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HF1963 (Legislative Session 94 (2025-2026))

Medical claims filing timelines, withdrawal management services, and mental health diagnostic services assessments provisions modified; and closure planning requirements imposed on peer recovery supports providers.

Related bill: SF1966

AI Generated Summary

This bill proposes amendments to Minnesota statutes related to human services, particularly concerning medical claims, withdrawal management services, peer recovery support services, and mental health diagnostic assessments. Key provisions include:

  1. Medical Claims Filing:

    • Extends the timeline for health care providers to submit claims from six months to twelve months if they experience a significant disruption to operations.
    • Allows an additional six-month extension if a health plan company or third-party administrator makes adjustments or recoups payments.

  2. Financial Responsibility for Withdrawal Management Services:

    • Defines the county responsible for funding withdrawal management services.

  3. Closure Planning Requirements for Peer Recovery Support Providers:

    • Sets accreditation or certification requirements for recovery community organizations providing peer recovery support services.
    • Requires recovery community organizations to maintain transparency, follow specific ethical guidelines, support diverse communities, and ensure proper classification of recovery peers (prohibiting treatment of peers as independent contractors).
    • Implements oversight and complaint procedures for peer recovery participants.

  4. Timelines for Mental Health Diagnostic Assessments:

    • Modifies requirements to ensure that individuals receiving substance use disorder treatment with co-occurring mental health conditions obtain a mental health diagnostic assessment within ten days of admission.

  5. Substance Use Disorder Service Rates:

    • Establishes or modifies payment rates for various substance use disorder treatment services, including withdrawal management, residential treatment, and peer recovery support services.
    • Imposes limits on billing and service hours for peer recovery support providers.
    • Sets guidelines for reimbursement of services when clients miss scheduled treatment sessions.

Overall, the bill aims to streamline claims processing, clarify financial responsibility for withdrawal management services, enhance oversight and regulation of peer recovery support providers, and adjust service payment structures in the state's human services system.

Bill text versions

Actions

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

Citations

 
[
  {
    "analysis": {
      "added": [
        "Additional six-month extension for claims filing if payment adjustments occur."
      ],
      "removed": [],
      "summary": "This bill modifies timelines for filing medical claims under section 62Q.75.",
      "modified": [
        "Initial claims submission deadline adjusted from six months to twelve months in cases of operational disruption."
      ]
    },
    "citation": "62Q.75",
    "subdivision": "subdivision 3"
  },
  {
    "analysis": {
      "added": [
        "Allows American Indian programs licensed by tribal government to be eligible vendors."
      ],
      "removed": [
        "Detoxification programs licensed under Minnesota Rules parts 9530.6510 to 9530.6590 are not eligible vendors."
      ],
      "summary": "This bill modifies the licensure and eligibility requirements for vendors providing substance use disorder services under section 254B.05.",
      "modified": [
        "Clarifies vendor eligibility for counties and recovery organizations meeting certain criteria."
      ]
    },
    "citation": "254B.05",
    "subdivision": "subdivision 1"
  },
  {
    "analysis": {
      "added": [
        "Establishes higher rates for programs serving parents with children and culturally responsive programs."
      ],
      "removed": [],
      "summary": "This bill sets rate requirements for substance use disorder services under section 254B.05.",
      "modified": [
        "Adjusts rates for programs meeting specific additional requirements, including offering medical services and co-occurring mental health services."
      ]
    },
    "citation": "254B.05",
    "subdivision": "subdivision 5"
  }
]

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