HF 4118 Summary

• Expands MinnesotaCare eligibility to 300% of federal poverty guidelines effective January 1, 2022, increasing to 400% by January 1, 2024, and 401% or more by January 1, 2025, with farm households at 400% starting January 1, 2022.

• Sets provider payment rates at 120% of Medicare rates (enhanced Medicare payment rate) unless commissioner sets different rates based on all-payer claims data analysis or negotiates alternative rates with providers.

• Modifies service delivery by establishing Primary Care Case Management (PCCM) program and requiring integrated health partnerships to serve MinnesotaCare enrollees beginning January 1, 2022, while terminating managed care and county-based purchasing plan contracts.

• Revises premium sliding scale effective January 1, 2022, and allows employers with 150 or fewer employees to contribute toward employee MinnesotaCare premiums without regard to income limits.

• Establishes MinnesotaCare Advisory Council with 15 voting and 4 nonvoting members to advise commissioner on program expansion, coverage services, payment methodologies, and care delivery coordination; requires commissioner to present implementation plan by December 15, 2020.