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2006 Minnesota Statutes

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256B.19 DIVISION OF COST.
    Subdivision 1. Division of cost. The state and county share of medical assistance costs
not paid by federal funds shall be as follows:
(1) beginning January 1, 1992, 50 percent state funds and 50 percent county funds for the
cost of placement of severely emotionally disturbed children in regional treatment centers;
(2) beginning January 1, 2003, 80 percent state funds and 20 percent county funds for the
costs of nursing facility placements of persons with disabilities under the age of 65 that have
exceeded 90 days. This clause shall be subject to chapter 256G and shall not apply to placements
in facilities not certified to participate in medical assistance;
(3) beginning July 1, 2004, 90 percent state funds and ten percent county funds for the
costs of placements that have exceeded 90 days in intermediate care facilities for persons with
developmental disabilities that have seven or more beds. This provision includes pass-through
payments made under section 256B.5015; and
(4) beginning July 1, 2004, when state funds are used to pay for a nursing facility placement
due to the facility's status as an institution for mental diseases (IMD), the county shall pay 20
percent of the nonfederal share of costs that have exceeded 90 days. This clause is subject to
chapter 256G.
For counties that participate in a Medicaid demonstration project under sections 256B.69 and
256B.71, the division of the nonfederal share of medical assistance expenses for payments made
to prepaid health plans or for payments made to health maintenance organizations in the form of
prepaid capitation payments, this division of medical assistance expenses shall be 95 percent by
the state and five percent by the county of financial responsibility.
In counties where prepaid health plans are under contract to the commissioner to provide
services to medical assistance recipients, the cost of court ordered treatment ordered without
consulting the prepaid health plan that does not include diagnostic evaluation, recommendation,
and referral for treatment by the prepaid health plan is the responsibility of the county of financial
responsibility.
    Subd. 1a.[Repealed, 2002 c 277 s 34]
    Subd. 1b.[Repealed, 1Sp2001 c 9 art 2 s 76]
    Subd. 1c. Additional portion of nonfederal share. (a) Hennepin County shall be responsible
for a monthly transfer payment of $1,500,000, due before noon on the 15th of each month and the
University of Minnesota shall be responsible for a monthly transfer payment of $500,000 due
before noon on the 15th of each month, beginning July 15, 1995. These sums shall be part of the
designated governmental unit's portion of the nonfederal share of medical assistance costs.
(b) Beginning July 1, 2001, Hennepin County's payment under paragraph (a) shall be
$2,066,000 each month.
(c) Beginning July 1, 2001, the commissioner shall increase annual capitation payments to
the metropolitan health plan under section 256B.69 for the prepaid medical assistance program
by approximately $3,400,000, plus any available federal matching funds, to recognize higher
than average medical education costs.
(d) Effective August 1, 2005, Hennepin County's payment under paragraphs (a) and (b) shall
be reduced to $566,000, and the University of Minnesota's payment under paragraph (a) shall
be reduced to zero.
    Subd. 1d. Portion of nonfederal share to be paid by certain counties. (a) In addition to the
percentage contribution paid by a county under subdivision 1, the governmental units designated
in this subdivision shall be responsible for an additional portion of the nonfederal share of
medical assistance cost. For purposes of this subdivision, "designated governmental unit" means
the counties of Becker, Beltrami, Clearwater, Cook, Dodge, Hubbard, Itasca, Lake, Pennington,
Pipestone, Ramsey, St. Louis, Steele, Todd, Traverse, and Wadena.
(b) Beginning in 1994, each of the governmental units designated in this subdivision shall
transfer before noon on May 31 to the state Medicaid agency an amount equal to the number of
licensed beds in any nursing home owned and operated by the county on that date, with the county
named as licensee, multiplied by $5,723. If two or more counties own and operate a nursing
home, the payment shall be prorated. These sums shall be part of the designated governmental
unit's portion of the nonfederal share of medical assistance costs.
(c) Beginning in 2002, in addition to any transfer under paragraph (b), each of the
governmental units designated in this subdivision shall transfer before noon on May 31 to the
state Medicaid agency an amount equal to the number of licensed beds in any nursing home
owned and operated by the county on that date, with the county named as licensee, multiplied by
$10,784. The provisions of paragraph (b) apply to transfers under this paragraph.
(d) Beginning in 2003, in addition to any transfer under paragraphs (b) and (c), each of the
governmental units designated in this subdivision shall transfer before noon on May 31 to the
state Medicaid agency an amount equal to the number of licensed beds in any nursing home
owned and operated by the county on that date, with the county named as licensee, multiplied by
$2,230. The provisions of paragraph (b) apply to transfers under this paragraph.
(e) The commissioner may reduce the intergovernmental transfers under paragraphs (c)
and (d) based on the commissioner's determination of the payment rate in section 256B.431,
subdivision 23
, paragraphs (c), (d), and (e). Any adjustments must be made on a per-bed basis
and must result in an amount equivalent to the total amount resulting from the rate adjustment in
section 256B.431, subdivision 23, paragraphs (c), (d), and (e).
    Subd. 2. Distribution of federal funds. Federal funds available for administrative purposes
shall be distributed between the state and the county in the same proportion that expenditures
were made, except as provided for in section 256.017.
    Subd. 2a. Division of costs. The county shall ensure that only the least costly, most
appropriate transportation and travel expenses are used. The state may enter into volume purchase
contracts, or use a competitive bidding process, whenever feasible, to minimize the costs of
transportation services. If the state has entered into a volume purchase contract or used the
competitive bidding procedures of chapter 16C to arrange for transportation services, the county
may be required to use such arrangements.
    Subd. 2b. Pilot project reimbursement. In counties where a pilot or demonstration
project is operated under the medical assistance program, the state may pay 100 percent of the
administrative costs for the pilot or demonstration project after June 30, 1990.
    Subd. 2c. Obligation of local agency to investigate eligibility for medical assistance. (a)
When the commissioner receives information that indicates that a general assistance medical
care recipient or MinnesotaCare program enrollee may be eligible for medical assistance,
the commissioner may notify the appropriate local agency of that fact. The local agency
must investigate eligibility for medical assistance and take appropriate action and notify the
commissioner of that action within 90 days from the date notice is issued. If the person is eligible
for medical assistance, the local agency must find eligibility retroactively to the date on which the
person met all eligibility requirements.
(b) When a prepaid health plan under a contract with the state to provide medical assistance
services notifies the commissioner that an infant has been or will be born to an enrollee under
the contract, the commissioner may notify the appropriate local agency of that fact. The local
agency must investigate eligibility for medical assistance for the infant, take appropriate action,
and notify the commissioner of that action within 90 days from the date notice is issued. If the
infant would have been eligible on the date of birth, the local agency must establish eligibility
retroactively to that month.
(c) For general assistance medical care recipients and MinnesotaCare program enrollees, if
the local agency fails to comply with paragraph (a), the local agency is responsible for the entire
cost of general assistance medical care or MinnesotaCare program services provided from the
date the commissioner issues the notice until the date the local agency takes appropriate action
on the case and notifies the commissioner of the action. For infants, if the local agency fails to
comply with paragraph (b), the commissioner may determine eligibility for medical assistance for
the infant for a period of two months, and the local agency shall be responsible for the entire cost
of medical assistance services provided for that infant, in addition to a fee of $100 for processing
the case. The commissioner shall deduct any obligation incurred under this paragraph from the
amount due to the local agency under subdivision 1.
    Subd. 3. Study of medical assistance financial participation. The commissioner shall
study the feasibility and outcomes of implementing a variable medical assistance county
financial participation rate for long-term care services to developmentally disabled persons in
order to encourage the utilization of alternative services to long-term intermediate care for the
developmentally disabled. The commissioner shall submit findings and recommendations to
the legislature by January 20, 1984.
History: Ex1967 c 16 s 19; 1971 c 547 s 1; 1975 c 437 art 2 s 7; 1982 c 640 s 7; 1983 c 312
art 9 s 6; 1984 c 534 s 24; 1Sp1985 c 9 art 2 s 46; 1986 c 444; 1987 c 403 art 2 s 85; 1988 c 719
art 8 s 16,17; 1Sp1989 c 1 art 16 s 8,9; 1990 c 568 art 3 s 64; 1991 c 292 art 4 s 51-53; 1992 c
513 art 7 s 82; 1993 c 13 art 1 s 32; 1Sp1993 c 1 art 5 s 84-86; 1995 c 207 art 6 s 82-84; 1995 c
234 art 8 s 56; 1997 c 203 art 11 s 7; 1998 c 386 art 2 s 80; 1Sp2001 c 9 art 2 s 45; 2002 c 220
art 14 s 7,8; 2002 c 277 s 20-23; 2002 c 375 art 2 s 34; 2002 c 379 art 1 s 113; 2003 c 9 s 1;
1Sp2003 c 14 art 3 s 43; 2005 c 56 s 1; 1Sp2005 c 4 art 2 s 14; art 8 s 48

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