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SF1966 (Legislative Session 94 (2025-2026))

Timelines modification for filing medical claims after recoupment

Related bill: HF1963

AI Generated Summary

The bill S.F. No. 1966 proposes several modifications to regulations related to human services in Minnesota, focusing on medical claims, withdrawal management, peer recovery support, and mental health assessments. Key provisions include:

  1. Timelines for Filing Medical Claims:

    • Extends the period for health care providers to submit claims to a health plan company or third-party administrator from six months to 12 months in cases of significant operational disruptions.
    • Further extends the deadline an additional six months if a health plan company adjusts or recoups a payment.

  2. Financial Responsibility for Withdrawal Management Services:

    • Establishes that the county of financial responsibility for withdrawal management services will be determined according to Minnesota Statutes section 256G.02, subdivision 4.

  3. Closure Planning Requirements for Peer Recovery Support Providers:

    • Requires that peer recovery support service providers develop closure plans when ceasing operations.
    • Sets accreditation or certification standards and timelines for recovery community organizations providing peer recovery services.

  4. Modification of Timelines for Mental Health Diagnostic Assessments:

    • Adjusts timelines for mental health assessments, including requiring diagnostic assessments within ten days of admission for individuals scoring positive on a standardized mental health screen.

  5. Substance Use Disorder Treatment Program Updates:

    • Establishes new reimbursement rates for various substance use disorder treatment programs.
    • Sets requirements for program eligibility, including services for parents with children, culturally responsive programs, and programs serving individuals with co-occurring mental health disorders.
    • Limits peer recovery support services to 14 hours per week per provider.

  6. Monitoring & Compliance for Peer Recovery Support Services:

    • Introduces audits of up to 10% of claims for peer recovery support services billed separately.
    • Ensures compliance with Minnesota statutes, subjecting non-compliant peer recovery billing to monetary recovery.

The bill aligns with Minnesota’s broader efforts to strengthen oversight, accountability, and accessibility in human services, particularly in behavioral health, substance use treatment, and financial transparency.

Bill text versions

Actions

DateChamberWhereTypeNameCommittee Name
February 26, 2025SenateFloorActionIntroduction and first reading
February 26, 2025SenateFloorActionReferred toHuman Services
March 05, 2025SenateFloorActionComm report: To pass and re-referred toCommerce and Consumer Protection
April 02, 2025SenateFloorActionWithdrawn and re-referred toHuman Services
April 02, 2025SenateFloorActionWithdrawn and re-referred toHuman Services

Citations

 
[
  {
    "analysis": {
      "added": [
        "Extends claims submission requirements under specific conditions."
      ],
      "removed": [],
      "summary": "This bill modifies the timeline for filing medical claims affecting health care providers and health facilities under section 62Q.75.",
      "modified": [
        "Adjustments in timelines for claims filing under certain disruptions."
      ]
    },
    "citation": "62Q.75"
  },
  {
    "analysis": {
      "added": [],
      "removed": [],
      "summary": "This bill updates licensure or certification requirements for substance use disorder services under section 254B.05.",
      "modified": [
        "Clarifies eligible vendors and service requirements for recovery community organizations and treatment programs."
      ]
    },
    "citation": "254B.05"
  }
]

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