HHS Bill Crosses Finish Line on Legislature’s Last Day

May 25, 2023

After lengthy debate, the House and Senate finally approved the comprehensive Health and Human Services (HHS) conference committee bill on the final day of the session.  

The 845-page bill passed both bodies on a party-line vote and was sent to Gov. Tim Walz, who signed the bill on May 23. The legislation allocates $9.3 billion in total; $1.78 billion of which is new spending. 

The bill includes several MMA priorities. The first being a two-year coverage extension for audio-only telehealth services while the Minnesota Department of Health (MDH) continues a previously unfinished study on the matter. Coverage was previously set to expire in July of 2023. The MMA argued throughout the session that audio-only telehealth was a critical tool for providers, and necessary for patients who may not have access to visual technology. $16.7 million of new funding was dedicated towards continued coverage. 

The bill also directs the Commissioner of Health to establish a work group to develop a statewide electronic registry for Provider Orders for Life Sustaining Treatment (POLST) forms. A statewide registry for POLST forms will help ensure that patient end-of-life treatment preferences are available to providers. The language requires MDH to assemble stakeholders to develop a recommendation to the legislature by February 2024. The study is itemized to cost the state $365,000 in each of the next fiscal years. There is no additional funding for implementation. 

The bill funded another MMA priority— Medical Assistance (MA) coverage for recuperative care services. The MMA urged legislators to fund this expansion to better serve patients experiencing homelessness. With expanded recuperative care services, patients will be able to receive needed short-term care in their recovery following hospitalization. $2.27 million in fiscal year 2024-25 was dedicated towards this item. 

The bill also requires extensive actuarial and economic analyses prior to the implementation of a MinnesotaCare buy-in program in 2027. The MMA shared concerns regarding the sustainability of this public option if it includes the low reimbursement rates for providers in a public option program. That final language of the bill was included and underscored throughout the bill. Additionally, the bill would expand MinnesotaCare coverage for undocumented Minnesotans, which the MMA has supported. 

The MMA also shared concerns with the original bill language to create a Healthcare Affordability Commission – a politically appointed entity to collect data and set healthcare spending limits and assess penalties of up to $500,000 against providers. The MMA worked with stakeholders to amend the section to be more proactive and less punitive.  The final bill replaces this commission with a Center for Healthcare Affordability within MDH, which will conduct research and analyze the drivers of healthcare spending. The entity does not have regulatory or penalty authority beyond a $500 per day late fee for healthcare entities that do not provide already required spending data. 

The one MMA priority that was not adopted was a bill to prohibit insurers or pharmacy benefit managers (PBMs) from forcing a patient to change medications in the middle of their insurance contract year. This language was included in the Senate’s health omnibus bill, but not approved by the conference committee.  

“We would have had a 100% success rate this year if the legislature included mid-year formulary changes,” said Chad Fahning, MMA’s manager of state legislative affairs. “We will continue to pursue removals of insurance-imposed barriers next session, but in the meantime, this bill is really good legislation for physicians and patients. The MMA hasn’t had this many priorities pass in one session for a long time.” 

Alongside these items are several other top MMA issues, including: 

• Updates to the all-payer claims (APCD) database to gather nonclaims data to develop a more complete understanding of healthcare spending patterns in Minnesota 

• A one-time allocation of $4.7 million in grant funding for healthcare workplace safety 

• MA coverage for insertion of long-active reversable contraception (LARC) postpartum 

• Rural clinical, workforce training, and primary care residency grant funding 

• MA coverage for tobacco and nicotine cessation products 

• Required coverage for additional diagnostic services or testing after a mammogram. 

The bill also includes several MMA-backed reproductive healthcare items, including MA coverage for abortions services, broadened MinnesotaCare reproductive health care coverage, and the repeal of several Minnesota statutes intended to obstruct access to abortion services such as 24-hour waiting periods and reporting requirements. 

Additionally, the HHS omnibus bill was combined with the early childhood and family provisions in the final act. The bulk of the spending in the conference report, approximately $875 million of the $1.78 billion in new spending, is dedicated to children and families. These items include multiple early childhood program investments, childcare assistance, funding for youth and child housing, and the creation of a new Department of Children, Youth, and Families. 

Finally, the “Keeping Nurses at the Bedside Act” policy language was removed from the final HHS bill to act as a stand-alone bill. The bill originally required hospitals to establish staffing committees with at least 50% nurses and other direct care workers. After days of stakeholder negotiations, the staffing committee language was stripped from the bill and the legislature passed new loan forgiveness programs for nurses and requirements for hospitals to create action plans to address workplace violence.