Community engagement requirements for the medical assistance program established.

A bill for an act

relating to health care; establishing community engagement requirements for the

medical assistance program; amending Minnesota Statutes 2024, section 268.19,

subdivision 1a; Minnesota Statutes 2025 Supplement, sections 268.19, subdivision

1; 270B.14, subdivision 1; proposing coding for new law in Minnesota Statutes,

chapter 256B.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

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[256B.0562] COMMUNITY ENGAGEMENT REQUIREMENTS.

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Subdivision 1.

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Demonstrating community engagement.

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(a) To be eligible for medical

assistance, an applicable individual must demonstrate compliance with the community

engagement requirements under this section at application and renewal, unless the applicable

individual qualifies for an exception under subdivision 2 or 3. For purposes of this section,

"applicable individual" means an individual eligible for medical assistance under section

256B.055, subdivision 15.

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(b) At application, an applicable individual must demonstrate either compliance with

the requirements in the two consecutive months immediately preceding the month in which

the applicable individual applies for medical assistance, or exception from the requirements

in the month of application.

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(c) At renewal, an applicable individual must demonstrate either compliance with the

requirements in at least two months since application or last renewal, or exception from the

requirements in the month of renewal. The two months are not required to be consecutive.

The commissioner must not determine the specific months for which an applicable individual

must be in compliance.

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(d) To comply with the community engagement requirements in a given month, an

applicable individual must do one or more of the following:

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(1) work at least 80 hours;

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(2) complete at least 80 hours of community service;

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(3) participate in a work program, as defined in United States Code, title 7, section

2015(o)(1), for at least 80 hours;

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(4) be enrolled at least half-time in an educational program, including but not limited to

an institution of higher education and a program of career and technical education;

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(5) engage in any combination of the activities described in clauses (1) to (4) for a total

of at least 80 hours;

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(6) have a monthly income that is equal to or greater than the federal minimum wage

multiplied by 80 hours; or

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(7) have had an average monthly income over the preceding six months that is equal to

or greater than the federal minimum wage multiplied by 80 hours, and be a seasonal worker,

as defined under United States Code, title 26, section 45R(d)(5)(B).

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Subd. 2.

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Exceptions.

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(a) An applicable individual is not subject to the community

engagement requirements for part or all of a month in which the applicable individual is:

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(1) an individual enrolled under section 256B.055, subdivision 17;

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(2) an American Indian or Alaska Native who is an Indian, Urban Indian, or California

Indian as defined under United States Code, title 25, section 1603, or has otherwise been

determined eligible as an Indian for the Indian Health Service by the United States

Department of Health and Human Services;

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(3) a parent, guardian, caretaker relative, or family caregiver of a dependent child who

is 13 years of age and under or of an individual with a disability;

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(4) a veteran with a disability rated as total under United States Code, title 38, section

1155;

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(5) receiving benefits under the Minnesota family investment program under chapter

142G and meeting the work activity and participation requirements under that chapter;

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(6) a member of a household that receives Supplemental Nutrition Assistance Program

(SNAP) benefits under the federal Food and Nutrition Act of 2008 and is not exempt from

a work requirement under the act;

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(7) a participant in a drug addiction or alcohol treatment and rehabilitation program, as

defined under United States Code, title 7, section 2012;

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(8) an inmate of a public institution; or

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(9) an individual who is medically frail or otherwise has special medical needs, in

accordance with guidance issued by the United States Department of Health and Human

Services. This includes but is not limited to an individual who: is blind or has a disability;

has a substance use disorder; has a disabling mental disorder; has a physical, intellectual,

or developmental disability that significantly impairs the individual's ability to perform one

or more activities of daily living; or has a serious or complex medical condition.

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(b) The commissioner must develop standard forms that health care providers must

complete in order for an individual to apply for an exception from the community engagement

requirements on the basis of being medically frail or physically or mentally unfit for

employment. An individual seeking these exceptions must submit a completed form to the

county agency.

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(c) Enrollees who are excepted from the community engagement requirements under

this subdivision must report any changes related to the enrollee's exception status within

ten days of the change to the county agency. The agency must redetermine eligibility for

the exception when a change in exception status is reported and at the time of the enrollee's

renewal.

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Subd. 3.

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Short-term hardship exception.

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(a) The commissioner must deem an applicable

individual as meeting the community engagement requirements for a given month if for

part or all of the month the applicable individual:

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(1) requests an exception on the basis of receiving inpatient hospital services, nursing

facility services, services in an intermediate care facility for persons with developmental

disabilities, inpatient psychiatric hospital services, or such other services of similar acuity,

including but not limited to outpatient care relating to the above-listed services, in accordance

with guidance issued by the United States Department of Health and Human Services;

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(2) requests an exception on the basis of having to travel outside of the individual's

community for an extended period of time to receive medical services necessary to treat a

serious or complex medical condition, either for the individual or the individual's dependent,

when the services are not available in the individual's community of residence;

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(3) resides in a county or equivalent unit of local government in which an emergency

or disaster has been declared under the National Emergencies Act or the Robert T. Stafford

Disaster Relief and Emergency Assistance Act; or

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(4) resides in a county or equivalent unit of local government that has an unemployment

rate that is at or above the lesser of eight percent or 1.5 times the national unemployment

rate, and for which the United States Department of Health and Human Services has granted

an exception based on a request from the commissioner.

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(b) The commissioner must grant short-term hardship exceptions required under this

subdivision in accordance with standards specified by the United States Department of

Health and Human Services.

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Subd. 4.

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Determining and verifying compliance.

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(a) The commissioner must determine

whether an individual is subject to, compliant with, or excepted from the community

engagement requirements using processes established by the commissioner that rely on

information available to the commissioner through periodic data matching under section

256B.0561 and other electronic data sources. The commissioner must not request additional

information or documentation from an applicable individual unless the commissioner is

unable to make a determination using the information available to the commissioner.

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(b) The commissioner is prohibited from relying on managed care plans, county-based

purchasing plans, or contractors with direct or indirect financial relationships with managed

care or county-based purchasing plans to make determinations about whether an individual

is subject to, compliant with, or excepted from the community engagement requirements.

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Subd. 5.

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Failure to satisfy community engagement requirements.

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(a) If the

commissioner cannot establish an applicable individual's compliance with or exception from

the community engagement requirements, the commissioner must provide notice of

noncompliance and allow the applicant or beneficiary 30 calendar days from the date the

notice is received to demonstrate compliance with or exception from the requirements. The

notice must include:

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(1) information about how to demonstrate compliance with or exception from the

requirements; and

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(2) information about how to reapply for medical assistance if the individual's application

is denied or if the beneficiary is disenrolled.

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(b) An enrolled beneficiary continues to be eligible for medical assistance during the

30-day period under paragraph (a).

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(c) The commissioner must suspend medical assistance benefits for applicable individuals

who do not satisfy the community engagement requirements. The commissioner must

reinstate the medical assistance benefits once the applicable individual satisfies the

requirements for a calendar month. Medical assistance benefits must be reinstated the first

day of the month following the month for which the individual has satisfied the community

engagement requirements.

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(d) If the commissioner determines that an individual is subject to but not compliant

with the community engagement requirements after the 30-day period, then the commissioner

must:

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(1) determine whether the individual has any other basis for eligibility for medical

assistance or another insurance affordability program;

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(2) provide written notice and fair hearing rights in accordance with Code of Federal

Regulations, title 42, part 431, subpart E; and

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(3) if there is no other basis for medical assistance eligibility, deny the application or

terminate eligibility by the end of the month that follows the 30-day period.

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Subd. 6.

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Outreach to applicable individuals.

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(a) By September 1, 2026, the

commissioner must notify medical assistance enrollees who may be applicable individuals

about the community engagement requirements.

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(b) Beginning January 1, 2027, the commissioner must semiannually notify medical

assistance enrollees who may be applicable individuals about the community engagement

requirements.

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(c) The notifications required under this subdivision must include, at a minimum:

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(1) information about how to comply with the community engagement requirements;

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(2) an explanation of who is considered an applicable individual;

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(3) the list of exceptions to the community engagement requirements and how to obtain

an exception from the requirements;

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(4) information about how to report a change in status that could result in the individual

qualifying for an exception, meeting an exception, or being subject to the community

engagement requirements after an exception ends; and

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(5) information about the consequences of not complying with the community engagement

requirements.

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(d) The commissioner must provide the notices required under this subdivision by mail

or an electronic format, if elected by the individual, and one or more additional formats

deemed appropriate by the United States Department of Health and Human Services.

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Subd. 7.

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Additional requirements for the commissioner.

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The commissioner, in

collaboration with county agencies, must implement strategies to assist applicable individuals

in meeting the community engagement requirements and link applicable individuals to

additional resources for job training or other employment services, child care assistance,

transportation, or other supports to help applicable individuals prepare for work, maintain

employment, or increase earnings.

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Sec. 2.

Minnesota Statutes 2025 Supplement, section 268.19, subdivision 1, is amended

to read:

Subdivision 1.

Use of data.

(a) Except as provided by this section, data gathered from

any person under the administration of the Minnesota Unemployment Insurance Law are

private data on individuals or nonpublic data not on individuals as defined in section
13.02,

subdivisions 9
and 12, and may not be disclosed except according to a district court order

or section
13.05
. A subpoena is not considered a district court order. These data may be

disseminated to and used by the following agencies without the consent of the subject of

the data:

(1) state and federal agencies specifically authorized access to the data by state or federal

law;

(2) any agency of any other state or any federal agency charged with the administration

of an unemployment insurance program;

(3) any agency responsible for the maintenance of a system of public employment offices

for the purpose of assisting individuals in obtaining employment;

(4) the public authority responsible for child support in Minnesota or any other state in

accordance with section
518A.83
;

(5) human rights agencies within Minnesota that have enforcement powers;

(6) the Department of Revenue to the extent necessary for its duties under Minnesota

laws;

(7) public and private agencies responsible for administering publicly financed assistance

programs for the purpose of monitoring the eligibility of the program's recipients;

(8) the Department of Labor and Industry, the Department of Commerce, and the Bureau

of Criminal Apprehension for uses consistent with the administration of their duties under

Minnesota law;

(9) the Department of Human Services and the Office of Inspector General and its agents

within the Department of Human Services, including county fraud investigators, for

investigations related to recipient or provider fraud and employees of providers when the

provider is suspected of committing public assistance fraud;

(10) the Department of Human Services for the purpose of evaluating medical assistance

services
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and
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,
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supporting program improvement
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, and administering section 256B.0562
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;

(11) local and state welfare agencies for monitoring the eligibility of the data subject

for assistance programs, or for any employment or training program administered by those

agencies, whether alone, in combination with another welfare agency, or in conjunction

with the department or to monitor and evaluate the statewide Minnesota family investment

program and other cash assistance programs, the Supplemental Nutrition Assistance Program,

and the Supplemental Nutrition Assistance Program Employment and Training program by

providing data on recipients and former recipients of Supplemental Nutrition Assistance

Program (SNAP) benefits, cash assistance under chapter 256, 256D, 256J, or 256K, child

care assistance under chapter 142E, or medical programs under chapter 256B or 256L or

formerly codified under chapter 256D;

(12) local and state welfare agencies for the purpose of identifying employment, wages,

and other information to assist in the collection of an overpayment debt in an assistance

program;

(13) local, state, and federal law enforcement agencies for the purpose of ascertaining

the last known address and employment location of an individual who is the subject of a

criminal investigation;

(14) the United States Immigration and Customs Enforcement has access to data on

specific individuals and specific employers provided the specific individual or specific

employer is the subject of an investigation by that agency;

(15) the Department of Health for the purposes of epidemiologic investigations;

(16) the Department of Corrections for the purposes of case planning and internal research

for preprobation, probation, and postprobation employment tracking of offenders sentenced

to probation and preconfinement and postconfinement employment tracking of committed

offenders;

(17) the state auditor to the extent necessary to conduct audits of job opportunity building

zones as required under section
469.3201
;

(18) the Office of Higher Education for purposes of supporting program improvement,

system evaluation, and research initiatives including the Statewide Longitudinal Education

Data System;

(19) the Family and Medical Benefits Division of the Department of Employment and

Economic Development to be used as necessary to administer chapter 268B; and

(20) the executive director or interim executive director of the Minnesota Secure Choice

Retirement Program established under chapter 187 for the purposes of assisting with

communication with employers and to verify employer compliance with chapter 187.

(b) Data on individuals and employers that are collected, maintained, or used by the

department in an investigation under section
268.182
are confidential as to data on individuals

and protected nonpublic data not on individuals as defined in section
13.02, subdivisions 3

and 13, and must not be disclosed except under statute or district court order or to a party

named in a criminal proceeding, administrative or judicial, for preparation of a defense.

(c) Data gathered by the department in the administration of the Minnesota unemployment

insurance program must not be made the subject or the basis for any suit in any civil

proceedings, administrative or judicial, unless the action is initiated by the department.

Sec. 3.

Minnesota Statutes 2024, section 268.19, subdivision 1a, is amended to read:

Subd. 1a.

Wage detail data.

(a) Wage and employment data gathered under section

268.044
may be disseminated to and used, without the consent of the subject of the data,

by an agency of another state that is designated as the performance accountability and

consumer information agency for that state under Code of Federal Regulations, volume 20,

part 663.510(c), in order to carry out the requirements of the Workforce Investment Act of

1998, United States Code, title 29, sections 2842 and 2871.

(b) The commissioner may enter into a data exchange agreement with an employment

and training service provider under section
116L.17
, or the Workforce Investment Act of

1998, United States Code, title 29, section 2864, under which the commissioner, with the

consent of the subject of the data, may furnish data on the quarterly wages paid and number

of hours worked on those individuals who have received employment and training services

from the provider. With the initial consent of the subject of the data, this data may be shared

for up to three years after termination of the employment and training services provided to

the individual without execution of an additional consent. This data is furnished solely for

the purpose of evaluating the employment and training services provided. The data subject's

ability to receive service is not affected by a refusal to give consent under this paragraph.

The consent form must state this fact.

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(c) Wage and employment data gathered under section 268.044 may be disseminated to

and used by the commissioner of human services for the purpose of administering section

256B.0562 without the consent of the subject data.

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Sec. 4.

Minnesota Statutes 2025 Supplement, section 270B.14, subdivision 1, is amended

to read:

Subdivision 1.

Disclosure to commissioner of human services.

(a) The commissioner

shall provide the records and information necessary to administer the supplemental housing

allowance to the commissioner of human services.

(b) At the request of the commissioner of human services, the commissioner of revenue

shall electronically match the Social Security or individual taxpayer identification numbers

and names of participants in the telephone assistance plan operated under sections
237.69

to
237.71
, with those of property tax refund filers under chapter 290A or renter's credit filers

under section 290.0693, and determine whether each participant's household income is

within the eligibility standards for the telephone assistance plan.

(c) The commissioner may provide records and information collected under sections

295.50
to
295.59
to the commissioner of human services for purposes of the Medicaid

Voluntary Contribution and Provider-Specific Tax Amendments of 1991, Public Law

102-234. Upon the written agreement by the United States Department of Health and Human

Services to maintain the confidentiality of the data, the commissioner may provide records

and information collected under sections
295.50
to
295.59
to the Centers for Medicare and

Medicaid Services section of the United States Department of Health and Human Services

for purposes of meeting federal reporting requirements.

(d) The commissioner may provide records and information to the commissioner of

human services as necessary to administer the early refund of refundable tax credits.

(e) The commissioner may disclose information to the commissioner of human services

as necessary for income verification for eligibility and premium payment under the

MinnesotaCare program, under section
256L.05, subdivision 2
, as well as the medical

assistance program under chapter 256B.

(f) The commissioner may disclose information to the commissioner of human services

necessary to verify whether applicants or recipients for general assistance and the Minnesota

supplemental aid program have claimed refundable tax credits under chapter 290 and the

property tax refund under chapter 290A, and the amounts of the credits.

(g) At the request of the commissioner of human services and when authorized in writing

by the taxpayer, the commissioner of revenue may match the business legal name or

individual legal name, and the Minnesota tax identification number, federal Employer

Identification Number, or Social Security number of the applicant under section
142C.03
;

245A.04, subdivision 1
; or
245I.20
; or license or certification holder. The commissioner of

revenue may share the matching with the commissioner of human services. The matching

may only be used by the commissioner of human services to determine eligibility for provider

grant programs and to facilitate the regulatory oversight of license and certification holders

as it relates to ownership and public funds program integrity. This paragraph applies only

if the commissioner of human services and the commissioner of revenue enter into an

interagency agreement for the purposes of this paragraph.

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(h) The commissioner may disclose return information to the commissioner of human

services for the purpose of administering section 256B.0562.

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