Omnibus HHS Budget Bill Passes through Finance, Heads to the Floor

The Senate Omnibus HHS Finance Bill passed the Finance Committee on Wednesday and heads to the Floor on Friday. The package places an emphasis on long-term care, child protection, MNsure restructure, mental health, the health care workforce, Medical Assistance – Employees with Disabilities (MA-EPD) premiums, Medical Assistance (MA) spenddown, and telehealth.

Major proposals include:

Nursing Home Workforce Enhancement: $25.1 million to provide an operating payment rate increase to nursing facilities to increase wages and benefits for employees. The average rate increase to each facility is projected to be 5%.

Child Protection: $52.1 million provides additional oversight for the state’s child protection system, including best practice development, child protection workers training, and increasing child protections staffing levels at the county level.

Reducing the Basic Sliding Fee Waitlist: $19.2 million – In the first year of the biennium, the funds are targeted to counties with the largest Child Care Assistance Program (CCAP) waitlist. In the second year, the funds are distributed according to the current formula.

Mental Health Services: $35.2 million to expand access to mental health services through extensive investments. Projects include expanding respite care, increasing availability of crisis services, certifying behavioral health clinics, increasing available capacity at behavioral health homes, expanding residential treatment beds, expanding assertive community treatment, and investing in supportive housing with services.

Improving Access to Health Care for Persons with Disabilities and Seniors: $13.9 million in total

  • Eliminating MA-EPD Premium Increase: $5.2 million to restore the premium and additional fee on unearned income to pre-2014 levels. The minimum premium amount is reduced from $65 to $35, and the additional fee is reduced to one-half of one percent.
  • Reduce the MA Spenddown for Seniors and Persons with Disabilities: $3.5 million decreases the amount of income this population has to spenddown in order to qualify for MA. Current spenddown for those over 100% FPG (Federal Poverty Guidelines) is down to 75% FPG. Starting Jan. 1, 2017 the spenddown will be increased to 85% FPG and on Jan. 1, 2019 it will be increased again to 95% FPG. The legislation also repeals a state law that, for purposes of determining a spouse’s eligibility for MA for long-term care, treats assets converted to an income stream as available to an institutionalized spouse.

MNsure: $3.1 million transitions MNsure’s governance from a board to a state agency with a commissioner appointed by the Governor. The funds also provide an increase to assister payments to provide parity across enrollments in both public programs and Qualified Health Plans (QHPs).

Self-Directed Workforce: $16.2 million provides the funding for the negotiated contract between DHS and the newly-organized providers of direct support. As a result of these negotiations, the contracts now include funding for training, a wage floor of $10.75/hour in 2016 and $11/hour in 2017, and paid time off requirements.

Providing Support for Primary Care Providers: $13.8 million in total

Rural Health Professional Loan Forgiveness Program: $6.2 million from the HCAF to expand possible participants to advanced dental therapists, dental therapists, mental health professionals and public health nurses that practice in a designated rural area.

Primary Care MA Provider Increase: $5.6 million increases the MA reimbursement to physicians, APRNs and physician assistants that perform services when delivered with a specialty designation of family medicine, general internal medicine, or pediatric medicine.

Increasing Opportunities for International Medical Graduates: $2 million creates a revolving loan fund and increases residency slots for foreign-trained physicians.

DHS/MNsure Activities:

DHS Resources for MNsure Development and Operations: $11.6 million to transfer funds to MNsure to pay for DHS-related expenses in developing the IT system and ongoing business operations costs.

MN.IT Reimburse Excess Charges for Shared Technology Services: This saves $7.2 million (onetime) and reimburses DHS for a payment made to MN.IT. The Office of the Legislative Auditor report found that MN.IT overcharged DHS for the technology services it provided. Therefore, the Senate is requiring MN.IT to pay back the amount it overcharged.

Managed Care Administrative Costs Efficiency: This saves $18.2 million and captures savings from managed care contracts. DHS believes that there can be a .5% decrease in the managed care plans’ growth in the next biennium. Therefore, this yields savings for the HHS budget.

Increasing Reimbursement for Dental Providers in MA: $14.7 million to provide a 24% rate increase to dental providers in MA, and create a critical access pool available to individuals who serve MA clients with the stipulation that they also accept MNCare enrollees.

Minnesota Telemedicine Act: $773,000 requires both private health insurers and MA to provide reimbursement for telehealth services as if they were provided to the patient in-person, and treat the two deliveries the same when determining payment rates.

The Omnibus HHS Budget Bill will be heard on the Senate Floor Friday, April 24. (S.F. 1458)

Senate DFL Media