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HF1994 (Legislative Session 94 (2025-2026))

Payment rates established for certain substance use disorder treatment services, and vendor eligibility recodified for payments from the behavioral health fund.

Related bill: SF1826

AI Generated Summary

Purpose of the Bill

This bill addresses amendments related to substance use disorder (SUD) treatment services in Minnesota. It aims to update payment rates, define payment eligibility criteria, and restructure the statutory organization of SUD treatment services to improve clarity and access.

Main Provisions

  • Payment Rate Establishment: The bill outlines new payment rates for SUD treatment services, including various service levels defined by the American Society of Addiction Medicine (ASAM) care standards, which range from outpatient to intense residential services.
  • Enhanced Payment Rates: Programs offering services such as childcare on-site during treatment, culturally specific and disability-responsive services, and co-occurring mental health and SUD treatments can receive enhanced payment rates.
  • Adjustments and Implementation:
    • A base payment rate adjustment will start on January 1, 2026, with annual adjustments from January 1, 2027, based on the Medicare Economic Index to account for economic changes.
    • Certain rates for SUD services will be increased annually to align with changes in healthcare costs.
  • Telehealth and Service Delivery: Authorization for providing SUD services via telehealth when appropriate while ensuring equal reimbursement as in-person services.
  • Licensure and Vendor Eligibility: Clarifications on vendor eligibility for payment from the behavioral health fund, as well as licensing standards, are included to ensure that only qualified programs receive funding.

Significant Changes to Existing Law

  • New Payment Schedule: Introduces a detailed payment schedule for different types of SUD treatment services, with explicit amounts set for counseling sessions and residential treatment rates.
  • Rate Adjustments Mechanism: Establishes a mechanism for regular payment rate adjustments based on economic indices to keep up with rising healthcare costs.
  • Service Requirements for Enhanced Payments: Defines criteria that programs must meet to qualify for higher payment rates, including offering culturally specific services and providing childcare.
  • Recodification Efforts: The bill also engages in recodifying and reorganizing parts of existing statutes related to SUD treatment to reflect these changes more clearly.

Relevant Terms

  • Substance Use Disorder (SUD)
  • American Society of Addiction Medicine (ASAM)
  • Outpatient and Inpatient Treatment
  • Payment Rates
  • Behavioral Health Fund
  • Telehealth
  • Co-Occurring Disorders
  • Cultural Responsiveness
  • Medicare Economic Index

Bill text versions

Actions

DateChamberWhereTypeNameCommittee Name
March 05, 2025HouseFloorActionIntroduction and first reading, referred toHuman Services Finance and Policy

Citations

 
[
  {
    "analysis": {
      "added": [
        "New subdivisions are added regarding base year payment rates and annual adjustments."
      ],
      "removed": [],
      "summary": "The bill addresses the establishment of payment rates for substance use disorder treatment services.",
      "modified": [
        "Existing rate requirements under section 254B.05 are modified with added details on eligible services."
      ]
    },
    "citation": "254B.05"
  },
  {
    "analysis": {
      "added": [
        "Introduction of annual payment rate adjustment tied to the Medicare Economic Index."
      ],
      "removed": [],
      "summary": "The bill modifies reimbursement policies for mental health services.",
      "modified": [
        "Payment structures and rate details for outpatient mental health services and capitation adjustments."
      ]
    },
    "citation": "256B.761"
  },
  {
    "analysis": {
      "added": [],
      "removed": [],
      "summary": "Reference is made regarding the restructuring of coverage policy to improve access to adult mental health services.",
      "modified": [
        "Coverage policy and rates may be restructured to improve service access."
      ]
    },
    "citation": "256B.0623"
  },
  {
    "analysis": {
      "added": [],
      "removed": [],
      "summary": "Mentioned in regard to monetary recovery conditions for improperly paid services.",
      "modified": []
    },
    "citation": "256B.064"
  },
  {
    "analysis": {
      "added": [],
      "removed": [],
      "summary": "Referenced in improvements to mental health support services.",
      "modified": []
    },
    "citation": "256B.021"
  },
  {
    "analysis": {
      "added": [],
      "removed": [],
      "summary": "Referencing exclusions related to early intensive developmental and behavioral intervention EIDBI benefits from certain ratables.",
      "modified": []
    },
    "citation": "256B.0949"
  }
]

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