Bill > SF3115

This bill amends Minnesota's medical assistance regulations by establishing a new capitation payment withhold mechanism for managed care and county-based purchasing plans. Specifically, starting January 1, 2026, the state will withhold 2% of capitation payments for each medical assistance enrollee, contingent upon the plan submitting a verification of coverage form completed and signed by the enrollee. The verification form, to be developed by the commissioner, must include the enrollee's name, street address, and selected healthcare plan, along with a signature attesting to the information's accuracy. Plans must request all enrollees complete this form and submit the completed forms by February 27, 2026. If a completed form is not received for an enrollee, the state will: (1) permanently withhold the 2% payment for that enrollee, (2) stop making capitation payments for the enrollee starting in April 2026, and (3) disenroll the enrollee from medical assistance, with the enrollee retaining the right to appeal. The withheld funds can be returned between July 1 and July 31 of the following year for enrollees with submitted verification forms, essentially creating a new administrative mechanism to verify and confirm medical assistance enrollment and plan coverage.

Health and Social Services

https://www.revisor.mn.gov/bills/bill.php?b=Senate&f=SF3115&ssn=0&y=2025