Governor’s Budget Recommendations Raid the
Health Care Access Fund
On March 7, Governor Pawlenty released his recommendations on how to
address the projected $935 million shortfall in the state’s budget.
This is the first step in the process to pass a supplemental budget
bill to fill the hole.
Included in the Governor’s recommendations is a transfer of nearly
$400 million over the next three year from the Health Care Access
Fund (HCAF) to the General Fund. He also recommends cuts to Health
and Human Services programs of $187 million this year, and another
$277 million in the next biennium.
The HCAF was created to provide health care to low income
Minnesotans through the MinnesotaCare program and other access
related programs. It is funded by the 2 percent provider tax that
is assessed on health care services.
While physicians have never believed the provider tax is the right
way to fund health care services, at least there has been some
comfort in the fact that it is used to provide access to health
care. Now that it is being suggested as a way to fill the state’s
budget hole, it is totally inappropriate. This breaks a promise
made to physicians that this money would be used for health care.
There are many who are very disappointed with the Governor because
of comments he has made in recent months that he would not use the
HCAF to balance the budget.
Legislators are beginning to hear from providers and advocates for
the poor that the HCAF should not be used for budget relief. They
have begun hearings on the Governor’s budget as they begin to
develop their budget plans. MAFP Past President George
Schoephoerster testified on Thursday on behalf of the MMA strongly
opposing the HCAF transfer. If you haven’t already, contact your
legislators and tell them to oppose any use of the HCAF to balance
the budget
Medical Interpreter Registry
The MAFP has been pushing for health plan coverage for medical
interpreter services for many years (SF 827/Higgins, HF 1077/Ruud).
We have argued that the ability to communicate is critical to high
quality health care and if a person has insurance, that insurance
should also pay for the services needed to ensure communication.
Those efforts have been opposed by the health plans and by small
employers who have argued that any state insurance mandate cannot be
applied to self-insured ERISA plans, thereby only applying to
benefits offered by small employers.
This year legislation is moving to address the quality of medical
interpreters. HF 3592 (Thao)/SF 3427 (Moua) would direct the
Department of Health to establish a statewide roster, registry, and
certification process for interpreters. The registry would develop
educational and training requirements for interpreters, as well as a
code of ethics. The registry would be voluntary for interpreters.
The Department is also directed to develop a certification process
based on national testing standards once they exist.
This legislation does not deal with how interpreter services are
reimbursed, but it does begin the process of ensuring minimum
quality standards for interpreters. The legislation has passed the
Health policy committees in both the House and Senate. The bills
are awaiting action in the Finance committees in both bodies.
Newborn Screening
Legislation from the Department of Health is moving to clarify the
use of specimens in newborn screening tests for heritable and
congenital disorders. SF 3138 (Lynch)/HF 3438 (Thissen) states that
the department can perform those tests on every newborn unless a
parent objects. The bill requires the hospital to provide parents
with a document explaining the parents’ the right to decline all
tests.
The controversy with this bill relates to
whether parents should have the right to “opt-out” of the test,
which is current law, or whether they should be required to “opt-in”
before the tests are performed. While patient consent is always
important, the fear is that if this becomes an opt-in the compliance
with the tests will drop significantly and too many newborns will
not receive these tests.
The bills have passed out of all policy
committees in both bodies. They are awaiting final action on the
floor, where an opt-in amendment is expected.
Prairie St. John Psychiatric Hospital
To address the shortage of inpatient psychiatric beds in the state
legislation has been introduced to authorize a new 144 bed
psychiatric hospital run by Prairie St. John (HF 3539-Swails/SF
3429-Saltzman). This has become very controversial. While most
acknowledge there are shortages of services for psychiatric
patients, there is not consensus whether the problem is with
inpatient beds, community-based services, or personnel shortages.
To assist the Legislature with its decision making, the Department
of Health released a study saying that a new psychiatric hospital is
not in the public good. In spite of this report, the House Health
Policy Committee passed HF 3539 on Tuesday night and referred it to
the House Finance Committee. This has become very controversial
with many supporting the bill to increase the number of psychiatric
beds, and others opposing it claiming that Prairie St. John will
“cherry pick” by only serving patients with insurance. Because of
this controversy, the prognosis for the Senate bill is not clear.
Many do not believe this bill will pass this year.
Medical Debt History Services
Attorney General Lori Swanson is pursuing legislation to prohibit
health care providers from using services that provide a medical
debt rating score for potential patients. This is in response to an
announcement by some of the national credit scoring agencies to
begin offering a medical credit score.
The legislation, SF3132 (Scheid)/HF 3610 (Loffler) would prohibit a
health care provider from disclosing a patient’s financial or debt
information to an entity other the patient, the patient’s insurer,
or government. It also prohibits a provider from obtaining or using
debt information received from an entity that gathers or evaluates
patient financial or debt information prior to providing medical
services.
There was concern in committee that this bill would limit a provider
from discussing payments for patients with high deductable plans or
for cash paying patients for elective procedures. The bill was
amended to clarify that providers can continue to discuss financial
information with patents related to payment of bills. This bill has
passed all committees in the Senate and will be heard in the House
next week.
- Dave Renner, MAFP
Legislative Representative
(drenner@mnmed.org,
612-362-3750, 1-800-342-5662)
