MMGMA's 2008 Legislative Priorities
MMGMA's Government Affairs Committee has set the following priorities for the 2008 Legislative Session. There will no doubt be other issues we will engage with, opposing or supporting the initiatives as we determine their impact on our patients and practices. We will certainly monitor any legislation that emerges from the Governor's Health Care Transformation Task Force and the Legislative Commission on Health Care Access. We will communicate with members through MMGMA e-mail blasts.
1. Oppose Using the Health Care Access Fund to Balance the State's Budget: The state's general fund is forecast to have at least a $375 million dollar shortfall. The estimate may increase to close to a $1 billion dollar shortfall when the March forecast is made. When these numbers were released the Governor indicated that the deficit was not a major problem since the state has more than a $300 million dollar surplus in the Health Care Access Fund.
The Health Care Access Fund was created by imposing a two percent tax on providers and a one percent tax on health plan premiums. These funds should be dedicated exclusively to providing affordable health coverage to the uninsured.
During the state's record $4.1 billion deficit in 2003, the Governor proposed and the Legislature adopted a plan that transferred nearly $400 million out of the Health Care Access Fund to plug the state's budget shortfall. This fund should be used exclusively for the uninsured. Surplus funds should be used to expand eligibility for MnCare, fund a long-overdue increase in reimbursement to providers or to reduce the provider tax.
This position is supported by the Minnesota Medical Association, and the Minnesota Provider Coalition.
Opponents: While there are no known opponents of our position, budget pressures may make it tempting to again use the Health Care Access Fund to cover the projected shortfall in the General Fund.
2. Interpreter Reimbursement: The costs associated with providing interpretation for Limited English Proficiency (LEP) patients is increasing and it is a special hardship for health care providers in communities with a large influx of immigrants. Similarly, the cost of interpretation for the deaf and hard of hearing commonly exceeds the reimbursement for the services rendered.
Health plans should be required to reimburse providers for interpreter services whether provided by staff, contract or telecommunications. In addition, MinnesotaCare and Medical Assistance currently are only required to pay for interpreter services during face-to-face time with providers. The law should be expanded to cover all time associated with the visit requiring interpretation, such as registration, forms completion, prescriptions, etc.
Finally, the Department of Health should create a state registry for language interpreters, who would have to demonstrate competency in language, interpreting ethics and medical terminology to be listed in the registry.
The Minnesota Medical Association, Minnesota Hospital Association, Minnesota Provider Coalition, Minnesota Commission Serving Deaf and Hard of Hearing People, and the Minnesota Rural Health Association support our legislation.
Opponents: Health plans and the Minnesota Chamber of Commerce are the only known opponents of our bill. They argue:
- Interpreter costs are just a "cost of doing business". (response: the cost of interpreter services often exceeds the cost of the patient exam itself and is a significant "variable" cost, which is reimbursed by many other payers like no-fault, workers' compensation, MinnesotaCare and Medical Assistance.)
- Our proposal does not address self-insured employers who account for a substantial portion of the market. (response: most self-insured plans are administered by the health plans and employers often buy the basic benefit set that would include coverage for interpreter services).
- Our bill constitutes a "mandate" and will cause employers' premiums to increase.
3. HSA Direct Assignment and Collecting Estimated Payments From Patients With High Deductible Plans: The number of Minnesotans with HSA's is growing and may reach 500,000 to 600,000 in five years. While this pretax savings concept will assist many with health care coverage, it is important that the managers of these funds, usually health plans be required to pay providers directly for heath care services provided to the account holder. Additionally, many employers are changing their employee insurance plan to high deductible plans which require employees to pay thousands of dollars out-of-pocket before their insurance coverage kicks-in.
MMGMA supports legislation that would require direct payments by HSAs to providers for services rendered and permit providers to collect an estimated payment, at the time of service, from consumers with a high deductible insurance plan.
The Minnesota Provider Coalition also strongly supports this legislation.
Opponents: It is not yet known who would oppose this legislation. Health Plans have acknowledged that HSAs and high deductible insurance plans pose a special problem for providers that if not addressed will result in higher accounts receivables and higher collection costs.
4. The MnCare, M.A, and PMAP Fee Schedules Should be Increased: Provider reimbursement under the MinnesotaCare and Prepaid Medical Assistance and fee-for –service Medical Assistance fee schedule is the lowest of all public and private payers. The last fee schedule adjustment occurred in 1999. Since then the CPI-U has increased by more than 21%, eroding appreciably the value of payments under these plans. While MMGMA supports an expansion of eligibility under MinnesotaCare, we ask that it be coupled with an adjustment to the fee schedule. This adjustment would especially help providers in Greater Minnesota and in the inner-city areas whose patient census usually includes a higher percentage of MinnesotaCare and Medical Assistance patients.
Health Plans have received annual increases in payments under PMAP but have not passed any of the increases to providers.
Opponents: We would expect health plans to oppose fee increases under PMAP. We are unaware of opposition to an adjustment to the MnCare and M.A. fee schedule although we are aware that there would be a fiscal impact on the Health Care Access Fund and the General Fund.
MMGMA Government Affairs
Geoff Sylvester, Chair
Candy Simerson, Past Chair
Jim Wilkus, Chair-elect
MMGMA Government Affairs Advisor
Phil Riveness
MMGMA Lobbyists
Matthew Schafer
Dave Kunz
©2007 Minnesota Medical Group Management Association, 4248 Park Glen Road, Minneapolis, MN 55416
Phone: (952) 928-4644 | Fax: (952) 929-1318 | Email: info@mmgma.org