Minnesota Hospital Association

Policy & Advocacy

2018 legislative session outcomes

View the 2018 legislative session outcomes

Overview

MHA had positive results on several key priorities and made progress on other issues that are likely to be part of our 2019 agenda. In addition to our proactive legislative agenda, the Legislature passed several bills that will impact hospitals.

MHA priority issue: Continue to build mental health supports

Expanding our mental health infrastructure was a key component of this year’s capital investment bonding bill. HF 4425/SF 4021 contains $28.1 million for mental health crisis centers, $1.9 million for the Scott County mental health crisis center and $30 million for housing infrastructure bonds for persons with behavioral health needs. MHA members are encouraged to partner with their local counties to develop these services, adding capacity to a stretched-too-thin system.

MHA-sponsored legislation (HF 2945/SF 2545) to streamline the facility licensing process for both Intensive Residential Treatment Services (IRTS) and mental health crisis services passed as a stand-alone bill with bipartisan support. There is acknowledgment that hospitals and our patients need more community discharge options.

Unfortunately, $5 million in annual funding for mental health services to students in our schools via telemedicine technology was part of the supplemental budget bill that the governor vetoed. MHA will continue to support this important state funding.

MHA priority issue: Preserve meaningful health care coverage for low-income Minnesotans

Republican majorities in both the House and Senate actively pursued legislation initiating a work requirement for “able-bodied” adults to be eligible for Medical Assistance coverage. MHA voiced opposition to this proposal and joined with a diverse coalition of organizations to defeat this legislation, which would have added to the number of uninsured and costs to the counties.

MHA worked to defeat an amendment that would have thwarted our innovative Integrated Health Partnerships (IHPs). In its first four years, the IHP program has produced positive results including $213 million in cost savings to the state, a 7 percent decrease in emergency room visits and a 14 percent decrease in hospital stays, all while improving the quality of care for 460,000 Minnesotans.

MHA worked to stop the inclusion of a provision allowing for the sale of short-term coverage policies. MHA supports meaningful coverage for low-income Minnesotans and for those who purchase insurance in the individual market. MHA opposes a return to a health insurance system that collects premiums without coverage for essential health services.

At the end of the legislative session, the Department of Human Services alerted legislators that CMS had informed the department that it remained out of compliance with federal rules regarding reimbursement rates for outpatient prescription drugs.

MHA priority issue: Pass MHA-approved reform of Minnesota’s outpatient workers’ compensation system

After two years of negotiations with the Minnesota Department of Labor and Industry, the Minnesota Chamber of Commerce and workers’ compensation carriers, MHA was able to help develop compromise legislation (HF 3873/SF 3420) that reforms Minnesota’s outpatient workers’ compensation payment methodology. Key to this compromise was agreement that payment rates would be budget-neutral until there is documented compliance that 80 percent of the claims meet the new administrative simplification standards. Upon this 80 percent threshold being met, then there could be a 10 percent payment rate reduction. In addition, MHA successfully advocated for a narrow definition of eligibility for presumed post-traumatic stress disorder (PTSD). Only licensed nurses who are employed in emergency medical care outside of a medical facility will be included in a presumed PTSD benefit, rather than any employed licensed nurse as was originally adopted by the House.

MHA priority issue: Take bold action to address the opioid crisis

MHA supported holding pharmaceutical companies at least partially responsible for their role in Minnesota’s opioid crisis either through the “penny-a-pill” proposal or through increased opioid manufacturer licensing fees.The supplemental budget bill that was vetoed included more than $6 million in funding for various opioid prevention and response projects, including $2 million for the opioid prevention model programs being shepherded by CHI St. Gabriel’s Health to other communities.

MHA priority issue: Modernize Minnesota’s Health Records Act to improve coordination of patient care

Minnesota’s Health Records Act (MHRA) should align with federal laws rather than having a different standard. A coalition of MHA, the Minnesota Medical Association, the Minnesota Council of Health Plans, the Minnesota Chamber of Commerce, the Minnesota Business Partnership and numerous health advocacy organizations worked to successfully pass our bill (HF 3312) out of the House Health and Human Services Reform Committee, with full HIPAA alignment. The Civil Law Committee chair refused to schedule a hearing for the bill. We narrowed our approach to only allow assumed consent for treatment, payment and operations, commonly referred to as TPO. This is the standard that 48 other states have. We were pursuing a House floor amendment strategy, but in the closing days of the session, the clock and the privacy advocates prevailed.

Other issues affecting hospitals and health systems

Price transparency
Under current law, health care providers and health insurers are required to provide consumers with a nonbinding good-faith estimate of the price for a specific health care service in response to a request for that information. Several revisions to the current law were made this year (SF 3480/HF 3893):

  • In response to an inquiry, health care providers must now provide information on other types of fees or charges that a consumer may be required to pay in conjunction with a visit, including but not limited to applicable facility fees.
  • Good-faith price estimates must now be delivered in 10 days.

A new provision starting July 1, 2019, requires primary care providers and clinics that specialize in family medicine, general internal medicine, gynecology or general pediatrics to maintain and post a list of the 25 most frequently billed services over $25, including the 10 most commonly billed evaluation and management services and the 10 most frequently billed preventive services.

MHA was successful in amending the bill so that health systems can develop one list to be used by all associated primary care providers and clinics. For each listed service, the provider or clinic must disclose:

  • Provider’s charge (the amount charged to an uninsured patient)
  • Average commercial health plan payment rate
  • Medicare payment rate
  • Medical assistance fee-for-service rate

The list must be updated annually and posted in the provider’s or clinic’s reception area and made available on the provider’s or clinic’s website, if a website is maintained. No contract between a health care provider and health plan company can prohibit the disclosure of pricing information to comply with these provisions.

Elder abuse and vulnerable adult protections
Legislators sought to enhance protections for seniors and vulnerable adults in assisted living and skilled nursing facilities. MHA worked to amend these bills throughout the legislative process to ensure that provisions aimed at protecting “residents” would not apply to a patient in a hospital setting. MHA’s focus was on amending language regarding false marketing claims and preventing any imposition of a private right of action. MHA’s concerns were addressed and we were supportive of the final bill language, but ultimately this legislation was included in the supplemental budget bill that was vetoed.