HF3519

Purpose

• Clarify how Minnesota’s medical assistance program handles federal funding (Federal Financial Participation, or FFP) when participation is temporarily withheld or discontinued.
• Allow the state to adjust payment practices to avoid losing federal funds and to determine service availability for enrollees when FFP changes.

Main Provisions

• Provision 1: The commissioner may, in aggregate and on a prospective basis, reduce payment rates for medical assistance providers that receive federal funds. This is to prevent reductions in federal financial participation (FFP) that would occur if provider payment rates exceed Medicare limitations.
• Provision 2: Effective June 1, 2026, if federal financial participation is temporarily withheld or discontinued for a covered service, that service is no longer available to medical assistance enrollees under this chapter as of the date of the withholding or discontinuance. The commissioner is prohibited from making payments to medical assistance providers for services provided on or after that date.

Changes to Existing Law

• Amends Minnesota Statutes 2024 section 256B.0642 to incorporate provisions related to Federal Financial Participation, rate reductions to protect FFP, and the temporary withholding/discontinuance scenario for covered services.

Implementation and Timeline

• The service-suspension mechanism ties to the date FFP is temporarily withheld or discontinued (the service becomes unavailable to enrollees on that date).
• The specific date stated for the suspension and payment prohibition is June 1, 2026.

Potential Impacts

• Providers may see reduced payment rates to maintain eligibility for FFP.
• If FFP is temporarily withheld for a service, that service could be unavailable to MA enrollees starting on the withholding date, potentially limiting access to that service.
• The changes shift how the state manages funding and service availability during periods when federal participation is not guaranteed.

Relevant Terms - Federal Financial Participation (FFP) - Medicare limitations - medical assistance (MA) - covered service - payment rates - commissioner - Minnesota Statutes 256B.0642 - temporary withhold - discontinuance - enrollees - providers