HF4785

Purpose

• The bill makes technical corrections to Minnesota Statutes 2024, specifically amending section 256B.056, subdivision 6, to clarify how assignment of benefits works for medical assistance.

Main Provisions

• Assignment of benefits when eligible for medical assistance
  • Applicants for medical assistance must apply or agree to apply for benefits.
  • By accepting medical assistance, the applicant assigns to the Department of Human Services all rights to medical support and to third-party payments from any person or entity liable for the costs of medical care, as required by Title 19 of the Social Security Act.
  • Any rights or amounts assigned are applied against the cost of medical care paid under the medical assistance program.
• Cooperation and paternity
  • Applicants must cooperate with the state in establishing paternity and obtaining third-party payments.
• Effect, retroactivity, and disclosure
  • The assignment takes effect once eligibility for medical assistance is determined.
  • The assignment can apply retroactively up to three months prior to the date of application if the applicant is determined eligible and receives medical assistance benefits.
  • The application must include a statement explaining the assignment.
• Scope of the “state”
  • The bill clarifies that “the Department of Human Services or the state” includes certain entities (see definitions section), which broadens who is considered part of the state for these purposes.

Definitions / Scope (Entities Included)

• Prepaid health plans under contract with the commissioner (per sections 256B.69 and 256L.12 and related provisions)
• Children’s mental health collaboratives under section 245.493
• Demonstration projects for persons with disabilities under section 256B.77
• Nursing facilities under the alternative payment demonstration project under section 256B.434
• County-based purchasing entities under section 256B.692

Notable Changes to Law

• Adds specific clarifications about retroactive applicability and the need for an explanatory statement in the application.
• Expands the list of entities considered part of the state for purposes of the assignment of benefits, ensuring these entities are encompassed in the assignment framework.

Practical Impact

• For applicants and recipients, the bill reinforces that third-party payments and medical support rights are assigned to the state from the start of receiving medical assistance, and it formalizes retroactive reachback and cooperation requirements.
• It may streamline recovery of third-party payments and clarify who the state can coordinate with to obtain those payments.

Relevant Terms - Assignment of benefits - Medical assistance - Third-party payments - Medical support - Paternity - Cooperation - Department of Human Services - Title 19 of the Social Security Act - Retroactive assignment - Up to three months prior to application - Prepaid health plans - County-based purchasing entities - Children’s mental health collaboratives - Demonstration projects for persons with disabilities - Nursing facilities - Minnesota Statutes 256B.056 subdivision 6