SF 4154 Summary

• Expands MinnesotaCare eligibility to 300 percent of federal poverty guidelines effective January 1, 2022, increasing to 400 percent by January 1, 2024, and 401 percent by January 1, 2025; farm households reach 400 percent by January 1, 2022.

• Increases provider payment rates to 120 percent of Medicare rates (enhanced Medicare payment rate) unless the commissioner sets different rates based on all-payer claims data analysis or negotiates alternative rates.

• Replaces managed care system with integrated health partnerships and primary care case management beginning January 1, 2022, requiring enrollees to annually select a primary care clinic or provider to coordinate care.

• Modifies MinnesotaCare premiums effective January 1, 2022, with new sliding scale exempting children under 20 and individuals below 35 percent of federal poverty guidelines; households with three or more persons limited to two-person household premium cap.

• Establishes MinnesotaCare Advisory Council with 15 voting members and 4 nonvoting members to advise on program expansion including covered services, provider payment methodologies, and care coordination; all changes contingent on federal certification that implementation will not reduce federal basic health program funding.