revisor of statutes when federal approval is obtained.
274.26     (b) This section prevails over any other amendment made to Minnesota Statutes, section
274.27 256B.761, during the 2025 First Special Session, regardless of order of enactment.
274.28   Sec. 30. Minnesota Statutes 2024, section 256B.766, is amended to read:
274.29     256B.766 REIMBURSEMENT FOR BASIC CARE SERVICES.
274.30     Subdivision 1. Payment reductions for base care services effective July 1, 2009. (a)
274.31 Effective for services provided on or after July 1, 2009, total payments for basic care services,
274.32 shall be reduced by three percent, except that for the period July 1, 2009, through June 30,
  Article 8 Sec. 30.  274
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
275.1  2011, total payments shall be reduced by 4.5 percent for the medical assistance and general
275.2  assistance medical care programs, prior to third-party liability and spenddown calculation.
275.3      Subd. 2. Classification of therapies as basic care services. Effective July 1, 2010, The
275.4  commissioner shall classify physical therapy services, occupational therapy services, and
275.5  speech-language pathology and related services as basic care services. The reduction in this
275.6  paragraph subdivision 1 shall apply to physical therapy services, occupational therapy
275.7  services, and speech-language pathology and related services provided on or after July 1,
275.8  2010.
275.9      Subd. 3. Payment reductions to managed care plans effective October 1, 2009. (b)
275.10 Payments made to managed care plans and county-based purchasing plans shall be reduced
275.11 for services provided on or after October 1, 2009, to reflect the reduction in subdivision 1
275.12 effective July 1, 2009, and payments made to the plans shall be reduced effective October
275.13 1, 2010, to reflect the reduction in subdivision 1 effective July 1, 2010.
275.14     Subd. 4. Temporary payment reductions effective September 1, 2011. (c) (a) Effective
275.15 for services provided on or after September 1, 2011, through June 30, 2013, total payments
275.16 for outpatient hospital facility fees shall be reduced by five percent from the rates in effect
275.17 on August 31, 2011.
275.18     (d) (b) Effective for services provided on or after September 1, 2011, through June 30,
275.19 2013, total payments for ambulatory surgery centers facility fees, medical supplies and
275.20 durable medical equipment not subject to a volume purchase contract, prosthetics and
275.21 orthotics, renal dialysis services, laboratory services, public health nursing services, physical
275.22 therapy services, occupational therapy services, speech therapy services, eyeglasses not
275.23 subject to a volume purchase contract, hearing aids not subject to a volume purchase contract,
275.24 and anesthesia services shall be reduced by three percent from the rates in effect on August
275.25 31, 2011.
275.26     Subd. 5. Payment increases effective September 1, 2014. (e) (a) Effective for services
275.27 provided on or after September 1, 2014, payments for ambulatory surgery centers facility
275.28 fees, hospice services, renal dialysis services, laboratory services, public health nursing
275.29 services, eyeglasses not subject to a volume purchase contract, and hearing aids not subject
275.30 to a volume purchase contract shall be increased by three percent and payments for outpatient
275.31 hospital facility fees shall be increased by three percent.
275.32     (b) Payments made to managed care plans and county-based purchasing plans shall not
275.33 be adjusted to reflect payments under this paragraph subdivision.
  Article 8 Sec. 30.  275
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
276.1      Subd. 6. Temporary payment reductions effective July 1, 2014. (f) Payments for
276.2  medical supplies and durable medical equipment not subject to a volume purchase contract,
276.3  and prosthetics and orthotics, provided on or after July 1, 2014, through June 30, 2015, shall
276.4  be decreased by .33 percent.
276.5      Subd. 7. Payment increases effective July 1, 2015. (a) Payments for medical supplies
276.6  and durable medical equipment not subject to a volume purchase contract, and prosthetics
276.7  and orthotics, provided on or after July 1, 2015, shall be increased by three percent from
276.8  the rates as determined under paragraphs (i) and (j) subdivisions 9 and 10.
276.9      (g) (b) Effective for services provided on or after July 1, 2015, payments for outpatient
276.10 hospital facility fees, medical supplies and durable medical equipment not subject to a
276.11 volume purchase contract, prosthetics, and orthotics to a hospital meeting the criteria specified
276.12 in section 62Q.19, subdivision 1, paragraph (a), clause (4), shall be increased by 90 percent
276.13 from the rates in effect on June 30, 2015.
276.14     (c) Payments made to managed care plans and county-based purchasing plans shall not
276.15 be adjusted to reflect payments under this paragraph (b).
276.16     Subd. 8. Exempt services. (h) This section does not apply to physician and professional
276.17 services, inpatient hospital services, family planning services, mental health services, dental
276.18 services, prescription drugs, medical transportation, federally qualified health centers, rural
276.19 health centers, Indian health services, and Medicare cost-sharing.
276.20     Subd. 9. Individually priced items. (i) (a) Effective for services provided on or after
276.21 July 1, 2015, the following categories of medical supplies and durable medical equipment
276.22 shall be individually priced items: customized and other specialized tracheostomy tubes
276.23 and supplies, electric patient lifts, and durable medical equipment repair and service.
276.24     (b) This paragraph subdivision does not apply to medical supplies and durable medical
276.25 equipment subject to a volume purchase contract, products subject to the preferred diabetic
276.26 testing supply program, and items provided to dually eligible recipients when Medicare is
276.27 the primary payer for the item.
276.28     (c) The commissioner shall not apply any medical assistance rate reductions to durable
276.29 medical equipment as a result of Medicare competitive bidding.
276.30     Subd. 10. Rate increases effective July 1, 2015. (j) (a) Effective for services provided
276.31 on or after July 1, 2015, medical assistance payment rates for durable medical equipment,
276.32 prosthetics, orthotics, or supplies shall be increased as follows:
  Article 8 Sec. 30.  276
  06/07/25  REVISOR        DTT/LN  25-05697  as introduced
277.1      (1) payment rates for durable medical equipment, prosthetics, orthotics, or supplies that
277.2  were subject to the Medicare competitive bid that took effect in January of 2009 shall be
277.3  increased by 9.5 percent; and
277.4      (2) payment rates for durable medical equipment, prosthetics, orthotics, or supplies on
277.5  the medical assistance fee schedule, whether or not subject to the Medicare competitive bid
277.6  that took effect in January of 2009, shall be increased by 2.94 percent, with this increase
277.7  being applied after calculation of any increased payment rate under clause (1).
277.8      This (b) Paragraph (a) does not apply to medical supplies and durable medical equipment
277.9  subject to a volume purchase contract, products subject to the preferred diabetic testing
277.10 supply program, items provided to dually eligible recipients when Medicare is the primary
277.11 payer for the item, and individually priced items identified in paragraph (i) subdivision 9.
277.12     (c) Payments made to managed care plans and county-based purchasing plans shall not
277.13 be adjusted to reflect the rate increases in this paragraph subdivision.
277.14     Subd. 11. Rates for ventilators. (k) (a) Effective for nonpressure support ventilators
277.15 provided on or after January 1, 2016, the rate shall be the lower of the submitted charge or
277.16 the Medicare fee schedule rate.
277.17     (b) Effective for pressure support ventilators provided on or after January 1, 2016, the
277.18 rate shall be the lower of the submitted charge or 47 percent above the Medicare fee schedule
277.19 rate.
277.20     (c) For payments made in accordance with this paragraph subdivision, if, and to the
277.21 extent that, the commissioner identifies that the state has received federal financial
277.22 participation for ventilators in excess of the amount allowed effective January 1, 2018,
277.23 under United States Code, title 42, section 1396b(i)(27), the state shall repay the excess
277.24 amount to the Centers for Medicare and Medicaid Services with state funds and maintain
277.25 the full payment rate under this paragraph subdivision.
277.26     Subd. 12. Rates subject to the upper payment limit. (l) Payment rates for durable
277.27 medical equipment, prosthetics, orthotics or supplies, that are subject to the upper payment
277.28 limit in accordance with section 1903(i)(27) of the Social Security Act, shall be paid the
277.29 Medicare rate. Rate increases provided in this chapter shall not be applied to the items listed
277.30 in this paragraph subdivision.
277.31     Subd. 13. Temporary rates for enteral nutrition and supplies. (m) For dates of service
277.32 on or after July 1, 2023, through June 30, 2025, enteral nutrition and supplies must be paid
277.33 according to this paragraph subdivision. If sufficient data exists for a product or supply,
  Article 8 Sec. 30.  277
  06/07/25  REVISOR        DTT/LN  25-05697  as introduced
278.1  payment must be based upon the 50th percentile of the usual and customary charges per
278.2  product code submitted to the commissioner, using only charges submitted per unit. Increases
278.3  in rates resulting from the 50th percentile payment method must not exceed 150 percent of
278.4  the previous fiscal year's rate per code and product combination. Data are sufficient if: (1)
278.5  the commissioner has at least 100 paid claim lines by at least ten different providers for a
278.6  given product or supply; or (2) in the absence of the data in clause (1), the commissioner
278.7  has at least 20 claim lines by at least five different providers for a product or supply that
278.8  does not meet the requirements of clause (1). If sufficient data are not available to calculate
278.9  the 50th percentile for enteral products or supplies, the payment rate must be the payment
278.10 rate in effect on June 30, 2023.
278.11     Subd. 14. Rates for enteral nutrition and supplies. (n) For dates of service on or after
278.12 July 1, 2025, enteral nutrition and supplies must be paid according to this paragraph
278.13 subdivision and updated annually each January 1. If sufficient data exists for a product or
278.14 supply, payment must be based upon the 50th percentile of the usual and customary charges
278.15 per product code submitted to the commissioner for the previous calendar year, using only
278.16 charges submitted per unit. Increases in rates resulting from the 50th percentile payment
278.17 method must not exceed 150 percent of the previous year's rate per code and product
278.18 combination. Data are sufficient if: (1) the commissioner has at least 100 paid claim lines
278.19 by at least ten different providers for a given product or supply; or (2) in the absence of the
278.20 data in clause (1), the commissioner has at least 20 claim lines by at least five different
278.21 providers for a product or supply that does not meet the requirements of clause (1). If
278.22 sufficient data are not available to calculate the 50th percentile for enteral products or
278.23 supplies, the payment must be the manufacturer's suggested retail price of that product or
278.24 supply minus 20 percent. If the manufacturer's suggested retail price is not available, payment
278.25 must be the actual acquisition cost of that product or supply plus 20 percent.
278.26     Subd. 15. Rates for phototherapy services. For dates of service on or after July 1,
278.27 2025, the payment rate for phototherapy services provided to newborns in the home setting
278.28 must include a service fee in the amount of $520 per patient episode, in addition to the daily
278.29 rental rate for the medical equipment in subdivision 12. The commissioner shall provide an
278.30 annual inflation adjustment for the phototherapy service fee. The index for the inflation
278.31 adjustment must be based on the Consumer Price Index for All Urban Consumers increase
278.32 published by the Bureau of Labor Statistics.
  Article 8 Sec. 30.  278
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
279.1    Sec. 31. Minnesota Statutes 2024, section 256L.03, subdivision 3b, is amended to read:
279.2      Subd. 3b. Chiropractic services. MinnesotaCare covers the following chiropractic
279.3  services for individuals under the age of 21: (1) medically necessary exams,; (2) manual
279.4  manipulation of the spine,; and (3) x-rays.
279.5      EFFECTIVE DATE. This section is effective January 1, 2026, or upon federal approval,
279.6  whichever is later. The commissioner of human services shall notify the revisor of statutes
279.7  when federal approval is obtained.
279.8    Sec. 32. Minnesota Statutes 2024, section 295.50, subdivision 3, is amended to read:
279.9      Subd. 3. Gross revenues. (a) "Gross revenues" are total amounts received in money or
279.10 otherwise by:
279.11     (1) a hospital for patient services;
279.12     (2) a surgical center for patient services;
279.13     (3) a health care provider, other than a staff model health plan company, for patient
279.14 services;
279.15     (4) a wholesale drug distributor for sale or distribution of legend drugs that are delivered
279.16 in Minnesota by the wholesale drug distributor, by common carrier, or by mail, unless the
279.17 legend drugs are delivered to another wholesale drug distributor who sells legend drugs
279.18 exclusively at wholesale; and
279.19     (5) a staff model health plan company as gross premiums for enrollees, co-payments,
279.20 deductibles, coinsurance, and fees for patient services.
279.21     (b) For purposes of paragraph (a), clause (4), "gross revenues" includes the amount of
279.22 any rebate provided by the wholesale drug distributor to a customer, however provided,
279.23 including a rebate provided under a contractual obligation. "Rebate" means any price
279.24 concession provided by a wholesale drug distributor, including any price concession based
279.25 on the actual or estimated utilization, sale volume, or effectiveness of a legend drug.
279.26     EFFECTIVE DATE. This section is effective for gross revenues received after June
279.27 30, 2025.
279.28   Sec. 33. [295.525] MANAGED CARE ORGANIZATION ASSESSMENT.
279.29     Subdivision 1. Definitions. (a) For the purposes of this section, the terms in this
279.30 subdivision have the meanings given.
  Article 8 Sec. 33.  279
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
280.1(b) "Commissioner" means the commissioner of human services.
280.2(c) "Enrollee" has the meaning given in section 62Q.01, except that enrollee does not
280.3  include:
280.4(1) an individual enrolled in a Medicare plan;
280.5(2) a plan-to-plan enrollee; or
280.6(3) an individual enrolled in a health plan pursuant to the Federal Employees Health
280.7  Benefits Act of 1959, Public Law 86-382, as amended, to the extent the imposition of the
280.8  assessment under this section is preempted pursuant to United States Code, title 5, section
280.9  8909, subsection (f).
280.10(d) "Managed care organization" or "MCO" means:
280.11(1) an insurance company licensed under chapter 60A to sell health plans as defined in
280.12 section 62A.011;
280.13(2) a nonprofit health services plan corporation as defined in section 62C.02, subdivision
280.14 6;
280.15(3) a health maintenance organization licensed under chapter 62D; or
280.16(4) a county-based purchasing plan participating in a public health care program under
280.17 chapter 256B or 256L.
280.18(e) "Medical assistance" means the medical assistance program established under chapter
280.19 256B.
280.20(f) "Medical assistance enrollee" means an enrollee in medical assistance or
280.21 MinnesotaCare for whom the Department of Human Services directly pays the managed
280.22 care organization a capitated payment.
280.23(g) "Member months" means the number of months an enrollee is covered by an MCO
280.24 in the calendar year immediately preceding the year of the assessment.
280.25(h) "MinnesotaCare" means the MinnesotaCare program established under chapter 256L.
280.26(i) "Plan-to-plan enrollee" means an individual who receives coverage for health care
280.27 services through a health plan pursuant to a subcontract from another health plan.
280.28Subd. 2. MCO assessment. (a) An annual assessment is imposed on managed care
280.29 organizations for each calendar year beginning in calendar year 2026. The total annual
280.30 assessment amount is equal to the sum of the amounts assessed for medical assistance
280.31 enrollees under paragraph (b) and for nonmedical assistance enrollees under paragraph (c).
  Article 8 Sec. 33.  280
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
281.1(b) The amount assessed for medical assistance enrollees is equal to the sum of the
281.2  following:
281.3(1) for medical assistance member months 0 to 60,000, $0 per member month;
281.4(2) for medical assistance member months 60,001 to 100,000, $340 per member month;
281.5(3) for medical assistance member months 100,001 to 200,000, $365 per member month;
281.6  and
281.7(4) for medical assistance member months 200,001 to 350,000, $380 per member month.
281.8(c) The amount assessed for nonmedical assistance enrollees is equal to the sum of the
281.9  following:
281.10(1) for nonmedical assistance member months 0 to 60,000, $0 per member month;
281.11(2) for nonmedical assistance member months 60,001 to 100,000, 50 cents per member
281.12 month;
281.13(3) for nonmedical assistance member months 100,001 to 200,000, 75 cents per member
281.14 month; and
281.15(4) for nonmedical assistance member months 200,001 to 350,000, $1 per member
281.16 month.
281.17(d) The commissioner must annually use the commissioner's authority as necessary to
281.18 modify the rate of assessment provided under paragraph (e) such that the annual assessment
281.19 imposed under this subdivision does not exceed the forecasted cumulative costs attributable
281.20 to the program changes in subdivision 4, paragraph (e), and the appropriation in subdivision
281.21 4, paragraph (f).
281.22(e) The commissioner must, after consultation with managed care organizations likely
281.23 to be affected, modify the rate of assessment, as set forth in paragraphs (a) to (d), as necessary
281.24 to:
281.25(1) comply with federal law; obtain or maintain a waiver under Code of Federal
281.26 Regulations, title 42, section 433.72; ensure the state's aggregated health care-related taxes
281.27 on managed care organizations do not exceed 5.75 percent of the net patient revenue
281.28 attributable to those services; or otherwise maximize under this section federal financial
281.29 participation for medical assistance; and
281.30(2) comply with paragraph (d).
  Article 8 Sec. 33.  281
  06/07/25  REVISOR        DTT/LN  25-05697  as introduced
282.1      Subd. 3. Assessment computation; collection. (a) The commissioner must annually
282.2  forecast the following for each managed care organization:
282.3      (1) total member months for the calendar year;
282.4      (2) total Medicare member months for the calendar year;
282.5      (3) total medical assistance member months for the calendar year;
282.6      (4) total plan-to-plan member months for the calendar year;
282.7      (5) total member months through the Federal Employees Health Benefits Act of 1959,
282.8  Public Law 86-382, as amended, for the calendar year; and
282.9      (6) total other enrollment for the calendar year that is not otherwise counted in clauses
282.10 (2) to (5).
282.11     (b) Managed care organizations must provide any information requested by the
282.12 commissioner for the purpose of this subdivision, provided that the commissioner determines
282.13 such information is necessary to accurately determine the information in paragraph (a).
282.14     (c) The commissioner may correct errors in data provided to the commissioner by a
282.15 managed care organization to the extent necessary to accurately determine the information
282.16 in paragraph (a).
282.17     (d) For purposes of calculating the information in paragraph (a) for a managed care
282.18 organization, the commissioner must count any individual that was an enrollee of a health
282.19 plan at any point of the calendar year, regardless of the enrollee's duration as an enrollee of
282.20 the health plan.
282.21     (e) The commissioner must annually use the information in paragraph (a) to compute
282.22 the assessment for each managed care organization.
282.23     (f) The commissioner must collect the annual assessment for each managed care
282.24 organization in four equal installments, in the manner determined by the commissioner.
282.25     (g) Managed care organizations must pay the four installments under paragraph (f) on
282.26 the following schedule:
282.27     (1) the first installment is due by March 31;
282.28     (2) the second installment is due by July 31;
282.29     (3) the third installment is due by September 30; and
282.30     (4) the fourth installment is due by November 30.
  Article 8 Sec. 33.  282
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
283.1      (h) The commissioner is prohibited from collecting any amount under this section until
283.2  20 days after the commissioner has notified the managed care organization of:
283.3      (1) the effective date of this section; and
283.4      (2) the annual assessment amount.
283.5      (i) In the event of a merger, acquisition, or other transaction that results in the transfer
283.6  of health plan responsibility to another managed care organization or similar entity, the
283.7  surviving, acquiring, or controlling managed care organization or similar entity is responsible
283.8  for paying the full assessment amount as provided in this section that would have been the
283.9  responsibility of the managed care organization to which that full assessment amount was
283.10 assessed upon the effective date of the transaction. If a transaction results in the transfer of
283.11 health plan responsibility for only some of a health plan's enrollees under this section but
283.12 not all enrollees, the full assessment amount as provided in this section remains the
283.13 responsibility of the managed care organization to which that full assessment amount was
283.14 assessed.
283.15     (j) The commissioner is prohibited from collecting any assessment under this subdivision
283.16 during any period of time when the assessment is not considered a permissible health
283.17 care-related tax under Code of Federal Regulations, title 42, section 433.68, or would result
283.18 in a net loss of federal financial participation.
283.19     Subd. 4. MCO assessment expenditures. (a) All amounts collected by the commissioner
283.20 under this section must be deposited in the special revenue fund.
283.21     (b) The arrangement under this section must be implemented in managed care through
283.22 the prospective capitation rate setting process and must follow all federal requirements,
283.23 including Code of Federal Regulations, title 42, section 438.5, paragraph (e).
283.24     (c) The assessment money must be used to supplement money for medical assistance
283.25 from the general fund.
283.26     (d) The commissioner must disclose to all managed care organizations, in a time and
283.27 manner determined by the commissioner, the following information:
283.28     (1) the assessments imposed on each managed care organization pursuant to this section;
283.29 and
283.30     (2) an accounting of all money raised by the MCO assessment.
283.31     (e) All amounts collected by the commissioner under this section, except for the amount
283.32 necessary for the appropriation under paragraph (f), are annually appropriated from the
  Article 8 Sec. 33.  283
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
284.1  special revenue fund to the commissioner to provide nonfederal money for medical assistance
284.2  and MinnesotaCare program rate changes made in this act related to:
284.3      (1) behavioral health home services under section 256B.0757;
284.4      (2) mental health rates reimbursed under the resource-based relative value scale to 100
284.5  percent of the Medicare Physician Fee Schedule under section 256B.76, subdivision 6;
284.6      (3) mental health services under section 256B.761; and
284.7      (4) mental health services provided by masters-prepared mental health professionals
284.8  and physician assistants resulting from the repeal of section 256B.0625, subdivision 38.
284.9      (f) Reasonable costs for administering the MCO assessment are annually appropriated
284.10 from the special revenue fund to the commissioner.
284.11     (g) A payment rate adjusted under this paragraph may not be lower than the base payment
284.12 rate for the service in effect on December 31, 2025.
284.13     (h) If provider payment rates are adjusted as the result of insufficient revenue from the
284.14 MCO assessment relative to the medical assistance and MinnesotaCare program changes
284.15 in paragraphs (e), clauses (1) to (4), and (f), as directed in this act, the commissioner must:
284.16     (1) provide the chairs and ranking minority members of the legislative committees with
284.17 jurisdiction over health and human services finance and policy an overview of the changes
284.18 and recommended statutory language to codify the adjusted payment rate methodology;
284.19 and
284.20     (2) consult with impacted providers and provide a public comment period of at least 30
284.21 days prior to seeking federal approval for rate changes.
284.22     EFFECTIVE DATE. This section is effective January 1, 2026, or upon federal approval
284.23 for the assessment established in this section to be considered a permissible health
284.24 care-related tax under Code of Federal Regulations, title 42, section 433.68, eligible for
284.25 federal financial participation, including but not limited to federal approval of a waiver
284.26 under Code of Federal Regulations, title 42, section 433.72, if such waiver is necessary to
284.27 receive health care-related taxes without a reduction in federal financial participation,
284.28 whichever is later. The commissioner of human services shall notify the revisor of statutes
284.29 when federal approval is obtained.
  Article 8 Sec. 33.  284
  06/07/25  REVISOR       DTT/LN  25-05697  as introduced
285.1    Sec. 34. Laws 2021, First Special Session chapter 7, article 1, section 39, is amended to
285.2  read:
285.3    Sec. 39. CONTINGENT FUNDING RELATED TO DENTAL ADMINISTRATOR.
285.4      If managed care and county-based purchasing plans do not meet in the aggregate the
285.5  dental access performance benchmark under Minnesota Statutes, section 256B.0371,
285.6  subdivision 1, for coverage year 2024, the general fund base for the department of human
285.7  services for the 2026-2027 2028-2029 biennium shall include $107,000 in fiscal year 2026
285.8  2028 and $122,000 in fiscal year 2027 2029 for staffing necessary to contract with a dental
285.9  administrator, and $5,000 in fiscal year 2026 2028 and $1,000 in fiscal year 2027 2029 for
285.10 systems changes necessary to contract with a dental administrator.
285.11   Sec. 35. IMPLEMENTATION OF HOSPITAL ASSESSMENT AND DIRECTED
285.12 PAYMENT PROGRAM.
285.13     (a) The commissioner of human services must immediately begin all necessary claims
285.14 analysis to calculate the assessment and payments required under Minnesota Statutes, section
285.15 256.9657, subdivision 2b, and the hospital directed payment program described in Minnesota
285.16 Statutes, section 256B.1974.
285.17     (b) The commissioner of human services, in consultation with the Minnesota Hospital
285.18 Association, must submit to the Centers for Medicare and Medicaid Services a request for
285.19 federal approval to implement the hospital assessment described in Minnesota Statutes,
285.20 section 256.9657, subdivision 2b, and the hospital directed payment program under
285.21 Minnesota Statutes, section 256B.1974. At least 15 days before submitting the request for
285.22 approval, the commissioner must make available to the public the draft assessment
285.23 requirements, the draft directed payment details, and an estimate of each assessment amount
285.24 for each eligible hospital.
285.25     (c) During the design and prior to submission of the request for approval under paragraph
285.26 (b), the commissioner of human services must consult with the Minnesota Hospital
285.27 Association and any eligible hospitals that are not members of the Minnesota Hospital
285.28 Association.
285.29     (d) If federal approval is received for the request under paragraph (b), the commissioner
285.30 of human services must provide at least 15 days of public posting and review of the federally
285.31 approved terms and conditions for the assessment and the directed payment program prior
285.32 to any assessment under Minnesota Statutes, section 256.9657, subdivision 2b, becoming
285.33 due from an eligible hospital.
  Article 8 Sec. 35.  285
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
286.1      EFFECTIVE DATE. This section is effective the day following final enactment.
286.2    Sec. 36. DENTAL ACCESS WORKING GROUP.
286.3      Subdivision 1. Establishment. (a) The commissioner of human services must establish
286.4  a working group as part of the Dental Services Advisory Committee to identify and make
286.5  recommendations on the state's goals, priorities, and processes for contracting with a dental
286.6  administrator under Minnesota Statutes, section 256B.0371, and to consult with the
286.7  commissioner on implementation of the recommendations.
286.8      (b) The working group expires on January 1, 2028.
286.9      Subd. 2. Membership. The working group must include members of the Dental Services
286.10 Advisory Committee, and must also include additional members as needed to ensure
286.11 representation from each of the following:
286.12     (1) critical access dental providers;
286.13     (2) dental providers that primarily serve low-income and socioeconomically complex
286.14 populations;
286.15     (3) dental providers that serve private-pay patients as well as medical assistance and
286.16 MinnesotaCare enrollees;
286.17     (4) rural critical access dental providers that do not have clinics in the seven-county
286.18 metropolitan area as defined in Minnesota Statutes, section 473.121, subdivision 2;
286.19     (5) managed care plans; and
286.20     (6) county-based purchasing plans.
286.21     Subd. 3. Recommendations. (a) The working group must provide recommendations to
286.22 the commissioner on:
286.23     (1) establishing and implementing a dental payment rate structure for medical assistance
286.24 and MinnesotaCare that:
286.25     (i) is based on the most recent cost data available;
286.26     (ii) promotes accountability while considering geographic differences in access to and
286.27 cost of dental services, critical access dental status, patient characteristics, transportation
286.28 needs, and medical and dental benefit coordination;
286.29     (iii) can be updated regularly; and
  Article 8 Sec. 36.  286
  06/07/25  REVISOR        DTT/LN  25-05697  as introduced
287.1      (iv) is based on the payment rates for dental providers established under Minnesota
287.2  Statutes, sections 256B.76 and 256L.11;
287.3      (2) performance benchmarks that focus on improving oral health for medical assistance
287.4  and MinnesotaCare enrollees, including consideration of Dental Quality Alliance and Oral
287.5  Health Impact Profile measures for broader assessment of a full range of services, and the
287.6  feasibility, cost, and value of providing the services;
287.7      (3) methods for measuring progress toward the performance benchmarks and holding
287.8  the dental administrator accountable for progress, including providing rewards for progress;
287.9      (4) establishing goals and processes to ensure coordination of care among medical
287.10 assistance and MinnesotaCare providers, including dental, medical, and other care providers,
287.11 particularly for patients with complex cases engaged in active treatment plans at the time
287.12 of transition to the dental administrator under Minnesota Statutes, section 256B.0371;
287.13     (5) developing and implementing an infrastructure and workforce development strategy
287.14 that invests in the medical assistance and MinnesotaCare dental system through grants and
287.15 loans at a level that enables continued development of dental capacity commensurate with
287.16 that obtained through the managed care delivery system and from philanthropic sources;
287.17 and
287.18     (6) developing and implementing a workforce development strategy to support the
287.19 pipeline of dental providers and oral health practitioners at all levels.
287.20     (b) By February 1, 2026, the working group must provide the recommendations required
287.21 under paragraph (a), clause (1), to the commissioner. By September 1, 2026, the working
287.22 group must provide all other recommendations required under this subdivision to the
287.23 commissioner.
287.24     Subd. 4. Reporting requirements. By March 1, 2027, the commissioner, in consultation
287.25 with the commissioner's contracted dental administrator, must develop an implementation
287.26 plan and timeline to effectuate the recommendations from the working group under this
287.27 section and must submit a report with the recommendations, plan, timeline, and any draft
287.28 legislation required to implement the plan to the chairs and ranking minority members of
287.29 the legislative committees with jurisdiction over health and human services policy and
287.30 finance.
287.31   Sec. 37. REQUEST FOR FEDERAL WAIVER.
287.32     The commissioner of human services must seek all federal waivers and authority
287.33 necessary to implement the county-assisted rural medical assistance (CARMA) program
  Article 8 Sec. 37.  287
  06/07/25  REVISOR        DTT/LN  25-05697  as introduced
288.1  under Minnesota Statutes, section 256B.695. The commissioner of human services shall
288.2  notify the revisor of statutes when federal approval is obtained.
288.3      EFFECTIVE DATE. This section is effective the day following final enactment.
288.4    Sec. 38. COUNTY-ADMINISTERED RURAL MEDICAL ASSISTANCE PROGRAM
288.5  IMPLEMENTATION COSTS.
288.6      Up to $500,000 of the nonfederal share of the costs to the Department of Human Services
288.7  for implementation of the requirements under the county-assisted rural medical assistance
288.8  (CARMA) program under Minnesota Statutes, section 256B.695, must be paid via an
288.9  intergovernmental funds transfer to the commissioner of human services by each county or
288.10 group of counties authorized under Minnesota Statutes, section 256B.692, seeking to
288.11 administer a CARMA program. The costs must be paid in a manner that is in compliance
288.12 with the requirements of Code of Federal Regulations, title 42, section 433.51. Within one
288.13 year of receiving payment under this section, the commissioner must provide a settle-up
288.14 process for any county or group of counties authorized under Minnesota Statutes, section
288.15 256B.692, administering a CARMA program and making payment under this section to
288.16 document and adjust payments owed to account for the commissioner's actual implementation
288.17 costs for Minnesota Statutes, section 256B.695.
288.18   Sec. 39. MEDICAL ASSISTANCE COVERAGE OF TRADITIONAL HEALTH
288.19 CARE PRACTICES.
288.20     Subdivision 1. Waiver request. By October 1, 2025, the commissioner of human services,
288.21 in consultation with Tribes, Tribal organizations, and urban Indian organizations, shall apply
288.22 to the Centers for Medicare and Medicaid Services for a waiver to allow the state's medical
288.23 assistance program to provide coverage for traditional health care practices received through
288.24 Indian health service facilities, facilities operated by Tribes or Tribal organizations under
288.25 the Indian Self-Determination and Education Assistance Act, or facilities operated by urban
288.26 Indian organizations under Title V of the Indian Health Care Improvement Act.
288.27     Subd. 2. Requirements. (a) A qualified provider must determine whether a medical
288.28 assistance enrollee is eligible to receive traditional health care practices under this section.
288.29     (b) Traditional health care practices are covered under this section if they are received
288.30 from a qualified provider.
288.31     (c) For purposes of this section, "qualified provider" means a practitioner or provider
288.32 who is employed by or under contract with the Indian Health Service, a 638 Tribal clinic,
  Article 8 Sec. 39.  288
  06/07/25  REVISOR  DTT/LN  25-05697  as introduced
289.1  or a Title V urban Indian organization. Each facility is responsible for ensuring that a
289.2  qualified provider has the necessary experience and appropriate training to provide traditional
289.3  health care practices.
289.4      Subd. 3. Payments for traditional health care practices. Reimbursement for traditional
289.5  health care practices under this section is set at the out