SF4933

Purpose

• The bill aims to increase medical assistance reimbursement rates for mental health services and update how certain psychological testing and assessment services are paid under Minnesota’s Medicaid program. It also repeals an existing payment schedule for some mental health providers.

Main Provisions

• New rate for psychological testing and assessments (Subd.5 under 256B.761):

  • Effective for services on or after January 1, 2027 or once federal approval occurs (whichever is later).
  • The state must pay 100% of the total published Medicare payment rate (as defined in 42 CFR 438.6) for:
  • neuropsychological assessments (256B.0671 subd. 8)
  • neuropsychological testing (256B.0671 subd. 9)
  • psychological testing (256B.0671 subd. 10)
  • Managed care organizations (MCOs) and county-based purchasing plans must reimburse providers at least the fee-for-service (FFS) rate for these services.
  • The state must monitor how this rate change affects enrollee access to mental health services.
  • If federal approval is not obtained for this provision in a contract year, capitation rates paid to MCOs/CBP plans must be adjusted to reflect the removal of this provision. Provider contracts must allow recovery of payments if capitation rates are adjusted, but recoveries cannot exceed the amount of the rate increase attributable to this provision.
  • This subdivision has a sunset provision tied to the effective date of Laws 2025 First Special Session chapter 3 article 8 section 29.

• Repeal of prior payment rules (Sec. 2):

  • Repeals Minnesota Statutes 2024 section 256B.0625 subdivision 38, along with the old Appendix language that defined payments for mental health services by different provider types (e.g., master's-prepared professionals, community mental health center staff, and physician assistants) and their respective payment percentages relative to doctoral-prepared professionals and psychiatrists.

Significant Changes to Existing Law

• Replaces the previous schedule of payments for mental health services (the 256B.0625 subd. 38 framework) with a new framework that ties payment to 100% of the Medicare rate for specified psychological testing and assessments.
• Aligns certain mental health service payments with federal Medicare rates instead of the prior, more varied state-established percentages.
• Establishes oversight and potential adjustments to capitation payments if federal approval is not obtained, and creates constraints on recoveries tied to those adjustments.

Implementation & Oversight Details

• Effective date: January 1, 2027 or upon federal approval (whichever is later).
• Monitoring: The commissioner must monitor enrollees' access to mental health services after the rate change.
• Federal approval contingency: If federal approval is not received, capitation rates must be adjusted, and payment recoveries are limited to the increase caused by this provision.
• Sunset: The new rate provision will sunset when the referenced laws take effect (as indicated by the specified section).

Repealed Provisions (Context)

• Repeal of the old 256B.0625 subdivision 38 and its Appendix language, which previously set differentiated payments for masters-, doctoral-, and physician assistant-provided mental health services and for community mental health center employees.

Relevant Terms - 256B.761, Subd.5 - 256B.0671, subd. 8 (neuropsychological assessments) - 256B.0671, subd. 9 (neuropsychological testing) - 256B.0671, subd. 10 (psychological testing) - 42 CFR 438.6 (Medicare payment rate) - Medicare payment rate - neuropsychological assessments - neuropsychological testing - psychological testing - fee-for-service rate - managed care organization (MCO) - county-based purchasing plan (CBP) - capitation rates - federal approval - enrollee access to mental health services - master’s-prepared mental health professionals - doctoral-prepared professionals - community mental health centers - physician assistants - psychiatrists - 256B.0625 subdivision 38 - Laws 2025 First Special Session chapter 3 article 8 section 29