Read the full stored bill text
A bill for an act
relating to human services; regulating electronic visit verification requirements;
modifying nonemergency medical transportation; amending Minnesota Statutes
2024, sections 256B.0625, subdivision 17b; 256B.073, subdivisions 1, 2, 3, 5, by
adding subdivisions; Minnesota Statutes 2025 Supplement, section 256B.0625,
subdivision 17; repealing Minnesota Statutes 2024, section 256B.073, subdivision
4.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Section 1.
Minnesota Statutes 2025 Supplement, section 256B.0625, subdivision 17, is
amended to read:
Subd. 17.
Transportation costs.
(a) "Nonemergency medical transportation service"
means motor vehicle transportation provided by a public or private person that serves
Minnesota health care program beneficiaries who do not require emergency ambulance
service, as defined in section
144E.001, subdivision 3
, to obtain covered medical services.
(b) For purposes of this subdivision, "rural urban commuting area" or "RUCA" means
a census-tract based classification system under which a geographical area is determined
to be urban, rural, or super rural. This paragraph expires July 1, 2026, for medical assistance
fee-for-service and January 1, 2027, for prepaid medical assistance.
(c) Medical assistance covers medical transportation costs incurred solely for obtaining
emergency medical care or transportation costs incurred by eligible persons in obtaining
emergency or nonemergency medical care when paid directly to an ambulance company,
nonemergency medical transportation company, or other recognized providers of
transportation services. Medical transportation must be provided by:
(1) nonemergency medical transportation providers who meet the requirements of this
subdivision;
(2) ambulances, as defined in section
144E.001, subdivision 2
;
(3) taxicabs that meet the requirements of this subdivision;
(4) public transportation, within the meaning of "public transportation" as defined in
section
174.22
, subdivision 7; or
(5) not-for-hire vehicles, including volunteer drivers, as defined in section
65B.472
,
subdivision 1, paragraph (p).
(d) Medical assistance covers nonemergency medical transportation provided by
nonemergency medical transportation providers enrolled in the Minnesota health care
programs. All nonemergency medical transportation providers must comply with the
operating standards for special transportation service as defined in sections
174.29
to
174.30
and Minnesota Rules, chapter 8840, and all drivers must be individually enrolled with the
commissioner and reported on the claim as the individual who provided the service. All
nonemergency medical transportation providers shall bill for nonemergency medical
transportation services in accordance with Minnesota health care programs criteria. Publicly
operated transit systems, volunteers, and not-for-hire vehicles are exempt from the
requirements outlined in this paragraph.
new text begin
This paragraph expires upon the effective date of
paragraph (e).
new text end
new text begin
(e) Effective January 1, 2027, or upon federal approval, whichever is later, medical
assistance covers nonemergency medical transportation provided by nonemergency medical
transportation providers enrolled in the Minnesota health care programs. All nonemergency
medical transportation providers must comply with the operating standards for special
transportation service as defined in sections 174.29 to 174.30 and Minnesota Rules, chapter
8840, and all drivers must be individually enrolled with the commissioner and reported on
the claim as the individual who provided the service. All nonemergency medical
transportation providers must bill for nonemergency medical transportation services in
accordance with Minnesota health care programs criteria and comply with the requirements
under section 256B.073. Publicly operated transit systems, volunteers, and not-for-hire
vehicles are exempt from the requirements in this paragraph.
new text end
deleted text begin
(e)
deleted text end
new text begin
(f)
new text end
An organization may be terminated, denied, or suspended from enrollment if:
(1) the provider has not initiated background studies on the individuals specified in
section
174.30, subdivision 10
, paragraph (a), clauses (1) to (3); or
(2) the provider has initiated background studies on the individuals specified in section
174.30, subdivision 10
, paragraph (a), clauses (1) to (3), and:
(i) the commissioner has sent the provider a notice that the individual has been
disqualified under section
245C.14
; and
(ii) the individual has not received a disqualification set-aside specific to the special
transportation services provider under sections
245C.22
and
245C.23
.
deleted text begin
(f)
deleted text end
new text begin
(g)
new text end
The administrative agency of nonemergency medical transportation must:
(1) adhere to the policies defined by the commissioner;
(2) pay nonemergency medical transportation providers for services provided to
Minnesota health care programs beneficiaries to obtain covered medical services;
(3) provide data monthly to the commissioner on appeals, complaints, no-shows, canceled
trips, and number of trips by mode; and
(4) by July 1, 2016, in accordance with subdivision 18e, utilize a web-based single
administrative structure assessment tool that meets the technical requirements established
by the commissioner, reconciles trip information with claims being submitted by providers,
and ensures prompt payment for nonemergency medical transportation services. This
paragraph expires July 1, 2026, for medical assistance fee-for-service and January 1, 2027,
for prepaid medical assistance.
deleted text begin
(g)
deleted text end
new text begin
(h)
new text end
Effective July 1, 2026, for medical fee-for-service and January 1, 2027, for prepaid
medical assistance, the administrative agency of nonemergency medical transportation must:
(1) adhere to the policies defined by the commissioner;
(2) pay nonemergency medical transportation providers for services provided to
Minnesota health care program beneficiaries to obtain covered medical services; and
(3) provide data monthly to the commissioner on appeals, complaints, no-shows, canceled
trips, and number of trips by mode.
deleted text begin
(h)
deleted text end
new text begin
(i)
new text end
Until the commissioner implements the single administrative structure and delivery
system under subdivision 18e, clients shall obtain their level-of-service certificate from the
commissioner or an entity approved by the commissioner that does not dispatch rides for
clients using modes of transportation under paragraph
deleted text begin
(n)
deleted text end
new text begin
(o)
new text end
, clauses (4), (5), (6), and (7).
This paragraph expires July 1, 2026, for medical assistance fee-for-service and January 1,
2027, for prepaid medical assistance.
deleted text begin
(i)
deleted text end
new text begin
(j)
new text end
The commissioner may use an order by the recipient's attending physician, advanced
practice registered nurse, physician assistant, or a medical or mental health professional to
certify that the recipient requires nonemergency medical transportation services.
Nonemergency medical transportation providers shall perform driver-assisted services for
eligible individuals, when appropriate. Driver-assisted service includes passenger pickup
at and return to the individual's residence or place of business, assistance with admittance
of the individual to the medical facility, and assistance in passenger securement or in securing
of wheelchairs, child seats, or stretchers in the vehicle.
deleted text begin
(j)
deleted text end
new text begin
(k)
new text end
Nonemergency medical transportation providers must take clients to the health
care provider using the most direct route, and must not exceed 30 miles for a trip to a primary
care provider or 60 miles for a trip to a specialty care provider, unless the client receives
authorization from the local agency. This paragraph expires July 1, 2026, for medical
assistance fee-for-service and January 1, 2027, for prepaid medical assistance.
deleted text begin
(k)
deleted text end
new text begin
(l)
new text end
Effective July 1, 2026, for medical assistance fee-for-service and January 1, 2027,
for prepaid medical assistance, nonemergency medical transportation providers must take
clients to the health care provider using the most direct route and must not exceed 30 miles
for a trip to a primary care provider or 60 miles for a trip to a specialty care provider, unless
the client receives authorization from the administrator.
deleted text begin
(l)
deleted text end
new text begin
(m)
new text end
Nonemergency medical transportation providers may not bill for separate base
rates for the continuation of a trip beyond the original destination. Nonemergency medical
transportation providers must maintain trip logs, which include pickup and drop-off times,
signed by the medical provider or client, whichever is deemed most appropriate, attesting
to mileage traveled to obtain covered medical services. Clients requesting client mileage
reimbursement must sign the trip log attesting mileage traveled to obtain covered medical
services.
deleted text begin
(m)
deleted text end
new text begin
(n)
new text end
The administrative agency shall use the level of service process established by
the commissioner to determine the client's most appropriate mode of transportation. If public
transit or a certified transportation provider is not available to provide the appropriate service
mode for the client, the client may receive a onetime service upgrade.
deleted text begin
(n)
deleted text end
new text begin
(o)
new text end
The covered modes of transportation are:
(1) client reimbursement, which includes client mileage reimbursement provided to
clients who have their own transportation, or to family or an acquaintance who provides
transportation to the client;
(2) volunteer transport, which includes transportation by volunteers using their own
vehicle;
(3) unassisted transport, which includes transportation provided to a client by a taxicab
or public transit. If a taxicab or public transit is not available, the client can receive
transportation from another nonemergency medical transportation provider;
(4) assisted transport, which includes transport provided to clients who require assistance
by a nonemergency medical transportation provider;
(5) lift-equipped/ramp transport, which includes transport provided to a client who is
dependent on a device and requires a nonemergency medical transportation provider with
a vehicle containing a lift or ramp;
(6) protected transport, which includes transport provided to a client who has received
a prescreening that has deemed other forms of transportation inappropriate and who requires
a provider: (i) with a protected vehicle that is not an ambulance or police car and has safety
locks, a video recorder, and a transparent thermoplastic partition between the passenger and
the vehicle driver; and (ii) who is certified as a protected transport provider; and
(7) stretcher transport, which includes transport for a client in a prone or supine position
and requires a nonemergency medical transportation provider with a vehicle that can transport
a client in a prone or supine position.
deleted text begin
(o)
deleted text end
new text begin
(p)
new text end
The local agency shall be the single administrative agency and shall administer
and reimburse for modes defined in paragraph
deleted text begin
(n)
deleted text end
new text begin
(o)
new text end
according to paragraphs
deleted text begin
(r)
deleted text end
new text begin
(s)
new text end
to
deleted text begin
(t)
deleted text end
new text begin
(u)
new text end
when the commissioner has developed, made available, and funded the web-based single
administrative structure, assessment tool, and level of need assessment under subdivision
18e. The local agency's financial obligation is limited to funds provided by the state or
federal government. This paragraph expires July 1, 2026, for medical assistance
fee-for-service and January 1, 2027, for prepaid medical assistance.
deleted text begin
(p)
deleted text end
new text begin
(q)
new text end
The commissioner shall:
(1) verify that the mode and use of nonemergency medical transportation is appropriate;
(2) verify that the client is going to an approved medical appointment; and
(3) investigate all complaints and appeals.
deleted text begin
(q)
deleted text end
new text begin
(r)
new text end
The administrative agency shall pay for the services provided in this subdivision
and seek reimbursement from the commissioner, if appropriate. As vendors of medical care,
local agencies are subject to the provisions in section
256B.041
, the sanctions and monetary
recovery actions in section
256B.064
, and Minnesota Rules, parts
9505.2160
to
9505.2245
.
This paragraph expires July 1, 2026, for medical assistance fee-for-service and January 1,
2027, for prepaid medical assistance.
deleted text begin
(r)
deleted text end
new text begin
(s)
new text end
Payments for nonemergency medical transportation must be paid based on the
client's assessed mode under paragraph
deleted text begin
(m)
deleted text end
new text begin
(n)
new text end
, not the type of vehicle used to provide the
service. The medical assistance reimbursement rates for nonemergency medical transportation
services that are payable by or on behalf of the commissioner for nonemergency medical
transportation services are:
(1) $0.22 per mile for client reimbursement;
(2) up to 100 percent of the Internal Revenue Service business deduction rate for volunteer
transport;
(3) equivalent to the standard fare for unassisted transport when provided by public
transit, and $12.10 for the base rate and $1.43 per mile when provided by a nonemergency
medical transportation provider;
(4) $14.30 for the base rate and $1.43 per mile for assisted transport;
(5) $19.80 for the base rate and $1.70 per mile for lift-equipped/ramp transport;
(6) $75 for the base rate and $2.40 per mile for protected transport; and
(7) $60 for the base rate and $2.40 per mile for stretcher transport, and $9 per trip for
an additional attendant if deemed medically necessary. This paragraph expires July 1, 2026,
for medical assistance fee-for-service and January 1, 2027, for prepaid medical assistance.
deleted text begin
(s)
deleted text end
new text begin
(t)
new text end
Effective July 1, 2026, for medical assistance fee-for-service and January 1, 2027,
for prepaid medical assistance, payments for nonemergency medical transportation must
be paid based on the client's assessed mode under paragraph
deleted text begin
(m)
deleted text end
new text begin
(n)
new text end
, not the type of vehicle
used to provide the service.
deleted text begin
(t)
deleted text end
new text begin
(u)
new text end
The base rate for nonemergency medical transportation services in areas defined
under RUCA to be super rural is equal to 111.3 percent of the respective base rate in
paragraph
deleted text begin
(r)
deleted text end
new text begin
(s)
new text end
, clauses (1) to (7). The mileage rate for nonemergency medical transportation
services in areas defined under RUCA to be rural or super rural areas is:
(1) for a trip equal to 17 miles or less, equal to 125 percent of the respective mileage
rate in paragraph
deleted text begin
(r)
deleted text end
new text begin
(s)
new text end
, clauses (1) to (7); and
(2) for a trip between 18 and 50 miles, equal to 112.5 percent of the respective mileage
rate in paragraph
deleted text begin
(r)
deleted text end
new text begin
(s)
new text end
, clauses (1) to (7). This paragraph expires July 1, 2026, for medical
assistance fee-for-service and January 1, 2027, for prepaid medical assistance.
deleted text begin
(u)
deleted text end
new text begin
(v)
new text end
For purposes of reimbursement rates for nonemergency medical transportation
services under paragraphs
deleted text begin
(r)
deleted text end
new text begin
(s)
new text end
to
deleted text begin
(t)
deleted text end
new text begin
(u)
new text end
, the zip code of the recipient's place of residence
shall determine whether the urban, rural, or super rural reimbursement rate applies. This
paragraph expires July 1, 2026, for medical assistance fee-for-service and January 1, 2027,
for prepaid medical assistance.
deleted text begin
(v)
deleted text end
new text begin
(w)
new text end
The commissioner, when determining reimbursement rates for nonemergency
medical transportation, shall exempt all modes of transportation listed under paragraph
deleted text begin
(n)
deleted text end
new text begin
(o)
new text end
from Minnesota Rules, part
9505.0445
, item R, subitem (2).
deleted text begin
(w)
deleted text end
new text begin
(x)
new text end
Effective for the first day of each calendar quarter in which the price of gasoline
as posted publicly by the United States Energy Information Administration exceeds $3.00
per gallon, the commissioner shall adjust the rate paid per mile in paragraph
deleted text begin
(r)
deleted text end
new text begin
(s)
new text end
by one
percent up or down for every increase or decrease of ten cents for the price of gasoline. The
increase or decrease must be calculated using a base gasoline price of $3.00. The percentage
increase or decrease must be calculated using the average of the most recently available
price of all grades of gasoline for Minnesota as posted publicly by the United States Energy
Information Administration. This paragraph expires July 1, 2026, for medical assistance
fee-for-service and January 1, 2027, for prepaid medical assistance.
Sec. 2.
Minnesota Statutes 2024, section 256B.0625, subdivision 17b, is amended to read:
Subd. 17b.
Documentation required.
(a) As a condition for payment, nonemergency
medical transportation providers must document each occurrence of a service provided to
a recipient according to this subdivision. Providers must maintain records sufficient to
distinguish individual trips with specific vehicles and drivers. The documentation may be
collected and maintained using electronic systems or software or in paper form but must be
made available and produced upon request. Program funds paid for transportation that is
not documented according to this subdivision may be subject to recovery by the commissioner
pursuant to section
256B.064
.
(b) A nonemergency medical transportation provider must compile transportation trip
records that are written in English and legible according to the standard of a reasonable
person and that include each of the following elements:
(1) the recipient's name;
(2) the date or dates the service is provided, if different than the date the entry was made;
(3) either the printed name of the driver sufficient to distinguish the driver of service or
the driver's provider number;
(4) the date and the signature of the driver attesting that the record accurately represents
the services provided and the actual miles driven, and acknowledging that misreporting
information that results in ineligible or excessive payments may result in civil or criminal
action;
(5) the date and the signature of the recipient or authorized party attesting that
transportation services were provided as indicated on the transportation trip record, or the
signature of the medical services provider certifying that the recipient was transported to
the medical services provider destination. In the event that both the medical services provider
and the recipient or authorized party refuse or are unable to provide signatures, the driver
must document on the transportation trip record that signatures were requested and not
provided;
(6) the address, or the description if the address is not available, of both the origin and
destination, and the mileage for the most direct route from the origin to the destination;
(7) the name or number of the mode of transportation in which the service is provided;
(8) the license plate number of the vehicle used to transport the recipient;
(9) the time of the recipient pickup;
(10) the time of the recipient drop-off;
(11) the odometer reading of the vehicle used to transport the recipient taken at the time
of pickup;
(12) the odometer reading of the vehicle used to transport the recipient taken at the time
of drop-off;
(13) the name of the extra attendant when an extra attendant is used to provide special
transportation service; and
(14) the documentation indicating the method that was used to determine the most direct
route.
(c) In determining whether the commissioner will seek recovery, the documentation
requirements in this section apply retroactively to audit findings beginning January 1, 2020,
and to all audit findings thereafter.
new text begin
(d) Effective January 1, 2027, or upon federal approval, whichever is later, records that
comply with section 256B.073 may be used to meet the requirements under this subdivision
if all required elements are included in the record.
new text end
Sec. 3.
Minnesota Statutes 2024, section 256B.073, subdivision 1, is amended to read:
Subdivision 1.
Documentation; establishment
new text begin
and operation
new text end
.
The commissioner of
human services shall establish
deleted text begin
implementation requirements and standards for
deleted text end
new text begin
and maintain
the requirements and standards for the ongoing operation of
new text end
electronic visit verification to
comply with the 21st Century Cures Act, Public Law 114-255. Within available
appropriations, the commissioner shall take steps to comply with the electronic visit
verification requirements in the 21st Century Cures Act, Public Law 114-255.
Sec. 4.
Minnesota Statutes 2024, section 256B.073, subdivision 2, is amended to read:
Subd. 2.
Definitions.
(a) For purposes of this section, the terms in this subdivision have
the meanings given
deleted text begin
them
deleted text end
.
new text begin
(b) "Data aggregator" means the entity designated by the commissioner to collect, store,
and transmit electronic visit verification data from providers and third-party systems to the
commissioner in accordance with the standards and requirements established under this
section.
new text end
deleted text begin
(b)
deleted text end
new text begin
(c)
new text end
"Electronic visit verification"
new text begin
or "EVV"
new text end
means the
deleted text begin
electronic documentation of
the
deleted text end
new text begin
process required under this section and United States Code, title 42, section 1396b(l),
used to electronically verify the
new text end
:
(1) type of service performed;
(2) individual receiving the service;
(3) date of the service;
(4) location of the service delivery;
(5) individual providing the service; and
(6) time the service begins and ends.
new text begin
(d) "Electronic visit verification data" means information collected through an electronic
visit verification system, including data elements required under United States Code, title
42, section 1396b(l), and any additional data elements specified by the commissioner under
this section.
new text end
deleted text begin
(c)
deleted text end
new text begin
(e)
new text end
"Electronic visit verification system" means a system
deleted text begin
that provides electronic
verification of services
deleted text end
new text begin
used to collect, verify, and transmit electronic visit verification data
to the commissioner or the commissioner's designated data aggregator
new text end
that complies with
the 21st Century Cures Act, Public Law 114-255, and the requirements of subdivision 3.
new text begin
(f) "Electronic visit verification vendor" means any entity that develops, provides, or
supports an electronic visit verification system, including the state-provided vendor and
any third-party vendor.
new text end
new text begin
(g) "Financial management services provider" means an entity enrolled with the
commissioner to provide financial management services under section 256B.85 or other
applicable law and responsible for fiscal, payroll, and reporting functions on behalf of
participant employers.
new text end
new text begin
(h) "Home health agency" means a home care provider agency that is Medicare certified
under Code of Federal Regulations, title 42, part 484, and licensed as a home care provider
under chapter 144A.
new text end
new text begin
(i) "Individual" means a person who receives services subject to electronic visit
verification under the medical assistance program.
new text end
new text begin
(j) "Managed care organization" means a public or private organization that contracts
with the commissioner under section 256B.69 or other applicable law to deliver health care
services to individuals eligible for medical assistance or MinnesotaCare.
new text end
new text begin
(k) "Manual visit" means a visit:
new text end
new text begin
(1) entered administratively and not by the caregiver at the time of service delivery; or
new text end
new text begin
(2) where data elements are edited after the time of service delivery.
new text end
new text begin
(l) "Provider" means an individual or organization that meets one or more of the following
conditions:
new text end
new text begin
(1) is enrolled as a Minnesota health care programs provider;
new text end
new text begin
(2) provides services through a managed care organization under contract with the
commissioner under section 256B.69;
new text end
new text begin
(3) is a financial management services provider; or
new text end
new text begin
(4) is a participant employer under section 256B.85, subdivision 7, or an employer of
record that is directing services under section 256B.49, subdivision 16.
new text end
deleted text begin
(d)
deleted text end
new text begin
(m)
new text end
"Service" means one of the following:
(1) personal care assistance services as defined in section
256B.0625, subdivision 19a
,
and provided according to section
256B.0659
;
(2) community first services and supports under section
256B.85
;
(3) home health services under section
256B.0625, subdivision 6a
;
deleted text begin
or
deleted text end
(4)
new text begin
adult companion services;
new text end
new text begin
(5) adult day services;
new text end
new text begin
(6) adult rehabilitative mental health services;
new text end
new text begin
(7) assertive community treatment;
new text end
new text begin
(8) early intensive developmental and behavioral intervention;
new text end
new text begin
(9) integrated community supports;
new text end
new text begin
(10) nonemergency medical transportation services;
new text end
new text begin
(11) recovery peer support;
new text end
new text begin
(12) home and community-based services reimbursed at an hourly or specified
minute-based rate and provided according to a federally approved waiver plan as authorized
under chapter 256S or section 256B.0913, 256B.092, or 256B.49; or
new text end
new text begin
(13)
new text end
other medical supplies and equipment or home and community-based services that
are required to be electronically verified by the 21st Century Cures Act, Public Law 114-255.
new text begin
(n) "State-provided electronic visit verification system" means the electronic visit
verification system made available by the commissioner to providers at no cost for services
subject to federal electronic visit verification requirements.
new text end
new text begin
(o) "Third-party electronic visit verification system" means an electronic visit verification
system purchased or operated by a provider or vendor other than the state-provided system
designated by the commissioner.
new text end
new text begin
(p) "Verification method" means the electronic process used to capture and verify visit
information, including telephone, fixed visit verification devices, or mobile applications,
as approved by the commissioner.
new text end
new text begin
(q) "Visit" means a single occurrence of service delivery subject to electronic visit
verification.
new text end
new text begin
(r) "Worker" means an individual who provides personal care assistance services,
community first services and supports, home health services, consumer-directed community
supports, or other services identified by the commissioner as subject to electronic visit.
new text end
Sec. 5.
Minnesota Statutes 2024, section 256B.073, subdivision 3, is amended to read:
Subd. 3.
Requirements.
(a) In
deleted text begin
developing implementation requirements for
deleted text end
new text begin
administering
new text end
electronic visit verification, the commissioner
deleted text begin
shall
deleted text end
new text begin
must
new text end
ensure that the
new text begin
system and related
new text end
requirements:
(1) are
deleted text begin
minimally
deleted text end
administratively and financially
deleted text begin
burdensome to a provider
deleted text end
new text begin
reasonable
for providers of services
new text end
;
(2)
deleted text begin
are minimally burdensome
deleted text end
new text begin
support continued access
new text end
to
deleted text begin
the
deleted text end
new text begin
services and are designed
to avoid disruption to
new text end
service
deleted text begin
recipient and the least disruptive to the service recipient in
receiving and maintaining allowed services
deleted text end
new text begin
delivery or receipt
new text end
;
(3) consider existing best practices and use of electronic visit verification;
(4) are conducted according to all state and federal laws;
(5) are effective methods for preventing fraud when balanced against the requirements
of clauses (1) and (2); and
(6) are consistent with the Department of Human Services' policies related to covered
services, flexibility of service use, and quality assurance.
(b) The commissioner
deleted text begin
shall
deleted text end
new text begin
must
new text end
make training
new text begin
and guidance
new text end
available to providers
new text begin
of
services
new text end
on the electronic visit verification
deleted text begin
system
deleted text end
requirements
new text begin
and system use
new text end
.
(c) The commissioner
deleted text begin
shall
deleted text end
new text begin
must
new text end
establish baseline measurements related to preventing
fraud and establish measures to determine the effect of electronic visit verification
requirements on program integrity.
(d) The commissioner
deleted text begin
shall
deleted text end
new text begin
must
new text end
make a
deleted text begin
state-selected
deleted text end
new text begin
state-provided
new text end
electronic visit
verification system available to providers of services.
(e) The commissioner
deleted text begin
shall
deleted text end
new text begin
must
new text end
make available and publish on the agency website the
name and contact information for the vendor of the
deleted text begin
state-selected
deleted text end
new text begin
state-provided
new text end
electronic
visit verification system and the other vendors that offer alternative electronic visit
verification systems. The information provided must state that the
deleted text begin
state-selected
deleted text end
new text begin
state-provided
new text end
electronic visit verification system is offered at no cost to the provider of
services and that the provider
new text begin
of services
new text end
may choose an alternative system that may be at
a cost to the provider.
new text begin
(f) The commissioner may establish implementation dates and implementation schedules
for system functions subject to electronic visit verification under this section, including but
not limited to verification methods or technical requirements.
new text end
new text begin
(g) The commissioner may waive the requirements under this section for any service
component or setting when the application of electronic visit verification is contrary to
paragraph (a).
new text end
Sec. 6.
Minnesota Statutes 2024, section 256B.073, is amended by adding a subdivision
to read:
new text begin
Subd. 4a.
new text end
new text begin
Electronic visit verification system options.
new text end
new text begin
(a) A provider of services must
use an electronic visit verification system that complies with the requirements established
by the commissioner. A provider of services may use either the state-provided system or a
third-party system. All systems used for compliance must provide data to the commissioner
in the format and with the frequency required by the commissioner.
new text end
new text begin
(b) The commissioner must make a state-provided electronic visit verification system
available at no cost to providers of services. The commissioner must provide training on
the system to all providers of services.
new text end
new text begin
(c) The commissioner must allow providers of services to utilize a third-party electronic
visit verification system that the commissioner determines meets the requirements under
this section.
new text end
new text begin
(d) A provider of services using a third-party electronic visit verification system that
meets all technical specifications and federal and state laws must:
new text end
new text begin
(1) collect and submit all data for each visit to the commissioner, including but not
limited to manual entries;
new text end
new text begin
(2) maintain compliance identified by the commissioner, including but not limited to
incorporating into the system any changes in data requirements that must be transmitted to
the commissioner; and
new text end
new text begin
(3) integrate the system with the data aggregator to accurately send data.
new text end
new text begin
(e) The data aggregator must be available at no cost to a provider of services for purposes
of transmitting electronic visit verification data from approved third-party systems to the
commissioner. Any costs associated with the development and use of a third-party system
are the responsibility of the provider.
new text end
new text begin
(f) If a provider is unable to integrate a third-party system with the data aggregator, the
provider of services must use the state-provided electronic visit verification system.
new text end
new text begin
(g) The commissioner must provide training on reviewing and correcting imported data
in the data aggregator to providers of services.
new text end
Sec. 7.
Minnesota Statutes 2024, section 256B.073, is amended by adding a subdivision
to read:
new text begin
Subd. 4b.
new text end
new text begin
Provider responsibilities.
new text end
new text begin
A provider of services must:
new text end
new text begin
(1) use an electronic visit verification system that meets all technical and data submission
requirements established by the commissioner;
new text end
new text begin
(2) enroll with the state-provided electronic visit verification system or the data
aggregator, as applicable;
new text end
new text begin
(3) provide all information requested by the commissioner for enrollment, access, and
data submission and ensure that the information remains accurate and up to date;
new text end
new text begin
(4) maintain records for each individual receiving services subject to electronic visit
verification, including but not limited to all required data elements;
new text end
new text begin
(5) maintain a current list of workers providing services subject to electronic visit
verification to individuals receiving services under medical assistance;
new text end
new text begin
(6) provide the commissioner and any managed care organization with immediate, direct,
and on-site or remote access to the electronic visit verification system;
new text end
new text begin
(7) at the request of the commissioner or a managed care organization, allow review or
copying of electronic visit verification documentation at no cost;
new text end
new text begin
(8) ensure that electronic visit verification systems and related processes meet accessibility
and confidentiality requirements under state and federal law;
new text end
new text begin
(9) comply with all policies, procedures, and technical specifications issued by the
commissioner under this section; and
new text end
new text begin
(10) ensure that workers, participants, and other individuals using electronic visit
verification are trained and comply with all documentation and data entry requirements
established by the commissioner.
new text end
Sec. 8.
Minnesota Statutes 2024, section 256B.073, subdivision 5, is amended to read:
Subd. 5.
Vendor requirements.
(a) The vendor of the electronic visit verification system
deleted text begin
selected
deleted text end
new text begin
provided
new text end
by the commissioner and the vendor's affiliate must comply with the
requirements of this subdivision.
(b) The vendor of the
deleted text begin
state-selected
deleted text end
new text begin
state-provided
new text end
electronic visit verification system
and the vendor's affiliate must:
(1) notify the provider of services that the provider may choose the
deleted text begin
state-selected
deleted text end
new text begin
state-provided
new text end
electronic visit verification system at no cost to the provider;
(2) offer the
deleted text begin
state-selected
deleted text end
new text begin
state-provided
new text end
electronic visit verification system to the
provider of services prior to offering any fee-based electronic visit verification system;
(3) notify the provider of services that the provider may choose any fee-based electronic
visit verification system prior to offering the vendor's or its affiliate's fee-based electronic
visit verification system; and
(4) when offering the
deleted text begin
state-selected
deleted text end
new text begin
state-provided
new text end
electronic visit verification system,
clearly differentiate between the
deleted text begin
state-selected
deleted text end
new text begin
state-provided
new text end
electronic visit verification
system and the vendor's or its affiliate's alternative fee-based system.
(c) The vendor of the
deleted text begin
state-selected
deleted text end
new text begin
state-provided
new text end
electronic visit verification system
and the vendor's affiliate must not use state data that are not available to other vendors of
electronic visit verification systems to promote or sell the vendor's or its affiliate's alternative
electronic visit verification system.
(d) Upon request from the provider, the vendor of the
deleted text begin
state-selected
deleted text end
new text begin
state-provided
new text end
electronic visit verification system must provide proof of compliance with the requirements
of paragraph (b).
(e) An agreement between the vendor of the
deleted text begin
state-selected
deleted text end
new text begin
state-provided
new text end
electronic visit
verification system or its affiliate and a provider of services for an electronic visit verification
system that is not the
deleted text begin
state-selected
deleted text end
new text begin
state-provided
new text end
system entered into on or after July 1,
2023, is subject to immediate termination by the provider if the vendor violates any of the
requirements of paragraph (b).
Sec. 9.
Minnesota Statutes 2024, section 256B.073, is amended by adding a subdivision
to read:
new text begin
Subd. 6.
new text end
new text begin
Data and documentation.
new text end
new text begin
(a) A provider of services must submit electronic
visit verification data to the commissioner or the data aggregator in accordance with the
technical standards, format, and frequency established under this section. The commissioner
may use integrated electronic visit verification data for oversight, quality assurance, and
program integrity purposes consistent with state and federal law.
new text end
new text begin
(b) The commissioner and managed care organizations must use electronic visit
verification data to validate claims for payment under medical assistance. Claims that cannot
be validated in accordance with electronic visit verification requirements may be subject
to actions by the commissioner as authorized under state and federal law, including actions
related to payment, program integrity, or provider compliance.
new text end
new text begin
(c) A provider of services must record all required electronic visit verification data at
the time of service delivery using an approved verification method. To be compliant with
electronic visit verification requirements, a provider of services must document a visit with
all required data elements recorded at the time of service delivery.
new text end
new text begin
(d) A manual visit does not comply with electronic visit verification requirements. A
manual visit must be confirmed and verified according to processes established by the
commissioner before being used to validate or support a claim for payment.
new text end
new text begin
(e) A worker providing services subject to electronic visit verification must record the
start and end times of each visit at the time the service is delivered using an approved
verification method. A worker must complete and verify all time documentation, including
but not limited to verification of service type, date, and duration, on the date the service
occurs and be consistent with documentation requirements of the service being provided.
A provider of services must maintain documentation demonstrating compliance with this
subdivision and make the documentation available to the commissioner or a managed care
organization upon request.
new text end
Sec. 10.
Minnesota Statutes 2024, section 256B.073, is amended by adding a subdivision
to read:
new text begin
Subd. 7.
new text end
new text begin
Third-party system responsibilities.
new text end
new text begin
(a) This subdivision is effective for Early
Intensive Developmental and Behavioral Intervention services beginning July 1, 2027, or
upon federal approval, whichever is later. This subdivision is effective for all other services
subject to this subdivision beginning January 1, 2027, or upon federal approval, whichever
is later.
new text end
new text begin
(b) A provider of services using a third-party electronic visit verification system must
ensure that the system meets all technical, functional, and data-exchange requirements
established by the commissioner and transmits data to the commissioner or the data
aggregator in the format and with the frequency required by the commissioner.
new text end
new text begin
(c) A third-party electronic visit verification vendor must:
new text end
new text begin
(1) comply with all technical, contractual, privacy, and security standards established
by the commissioner;
new text end
new text begin
(2) not use or disclose state data for any purpose other than fulfilling the requirements
under this section or federal law;
new text end
new text begin
(3) provide the commissioner access to system documentation, data mapping, and audit
records upon request; and
new text end
new text begin
(4) immediately report to the commissioner any data transmission failure, breach, or
interruption affecting the commissioner's ability to receive required electronic visit
verification data.
new text end
new text begin
(d) A provider of services remains responsible for ensuring compliance with this section
even when using a third-party electronic visit verification system.
new text end
new text begin
(e) The third-party vendor must ensure training on the system is available to providers
of services.
new text end
new text begin
EFFECTIVE DATE.
new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 11.
new text begin
ELECTRONIC VISIT VERIFICATION AND MEDICAL ASSISTANCE
CLAIMS VALIDATION.
new text end
new text begin
(a) The commissioner of human services must develop, test, and implement systems
changes necessary to integrate data collected through electronic visit verification systems,
as described under Minnesota Statutes, section 256B.073, with Minnesota's Medicaid
Management Information System. Data collected through electronic visit verification systems
must be used as part of the commissioner's processes for validating claims for services
subject to electronic visit verification.
new text end
new text begin
(b) The commissioner of human services must require that managed care plans and
county-based purchasing plans ensure electronic visit verification and claims system
interoperability by January 1, 2027.
new text end
new text begin
EFFECTIVE DATE.
new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 12.
new text begin
REPEALER.
new text end
new text begin
Minnesota Statutes 2024, section 256B.073, subdivision 4,
new text end
new text begin
is repealed.
new text end
new text begin
EFFECTIVE DATE.
new text end
new text begin
This section is effective July 1, 2026.
new text end
APPENDIX
Repealed Minnesota Statutes: S4400-1
256B.073 ELECTRONIC VISIT VERIFICATION.
Subd. 4.
Provider requirements.
(a) A provider of services may select any electronic visit verification system that meets the requirements established by the commissioner.
(b) All electronic visit verification systems used by providers to comply with the requirements established by the commissioner must provide data to the commissioner in a format and at a frequency to be established by the commissioner.
(c) Providers must implement the electronic visit verification systems required under this section by a date established by the commissioner to be set after the state-selected electronic visit verification systems for personal care services and home health services are in production. For purposes of this paragraph, "personal care services" and "home health services" have the meanings given in United States Code, title 42, section 1396b(l)(5). Reimbursement rates for providers must not be reduced as a result of federal action to reduce the federal medical assistance percentage under the 21st Century Cures Act, Public Law 114-255.