HF3476 (Legislative Session 94 (2025-2026))
Patient-Centered Care program established, direct state payments to health care providers authorized, contracting with administrative services organizations authorized, conforming changes made, and money appropriated.
Related bill: SF3612
AI Generated Summary
Purpose
- Establish a PatientCentered Care program to improve health outcomes, reduce overall health care costs for the state, and increase transparency and accountability in public health care programs.
Major Provisions
- Direct payments to providers: The state commissioner shall pay licensed health care providers directly for all services to medical assistance (MA) enrollees and MinnesotaCare enrollees, on a fee-for-service basis.
- Administrative services organizations (ASOs): The state may contract with ASOs to process claims, pay bills, and handle other administrative tasks, but ASOs cannot take on financial risk.
- County-based purchasing (CBP) option: Counties may form or join CBPs to administer the program, and the commissioner shall allow the CBP to serve as the ASO for the county unless the county requests the state to assume the role.
- Care coordination: The department may contract with CBPs, counties, Federally Qualified Health Centers (FQHCs), and community-based programs with interdisciplinary teams to provide care coordination. Services include patient navigation, maintaining eligibility, transportation, interdisciplinary care planning, chronic disease management, specialist consultations, case management for serious mental illness and substance use disorders, discharge planning and transitional care, behavioral health integration, and culturally competent outreach. Budgets for these programs shall be based on operating costs and community needs, not risk-based financial arrangements.
- Replacing or limiting managed care contracts: The state shall not renew contracts with certain managed care plans or integrated health partnerships to serve MA and MinnesotaCare enrollees under specified statutes.
- Definitions: Establish key terms—Administrative Services Organization (ASO), Care coordination, and related roles and responsibilities.
- Payment structure for providers: In addition to direct fee-for-service payments, the state will provide flat care coordination payments to primary care providers designated by enrollees as their primary care provider. The primary care provider oversees the enrollee’s health and coordinates with case managers.
- Provider reimbursement and oversight: The commissioner shall encourage collaboration with frontline providers to improve health care quality and control costs, ensure timely reimbursement, and make recommendations to legislative leaders about fair reimbursement rates.
- Community outreach and enrollment support: The department may fund community health clinics, FQHCs, and CBPs to hire community health workers, nurses, or social workers to conduct community outreach, assist with enrollment in MA or MinnesotaCare, and help patients access care.
- Enrollee supports and services: The department shall ensure medically necessary services are provided timely and equitably, recruit adequate, culturally competent providers, provide data analytics, maintain a hotline and a website to help enrollees locate providers, offer a 24/7 nurse consultation helpline, and actively contact enrollees with claims data who have not had preventive visits to help them choose a primary care provider.
- Data transparency and public reporting: All ASO contracts must comply with public access and data transparency laws. The department must create and maintain a publicly accessible data dashboard with deidentified MA and MinnesotaCare data, updated quarterly, plus an annual report on trends and disparities. Private entities cannot claim proprietary rights over data generated from publicly funded programs.
Significant Changes to Existing Law
- Establishes a new PatientCentered Care program that shifts some responsibilities from traditional managed care models to direct provider payments and new care coordination structures.
- Authorizes direct state payments to health care providers for MA and MinnesotaCare enrollees and creates a pathway for ASOs to handle administrative tasks without assuming financial risk.
- Enables counties to form or participate in county-based purchasing arrangements to support care delivery and administration.
- Replaces or limits existing managed care contracts and certain integrated health partnership arrangements for MA and MinnesotaCare enrollees.
- Requires a robust, transparent data infrastructure (public dashboards and annual reports) for monitoring use, outcomes, and disparities.
How It Would Work in Practice
- Providers would bill the state directly for services, with the state handling payments on a fee-for-service basis, while primary care practices receive additional flat payments for coordinating patient care.
- Care coordination teams drawn from physicians, nurses, community health workers, behavioral health professionals, and other licensed providers would work with patients to coordinate care, maintain eligibility, address transportation barriers, plan care, and connect patients to specialists and support services.
- County-based or community-based organizations would receive funding to conduct outreach, enroll patients, and help connect people to medical care.
- The state would avoid risk shifting to providers or other entities and would monitor costs and quality through data analytics, hotlines, and ongoing engagement with enrollees.
- Transparency requirements would ensure public access to data and regular reporting on trends, disparities, and program performance.
Relevant Changes to Law and Policy Context
- Repeals certain prior provisions related to MA/MinnesotaCare delivery models (e.g., specific sections of Minnesota Statutes 2024) and replaces them with the new PatientCentered Care framework.
- Requires ongoing evaluation of provider reimbursement fairness and timeliness, with mechanisms to keep costs in check while preserving access to care.
Relevant Terms - PatientCentered Care program - direct payment - Medical Assistance (MA) - MinnesotaCare - administrative services organization (ASO) - care coordination - county-based purchasing (CBP) - counties (as health purchasers) - FQHCs (Federally Qualified Health Centers) - community-based programs (CBPs) - interdisciplinary teams - primary care provider (PCP) - flat care coordination payments - fee-for-service - public access to government records - data dashboard - deidentified data - health analytics - nurse consultation helpline - care navigation - discharge planning - transitional care - behavioral health integration
Relevant Terms - MA (medical assistance) - MinnesotaCare - ASO - CBP - FQHC - care coordination - primary care provider (PCP) - fee-for-service - data dashboard - public records - deidentified data
Bill text versions
- Introduction PDF PDF file
Past committee meetings
- Health Finance and Policy on: March 18, 2026 17:00
- Health Finance and Policy on: March 16, 2026 13:00
Actions
| Date | Chamber | Where | Type | Name | Committee Name |
|---|---|---|---|---|---|
| February 19, 2026 | House | Action | Introduction and first reading, referred to | Health Finance and Policy | |
| March 12, 2026 | House | Action | Authors added | ||
| March 16, 2026 | House | Action | Author added |
Citations
[
{
"analysis": {
"added": [
"Direct state payments to providers to deliver services to MA and MinnesotaCare enrollees."
],
"removed": [],
"summary": "The bill amends 62Q.1841 subdivision 1 to establish the PatientCentered Care program and authorize direct payments to health care providers for Medical Assistance and MinnesotaCare enrollees.",
"modified": [
"Establishes and codifies the PatientCentered Care program within 62Q.1841."
]
},
"citation": "62Q.1841 subdivision 1",
"subdivision": "subdivision 1"
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "The bill amends 62U.03 subdivisions 1 and 10 in support of the new care coordination and payment framework.",
"modified": [
"Adjusts definitions or administrative provisions connected to care coordination and purchasing for the program."
]
},
"citation": "62U.03 subdivisions 1 10",
"subdivision": "subdivisions 1 and 10"
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "The bill amends 62U.06 subdivision 2 to align with the PatientCentered Care structure and related financing/eligibility mechanics.",
"modified": [
"Modifies the subdivision to reflect the new direct-payment and coordination framework."
]
},
"citation": "62U.06 subdivision 2",
"subdivision": "subdivision 2"
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "62W.14 is referenced in the amendments; the bill does not specify a subdivision here.",
"modified": [
"Cross-references to 62W.14 are used to implement program-related provisions."
]
},
"citation": "62W.14",
"subdivision": ""
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "The bill amends 256B.021 subdivision 4 to support the direct provider payment framework for MA enrollees.",
"modified": [
"Aligns 256B.021 subd. 4 with direct payments and care coordination provisions."
]
},
"citation": "256B.021 subdivision 4",
"subdivision": "subdivision 4"
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "The bill expands care coordination definitions and related provisions within 256B.0625 subdivisions 56a and 58.",
"modified": [
"Broadens care coordination scope and related administrative/operational requirements."
]
},
"citation": "256B.0625 subdivisions 56a 58",
"subdivision": "subdivisions 56a and 58"
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "The bill amends 256B.072 subdivisions 1 and 2 to support the program's implementation.",
"modified": [
"Updates provisions relevant to program administration or provider interactions under MA."
]
},
"citation": "256B.072 subdivisions 1 2",
"subdivision": "subdivisions 1 and 2"
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "The bill amends 256B.0757 subdivision 6 to reflect changes in provider payments and coordination.",
"modified": [
"Modifies language about payment or coordination requirements within 256B.0757."
]
},
"citation": "256B.0757 subdivision 6",
"subdivision": "subdivision 6"
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "256B.198 is referenced in the bill as part of the broader statutory framework for health care programs.",
"modified": [
"Incorporates or aligns 256B.198 with direct payments and care coordination provisions."
]
},
"citation": "256B.198",
"subdivision": ""
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "The bill references 256L.01 subdivision 7 in relation to MinnesotaCare terms within the new program.",
"modified": [
"Adjusts definitions or uses of terms related to MinnesotaCare in the context of direct payments."
]
},
"citation": "256L.01 subdivision 7",
"subdivision": "subdivision 7"
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "The bill references Minnesota Statutes 2025 Supplement section 256B.0625 subdivision 56 to align with overseen care coordination provisions.",
"modified": [
"Maps to an updated or codified cross-reference in the 2025 Supplement edition."
]
},
"citation": "Minnesota Statutes 2025 Supplement section 256B.0625 subdivision 56",
"subdivision": "subdivision 56"
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "The bill notes coding within Minnesota Statutes Chapter 256 (Medical Assistance and MinnesotaCare) as the governing chapter for provisions related to the program.",
"modified": [
"References to Chapter 256 as the governing framework for MA and MinnesotaCare provisions."
]
},
"citation": "Minnesota Statutes chapter 256",
"subdivision": ""
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "The bill references 256B.055 in the context of MA enrollment and eligibility for direct payment provisions.",
"modified": [
"Ensures MA enrollment/eligibility terms integrate with the new payment model."
]
},
"citation": "256B.055",
"subdivision": ""
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "The bill references 256L.05 in relation to MinnesotaCare enrollment and eligibility for direct provider payments.",
"modified": [
"Aligns MinnesotaCare eligibility provisions under 256L.05 with the care coordination framework."
]
},
"citation": "256L.05",
"subdivision": ""
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "The bill references 256L.03 to specify MinnesotaCare enrollees receiving services and payments.",
"modified": [
"Incorporates direct payment and care coordination provisions into MinnesotaCare payment flow under 256L.03."
]
},
"citation": "256L.03",
"subdivision": ""
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "The bill notes that the commissioner shall not renew contracts with managed care plans under 256B.069 as part of the new framework.",
"modified": [
"Alters vendor/contracting dynamics by limiting renewals under 256B.069."
]
},
"citation": "256B.069",
"subdivision": ""
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "The bill states that the commissioner shall not renew contracts with integrated health partnerships under 256L.12.",
"modified": [
"Changes in procurement/partnership renewal under 256L.12 to fit the new program structure."
]
},
"citation": "256L.12",
"subdivision": ""
},
{
"analysis": {
"added": [],
"removed": [
"Repeals 256B.0753."
],
"summary": "The bill repeals Minnesota Statutes 2024 sections 256B.0753.",
"modified": []
},
"citation": "256B.0753",
"subdivision": ""
},
{
"analysis": {
"added": [],
"removed": [
"Repeals 256B.0755."
],
"summary": "The bill repeals Minnesota Statutes 2024 sections 256B.0755.",
"modified": []
},
"citation": "256B.0755",
"subdivision": ""
}
]Progress through the legislative process
In Committee