2008 Legislative Session

1. 2008 Legislative Session MSBA Health Law Section May 30th, 2008 Presented by Phil Griffin, Kevin Goodno and Dannette Coleman

2. Productive Session • $935 Million Deficit Balanced • $6.6 Billion in Transportation Funding • Bonding Package Includes Central Corridor, Lake Vermillion State Park & VA Nursing Home • Property Tax Caps of 3.9% • Health Care Reform Moves Forward

3. Health Care Reform • Governor’s Transformation Task Force and Legislative Health Care Access Commission Recommend Similar Goals and Approaches to Addressing Health Care System and Costs • Investment in Public Health • Cost Containment through Payment Reform • Insurance Reform • Universal Coverage

4. Tax on Hospital and Health Plans to Fund Public Health* “Savings Recapturing Mechanism”* Insurance Exchange* Eligibility up to 300% FPG/Affordability Standards up to 400% FPG* “Level 3” Payment Reform* Health Techonology Assessment* Quality Incentive Payments Health Care Transformation Commission ($12-$15 million)* Provider Price and Quality Transparency Elements of Original Health Care Reform Bill

5. “Single Price” for Services Increased Tobacco Tax* Medical Home/Care Coordination Fee HP Submission of All Claims Section 125 Plan Mandate* Guarantee Issue for Individuals through Exchange* “Contingent” Individual Mandate* Increase in MNCare Hospital Benefit to $20K* Electronic Prescribing Funding for Federally Qualified Health Care Centers Long-Term Worker Coverage Study Community Benefit Requirements for Health Plans* Elements of Original Health Care Reform Bill (cont’d)

6. Health Care Reform – Round 2 • Governor Veto with 6 Days Remaining • DFL House and Senate Leaders Tie Health Care Reform to Final Global Deal • Eligibility Expansion Necessary to Satisfy DFL Caucuses • Whether or Not to Use HCAF Money Or Health Plan Reserves? • House Republicans Invited to the Table to Negotiate

7. Medical Home/Care Coordination Fee Public Health – Funded by HCAF Quality Incentive Payments Single Price for 7 “Baskets of Care” MNCare Eligibility for Adults now 250% FPG MDH Contract w/ Private Entity to Perform Quality/Pricing Analysis and “Peer Grouping” System Plans Required to Introduce Products Using “Peer Grouping” Data Long-Term Worker Health Coverage Study Section 125 Plan Mandate (Light) Employer Grants Available to Establish Section 125 Plans Tax Credits Available to Certain Small Employers to Offer Coverage? Elements of Final Health Care Reform Bill

8. Health Plan Submission of Claims and Pricing Data Electronic Prescribing Funding of Federally Qualified Health Care Centers ($1.8 million) “Seamless Coverage” for Children Increase in MNCare Eligibility Cap from $50K to $57.5K HSA-like option for state employees Creation of Essential Benefit Set Elements of Final Health Care Reform Bill (cont’d)

9. $50 Million Loan from HCAF – Repaid from “Savings” in Health Care Reform Bill 3-Month Delay in Home & Community Based Provider Payment Increases Increase in HP Withhold from 5% to 8% 0.5% Decrease in Average HP Administrative Rate Interpreter Services Registry 24-Month Delay in Hospital Rebasing 3.46% Cut in IP Hospital Payments for FY ’09 - 1.9% FY ’10 and 1.79% FY ’11 3% Cut in OP Hospital Rates Pharmacy Payments Reduced to AWP Minus 14% Nursing Homes - 1% COLA Health Care Provisions in Supplemental Budget Bill

10. County-Based Purchasing • County-Based Purchasing • No Expansion of Sole-Source • Automatic Enrollment Default to County Plan in 4 Counties Surrounding Olmstead Upon Federal Approval - Vetoed • Reserves Requirement with 3 Year Phase-In • Requirement to Pay for Cost of Regulatory Audits, Annual Base Fee and Per Enrollee Fee

11. Other Health Care Items Governor Not Afraid to Use Veto Pen • Vetoes Statewide School Pool Bill - Again • Vetoes Stem Cell Bill • Vetoes Domestic Partners Bill • Vetoes “Sick Leave” Flexibility • Vetoes Medical Debt Bill • Vetoes Newborn Testing • Vetoes Public Health • Optometrist Practice Act Amendments • Mesothelioma Study • E records and dead body transport

12. Other Health Care Items • PTs and MDs reach Agreement • DHS & FQHC Technical Bills • Naturopath Board Established • Social Security # Use Agreement • Abigail Taylor Pool Safety Act • DHS Policy - Statewide Health Info • Commerce Technical Bill • Legend Drug Bill

13. Other Health Care Items • Radiation Therapy Moratorium • Health profession licensing requirements changed and unlicensed complementary and alternative health care practitioner • Blood Donations for 16 year olds • No New MH Hospital in Woodbury

14. Other Health Care Items Don’t forget……… it was a bonding session!!!!!!!!!!!!!!

15. Looking Ahead to 2009 • All House Members up for Re-Election • Larger Deficit than 2008 Expected • Possible Modifications to Health Care Reform Bill as Details are Worked Through • Larger Single Payer Contingency in House?

16. QUESTIONS? Or wasn’t there enough health care legislation for you?