Minnesota Statutes
Chapter 256B — Medical Assistance For Needy Persons
Section 256B.0914 — Conflicts Of Interest Related To Medicaid Expenditures.

Subdivision 1. Definitions. (a) "Contract" means a written, fully executed agreement for the purchase of goods and services involving a substantial expenditure of Medicaid funding. A contract under a renewal period shall be considered a separate contract.
(b) "Contractor bid or proposal information" means cost or pricing data, indirect costs, and proprietary information marked as such by the bidder in accordance with applicable law.
(c) "Particular expenditure" means a substantial expenditure as defined below, for a specified term, involving specific parties. The renewal of an existing contract for the substantial expenditure of Medicaid funds is considered a separate, particular expenditure from the original contract.
(d) "Source selection information" means any of the following information prepared for use by the state, county, or independent contractor for the purpose of evaluating a bid or proposal to enter into a Medicaid procurement contract, if that information has not been previously made available to the public or disclosed publicly:
(1) bid prices submitted in response to a solicitation for sealed bids, or lists of the bid prices before bid opening;
(2) proposed costs or prices submitted in response to a solicitation, or lists of those proposed costs or prices;
(3) source selection plans;
(4) technical evaluations plans;
(5) technical evaluations of proposals;
(6) cost or price evaluation of proposals;
(7) competitive range determinations that identify proposals that have a reasonable chance of being selected for award of a contract;
(8) rankings of bids, proposals, or competitors;
(9) the reports and evaluations of source selection panels, boards, or advisory councils; and
(10) other information marked as "source selection information" based on a case-by-case determination by the head of the agency, contractor, designees, or the contracting officer that disclosure of the information would jeopardize the integrity or successful completion of the Medicaid procurement to which the information relates.
(e) "Substantial expenditure" and "substantial amounts" mean a purchase of goods or services in excess of $10,000,000 in Medicaid funding under this chapter or chapter 256L.
Subd. 2. Applicability. (a) Unless provided otherwise, this section applies to:
(1) any state or local officer, employee, or independent contractor who is responsible for the substantial expenditures of medical assistance or MinnesotaCare funding under this chapter or chapter 256L for which federal Medicaid matching funds are available;
(2) any individual who formerly was such an officer, employee, or independent contractor; and
(3) any partner of such a state or local officer, employee, or independent contractor.
(b) This section is intended to meet the requirements of state participation in the Medicaid program at United States Code, title 42, sections 1396a(a)(4) and 1396u-2(d)(3), which require that states have in place restrictions against conflicts of interest in the Medicaid procurement process, that are at least as stringent as those in effect under United States Code, title 41, section 423, and title 18, sections 207 and 208, as they apply to federal employees.
Subd. 3. Disclosure of procurement information. A person described in subdivision 2 may not knowingly disclose contractor bid or proposal information, or source selection information before the award by the state, county, or independent contractor of a Medicaid procurement contract to which the information relates unless the disclosure is otherwise authorized by law. No person, other than as provided by law, shall knowingly obtain contractor bid or proposal information or source selection information before the award of a Medicaid procurement contract to which the information relates.
Subd. 4. Offers of employment. When a person described in subdivision 2, paragraph (a), is participating personally and substantially in a Medicaid procurement for a contract contacts or is contacted by a person who is a bidder or offeror in the same procurement regarding possible employment outside of the entity by which the person is currently employed, the person must:
(1) report the contact in writing to the person's supervisor and employer's ethics officer; and
(2) either:
(i) reject the possibility of employment with the bidder or offeror; or
(ii) be disqualified from further participation in the procurement until the bidder or offeror is no longer involved in that procurement, or all discussions with the bidder or offeror regarding possible employment have terminated without an arrangement for employment. A bidder or offeror may not engage in employment discussions with an official who is subject to this subdivision, until the bidder or offeror is no longer involved in that procurement.
Subd. 5. Acceptance of compensation by a former official. (a) A former official of the state or county, or a former independent contractor, described in subdivision 2 may not accept compensation from a Medicaid contractor of a substantial expenditure as an employee, officer, director, or consultant of the contractor within one year after the former official or independent contractor:
(1) served as the procuring contracting officer, the source selection authority, a member of the source selection evaluation board, or the chief of a financial or technical evaluation team in a procurement in which the contractor was selected for award;
(2) served as the program manager, deputy program manager, or administrative contracting officer for a contract awarded to the contractor; or
(3) personally made decisions for the state, county, or independent contractor to:
(i) award a contract, subcontract, modification of a contract or subcontract, or a task order or delivery order to the contractor;
(ii) establish overhead or other rates applicable to a contract or contracts with the contractor;
(iii) approve issuance of a contract payment or payments to the contractor; or
(iv) pay or settle a claim with the contractor.
(b) Paragraph (a) does not prohibit a former official of the state, county, or independent contractor from accepting compensation from any division or affiliate of a contractor not involved in the same or similar products or services as the division or affiliate of the contractor that is responsible for the contract referred to in paragraph (a), clause (1), (2), or (3).
(c) A contractor shall not provide compensation to a former official knowing that the former official is accepting that compensation in violation of this subdivision.
Subd. 6. Permanent restrictions on representation and communication. (a) A person described in subdivision 2, after termination of service with the state, county, or independent contractor, is permanently restricted from knowingly making, with the intent to influence, any communication to or appearance before an officer or employee of a department, agency, or court of the United States, the state of Minnesota and its counties in connection with a particular expenditure:
(1) in which the United States, the state of Minnesota, or a Minnesota county is a party or has a direct and substantial interest;
(2) in which the person participated personally and substantially as an officer, employee, or independent contractor; and
(3) which involved a specific party or parties at the time of participation.
(b) For purposes of this subdivision and subdivisions 7 and 9, "participated" means an action taken through decision, approval, disapproval, recommendation, the rendering of advice, investigation, or other such action.
Subd. 7. Two-year restrictions on representation and communication. No person described in subdivision 2, within two years after termination of service with the state, county, or independent contractor, shall knowingly make, with the intent to influence, any communication to or appearance before any officer or employee of any government department, agency, or court in connection with a particular expenditure:
(1) in which the United States, the state of Minnesota, or a Minnesota county is a party or has a direct and substantial interest;
(2) which the person knows or reasonably should know was actually pending under the official's responsibility as an officer, employee, or independent contractor within one year before the termination of the official's service with the state, county, or independent contractor; and
(3) which involved a specific party or parties at the time the expenditure was pending.
Subd. 8. Exceptions to restrictions on representation and communication. Subdivisions 6 and 7 do not apply to:
(1) communications or representations made in carrying out official duties on behalf of the United States, the state of Minnesota or local government, or as an elected official of the state or local government;
(2) communications made solely for the purpose of furnishing scientific or technological information; or
(3) giving testimony under oath. A person subject to subdivisions 6 and 7 may serve as an expert witness in that matter, without restriction, for the state, county, or independent contractor. Under court order, a person subject to subdivisions 6 and 7 may serve as an expert witness for others. Otherwise, the person may not serve as an expert witness in that matter.
Subd. 9. Waiver. The commissioner of human services, or the governor in the case of the commissioner, may grant a waiver of a restriction in subdivisions 6 and 7 upon determining that a waiver is in the public interest and that the services of the officer or employee are critically needed for the benefit of the state or county government.
Subd. 10. Acts affecting a personal financial interest. A person described in subdivision 2, paragraph (a), clause (1), who participates in a particular expenditure in which the person has knowledge or has a financial interest, is subject to the penalties in subdivision 12. For purposes of this subdivision, "financial interest" also includes the financial interest of a spouse, minor child, general partner, organization in which the officer or employee is serving as an officer, director, trustee, general partner, or employee, or any person or organization with whom the individual is negotiating or has any arrangement concerning prospective employment.
Subd. 11. Exceptions to prohibitions regarding financial interest. Subdivision 10 does not apply if:
(1) the person first advises the person's supervisor and the employer's ethics officer regarding the nature and circumstances of the particular expenditure and makes full disclosure of the financial interest and receives in advance a written determination made by the commissioner of human services, or the governor in the case of the commissioner, that the interest is not so substantial as to likely affect the integrity of the services which the government may expect from the officer, employee, or independent contractor;
(2) the financial interest is listed as an exemption at Code of Federal Regulations, title 5, sections 2640.201 to 2640.203, as too remote or inconsequential to affect the integrity of the services of the office, employee, or independent contractor to which the requirement applies.
Subd. 12. Criminal penalties. (a) A person who violates subdivisions 3 to 5 for the purpose of either exchanging the information covered by this section for anything of value, or for obtaining or giving anyone a competitive advantage in the award of a Medicaid contract, may be sentenced to imprisonment for not more than five years or payment of a fine of not more than $50,000 for each violation, or the amount of compensation which the person received or offered for the prohibited conduct, whichever is greater, or both.
(b) A person who violates a provision of subdivisions 6 to 11 may be sentenced to imprisonment for not more than one year or payment of a fine of not more than $50,000 for each violation or the amount of compensation which the person received or offered for the prohibited conduct, whichever amount is greater, or both. A person who willfully engages in conduct in violation of subdivisions 6 to 11 may be sentenced to imprisonment for not more than five years or to payment of a fine of not more than $50,000 for each violation or the amount of compensation which the person received or offered for the prohibited conduct, whichever amount is greater, or both.
(c) Nothing in this section precludes prosecution under other laws such as section 609.43.
Subd. 13. Civil penalties and injunctive relief. (a) The Minnesota attorney general may bring a civil action in Ramsey county district court against a person who violates this section. Upon proof of such conduct by a preponderance of evidence, the person is subject to a civil penalty. An individual who violates this section is subject to a civil penalty of not more than $50,000 for each violation plus twice the amount of compensation which the individual received or offered for the prohibited conduct. An organization that violates this section is subject to a civil penalty of not more than $500,000 for each violation plus twice the amount of compensation which the organization received or offered for the prohibited conduct.
(b) If the Minnesota attorney general has reason to believe that a person is engaging in conduct in violation of this section, the attorney general may petition the Ramsey county district court for an order prohibiting that person from engaging in such conduct. The court may issue an order prohibiting that person from engaging in such conduct if the court finds that the conduct constitutes such a violation. The filing of a petition under this subdivision does not preclude any other remedy which is available by law.
Subd. 14. Administrative actions. (a) If a state agency, local agency, or independent contractor receives information that a contractor or a person has violated this section, the state agency, local agency, or independent contractor may:
(1) cancel the procurement if a contract has not already been awarded;
(2) rescind the contract; or
(3) initiate suspension or debarment proceedings according to applicable state or federal law.
(b) If the contract is rescinded, the state agency, local agency, or independent contractor is entitled to recover, in addition to any penalty prescribed by law, the amount expended under the contract.
(c) This section does not:
(1) restrict the disclosure of information to or from any person or class of persons authorized to receive that information;
(2) restrict a contractor from disclosing the contractor's bid or proposal information or the recipient from receiving that information;
(3) restrict the disclosure or receipt of information relating to a Medicaid procurement after it has been canceled by the state agency, county agency, or independent contractor before the contract award unless the agency or independent contractor plans to resume the procurement; or
(4) limit the applicability of any requirements, sanctions, contract penalties, and remedies established under any other law or regulation.
(d) No person may file a protest against the award or proposed award of a Medicaid contract alleging a violation of this section unless that person reported the information the person believes constitutes evidence of the offense to the applicable state agency, local agency, or independent contractor responsible for the procurement. The report must be made no later than 14 days after the person first discovered the possible violation.
1986 c 444; 1999 c 245 art 4 s 60

Structure Minnesota Statutes

Minnesota Statutes

Chapters 245 - 267 — Public Welfare And Related Activities

Chapter 256B — Medical Assistance For Needy Persons

Section 256B.01 — Policy.

Section 256B.011 — Policy For Childbirth And Abortion Funding.

Section 256B.02 — Definitions.

Section 256B.021 — Medical Assistance Reform Waiver.

Section 256B.03 — Payments To Vendors.

Section 256B.035 — Managed Care.

Section 256B.037 — Prospective Payment Of Dental Services.

Section 256B.0371 — Performance Benchmarks For Dental Access; Contingent Dental Administrator.

Section 256B.038 — Provider Rate Increases After June 30, 1999.

Section 256B.04 — Duties Of State Agency.

Section 256B.041 — Centralized Disbursement Of Medical Assistance Payments.

Section 256B.042 — Third-party Liability.

Section 256B.043 — Cost-containment Efforts.

Section 256B.05 — Administration By County Agencies.

Section 256B.051 — Housing Stabilization Services.

Section 256B.055 — Eligibility Categories.

Section 256B.056 — Eligibility Requirements For Medical Assistance.

Section 256B.0561 — Periodic Data Matching To Evaluate Continued Eligibility.

Section 256B.057 — Eligibility Requirements For Special Categories.

Section 256B.0571 — Long-term Care Partnership Program.

Section 256B.0575 — Availability Of Income For Institutionalized Persons.

Section 256B.058 — Treatment Of Income Of Institutionalized Spouse.

Section 256B.059 — Treatment Of Assets When A Spouse Is Institutionalized.

Section 256B.0594 — Payment Of Benefits From An Annuity.

Section 256B.0595 — Prohibitions On Transfer; Exceptions.

Section 256B.06 — Eligibility; Migrant Workers; Citizenship.

Section 256B.061 — Eligibility; Retroactive Effect; Restrictions.

Section 256B.0615 — Mental Health Certified Peer Specialist.

Section 256B.0616 — Mental Health Certified Family Peer Specialist.

Section 256B.0621 — Covered Services: Targeted Case Management Services.

Section 256B.0622 — Assertive Community Treatment And Intensive Residential Treatment Services.

Section 256B.0623 — Adult Rehabilitative Mental Health Services Covered.

Section 256B.0624 — Crisis Response Services Covered.

Section 256B.0625 — Covered Services.

Section 256B.0626 — Estimation Of 50th Percentile Of Prevailing Charges.

Section 256B.063 — Cost Sharing.

Section 256B.0631 — Medical Assistance Co-payments.

Section 256B.0635 — Continued Eligibility In Special Circumstances.

Section 256B.0636 — Controlled Substance Prescriptions; Abuse Prevention.

Section 256B.0637 — Presumptive Eligibility; Treatment For Breast Or Cervical Cancer.

Section 256B.0638 — Opioid Prescribing Improvement Program.

Section 256B.064 — Sanctions; Monetary Recovery.

Section 256B.0641 — Recovery Of Overpayments.

Section 256B.0642 — Federal Financial Participation.

Section 256B.0643 — Vendor Request For Contested Case Proceeding.

Section 256B.0644 — Reimbursement Under Other State Health Care Programs.

Section 256B.0646 — Minnesota Restricted Recipient Program; Personal Care Assistance Services.

Section 256B.065 — Social Security Amendments.

Section 256B.0651 — Home Care Services.

Section 256B.0652 — Authorization And Review Of Home Care Services.

Section 256B.0653 — Home Health Agency Services.

Section 256B.0654 — Home Care Nursing.

Section 256B.0658 — Housing Access Grants.

Section 256B.0659 — Personal Care Assistance Program.

Section 256B.0671 — Covered Mental Health Services.

Section 256B.0711 — Quality Self-directed Services Workforce.

Section 256B.072 — Performance Reporting And Quality Improvement System.

Section 256B.073 — Electronic Visit Verification.

Section 256B.075 — Disease Management Programs.

Section 256B.0751 — Health Care Homes.

Section 256B.0753 — Payment Restructuring; Care Coordination Payments.

Section 256B.0754 — Payment Reform.

Section 256B.0755 — Integrated Health Partnership Demonstration Project.

Section 256B.0756 — Hennepin And Ramsey Counties Pilot Program.

Section 256B.0757 — Coordinated Care Through A Health Home.

Section 256B.0758 — Health Care Delivery Pilot Program.

Section 256B.0759 — Substance Use Disorder Demonstration Project.

Section 256B.076 — Case Management Services.

Section 256B.08 — Application.

Section 256B.09 — Investigations.

Section 256B.0911 — Long-term Care Consultation Services.

Section 256B.0913 — Alternative Care Program.

Section 256B.0914 — Conflicts Of Interest Related To Medicaid Expenditures.

Section 256B.0916 — Expansion Of Home And Community-based Services.

Section 256B.0917 — Home And Community-based Services For Older Adults.

Section 256B.0918 — Employee Scholarship Costs.

Section 256B.0919 — Adult Foster Care And Family Adult Day Care.

Section 256B.092 — Services For Persons With Developmental Disabilities.

Section 256B.0921 — Home And Community-based Services Innovation Pool.

Section 256B.0922 — Essential Community Supports.

Section 256B.0924 — Targeted Case Management Services.

Section 256B.0926 — Admission Review Team; Intermediate Care Facilities.

Section 256B.093 — Services For Persons With Traumatic Brain Injuries.

Section 256B.094 — Child Welfare Targeted Case Management Services.

Section 256B.0941 — Psychiatric Residential Treatment Facility For Persons Younger Than 21 Years Of Age.

Section 256B.0943 — Children's Therapeutic Services And Supports.

Section 256B.0945 — Services For Children With Severe Emotional Disturbance.

Section 256B.0946 — Children's Intensive Behavioral Health Services.

Section 256B.0947 — Intensive Rehabilitative Mental Health Services.

Section 256B.0948 — Foster Care Rate Limits.

Section 256B.0949 — Early Intensive Developmental And Behavioral Intervention Benefit.

Section 256B.095 — Quality Assurance System Established.

Section 256B.0951 — Quality Assurance Commission.

Section 256B.0952 — County Duties; Quality Assurance Teams.

Section 256B.0953 — Quality Assurance Process.

Section 256B.0954 — Certain Persons Defined As Mandated Reporters.

Section 256B.0955 — Duties Of The Commissioner Of Human Services.

Section 256B.097 — Regional And Systems Improvement For Minnesotans Who Have Disabilities.

Section 256B.12 — Legal Representation.

Section 256B.121 — Treble Damages.

Section 256B.13 — Subpoenas.

Section 256B.14 — Relative's Responsibility.

Section 256B.15 — Claims Against Estates.

Section 256B.17 — Transfers Of Property.

Section 256B.18 — Methods Of Administration.

Section 256B.19 — Division Of Cost.

Section 256B.194 — Federal Payments.

Section 256B.196 — Intergovernmental Transfers; Hospital And Physician Payments.

Section 256B.197 — Intergovernmental Transfers; Inpatient Hospital Payments.

Section 256B.1973 — Directed Payment Arrangements.

Section 256B.198 — Payments For Non-hospital-based Governmental Health Centers.

Section 256B.199 — Payments Reported By Governmental Entities.

Section 256B.20 — County Appropriations.

Section 256B.21 — Change Of Residence.

Section 256B.22 — Compliance With Social Security Act.

Section 256B.23 — Use Of Federal Funds.

Section 256B.24 — Prohibitions.

Section 256B.25 — Payments To Certified Facilities.

Section 256B.26 — Agreements With Other State Departments.

Section 256B.27 — Medical Assistance; Cost Reports.

Section 256B.30 — Health Care Facility Report.

Section 256B.32 — Facility Fee Payment.

Section 256B.35 — Personal Needs Allowance; Persons In Certain Facilities.

Section 256B.36 — Special Personal Allowance For Certain Individuals.

Section 256B.37 — Private Insurance Policies, Causes Of Action.

Section 256B.39 — Avoidance Of Duplicate Payments.

Section 256B.40 — Subsidy For Abortions Prohibited.

Section 256B.421 — Definitions.

Section 256B.431 — Rate Determination.

Section 256B.434 — Payment Rates And Procedures; Contracts And Agreements.

Section 256B.439 — Long-term Care Quality Profiles.

Section 256B.48 — Conditions For Participation.

Section 256B.49 — Home And Community-based Service Waivers For Persons With Disabilities.

Section 256B.4905 — Home And Community-based Services Policy Statement.

Section 256B.4911 — Consumer-directed Community Supports.

Section 256B.4912 — Home And Community-based Waivers; Providers And Payment.

Section 256B.4914 — Home And Community-based Services Waivers; Rate Setting.

Section 256B.492 — Home And Community-based Settings For People With Disabilities.

Section 256B.493 — Adult Foster Care Planned Closure.

Section 256B.50 — Appeals.

Section 256B.501 — Rates For Community-based Services For Persons With Disabilities.

Section 256B.5011 — Icf/dd Reimbursement System Effective October 1, 2000.

Section 256B.5012 — Icf/dd Payment System Implementation.

Section 256B.5013 — Payment Rate Adjustments.

Section 256B.5014 — Reporting Requirements.

Section 256B.5015 — Pass-through Of Other Services Costs.

Section 256B.502 — Rules.

Section 256B.51 — Nursing Homes; Cost Of Home Care.

Section 256B.69 — Prepaid Health Plans.

Section 256B.6903 — Ombudsperson For Managed Care.

Section 256B.691 — Risk-based Transportation Payments.

Section 256B.692 — County-based Purchasing.

Section 256B.6925 — Enrollee Information.

Section 256B.6926 — State Monitoring.

Section 256B.6927 — Quality Assessment And Performance.

Section 256B.6928 — Managed Care Rates And Payments.

Section 256B.693 — State-operated Services; Managed Care.

Section 256B.694 — Sole-source Or Single-plan Managed Care Contract.

Section 256B.70 — Demonstration Project Waiver.

Section 256B.71 — Social Health Maintenance Organization Demonstration.

Section 256B.72 — Commissioner's Recovery Of Overpayments.

Section 256B.73 — Demonstration Project For Uninsured Low-income Persons.

Section 256B.74 — Special Payments.

Section 256B.75 — Hospital Outpatient Reimbursement.

Section 256B.756 — Reimbursement Rates For Births.

Section 256B.758 — Reimbursement For Doula Services.

Section 256B.76 — Physician And Dental Reimbursement.

Section 256B.761 — Reimbursement For Mental Health Services.

Section 256B.762 — Reimbursement For Health Care Services.

Section 256B.763 — Critical Access Mental Health Rate Increase.

Section 256B.7635 — Reimbursement For Evidence-based Public Health Nurse Home Visits.

Section 256B.764 — Reimbursement For Family Planning Services.

Section 256B.765 — Provider Rate Increases.

Section 256B.766 — Reimbursement For Basic Care Services.

Section 256B.767 — Medicare Payment Limit.

Section 256B.77 — Coordinated Service Delivery System For Persons With Disabilities.

Section 256B.771 — Complementary And Alternative Medicine Demonstration Project.

Section 256B.78 — Demonstration Project For Family Planning Services.

Section 256B.79 — Integrated Care For High-risk Pregnant Women.

Section 256B.795 — Maternal And Infant Health Report.

Section 256B.81 — Mental Health Provider Appeal Process.

Section 256B.82 — Prepaid Plans And Mental Health Rehabilitative Services.

Section 256B.84 — American Indian Contracting Provisions.

Section 256B.85 — Community First Services And Supports.

Section 256B.851 — Community First Services And Supports; Payment Rates.