Subdivision 1. Preadmission screening. (a) Medical assistance reimbursement for nursing facilities shall be authorized for a medical assistance recipient only if a preadmission screening has been conducted prior to admission or the county has authorized an exemption. Medical assistance reimbursement for nursing facilities shall not be provided for any recipient who the local screener has determined does not meet the level of care criteria for nursing facility placement in section 144.0724, subdivision 11, or, if indicated, has not had a level II OBRA evaluation as required under the federal Omnibus Budget Reconciliation Act of 1987, unless an admission for a recipient with mental illness is approved by the local mental health authority or an admission for a recipient with developmental disability is approved by the state developmental disability authority.
(b) The nursing facility must not bill a person who is not a medical assistance recipient for resident days that preceded the date of completion of screening activities as required under section 256.975, subdivisions 7a to 7c. The nursing facility must include unreimbursed resident days in the nursing facility resident day totals reported to the commissioner.
Subd. 2. Referrals to Medicare providers. (a) Notwithstanding sections 256R.04 and 256R.06, subdivisions 2 and 4, nursing facility providers that do not participate in or accept Medicare assignment must refer and document the referral of dual eligible recipients for whom placement is requested and for whom the resident would be qualified for a Medicare-covered stay to Medicare providers. The commissioner shall audit nursing facilities that do not accept Medicare and determine if dual eligible individuals with Medicare qualifying stays have been admitted. If such a determination is made, the commissioner shall deny Medicaid payment for the first 20 days of that resident's stay.
(b) A nursing facility that violates this subdivision is subject to section 256R.04, subdivisions 7 and 8.
2016 c 99 art 1 s 5
Structure Minnesota Statutes
Chapters 245 - 267 — Public Welfare And Related Activities
Chapter 256R — Nursing Facility Rates
Section 256R.02 — Definitions.
Section 256R.03 — Conditions For Funding.
Section 256R.04 — Prohibited Practices.
Section 256R.05 — Required Practices.
Section 256R.06 — Private Pay Residents; Required Practices.
Section 256R.07 — Adequate Documentation.
Section 256R.08 — Reporting Of Financial Statements.
Section 256R.09 — Reporting Of Statistical And Cost Reports.
Section 256R.10 — Allowed Costs.
Section 256R.11 — Nonallowed Costs.
Section 256R.12 — Cost Allocation.
Section 256R.13 — Auditing Requirements.
Section 256R.16 — Quality Of Care.
Section 256R.18 — Report By Commissioner Of Human Services.
Section 256R.21 — Total Payment Rate.
Section 256R.22 — Case Mix Adjusted Total Payment Rate.
Section 256R.23 — Total Care-related Payment Rates.
Section 256R.24 — Other Operating Payment Rate.
Section 256R.25 — External Fixed Costs Payment Rate.
Section 256R.26 — Property Payment Rate.
Section 256R.261 — Property Rate Definitions.
Section 256R.265 — Appraisals And Determination Of Replacement Costs.
Section 256R.267 — Threshold Project Property Payment Rate Interim Adjustments.
Section 256R.27 — Interim And Settle-up Payment Rates.
Section 256R.36 — Hold Harmless.
Section 256R.37 — Scholarships.
Section 256R.38 — Performance-based Incentive Payments.
Section 256R.39 — Quality Improvement Incentive Program.
Section 256R.40 — Nursing Facility Voluntary Closure; Alternatives.
Section 256R.41 — Single-bed Room Incentive.
Section 256R.42 — Rate Adjustment For The First 30 Days.
Section 256R.44 — Rate Adjustment For Private Rooms For Medical Necessity.
Section 256R.45 — Rate Adjustment For Ventilator-dependent Persons.
Section 256R.46 — Specialized Care Facilities.
Section 256R.47 — Rate Adjustment For Critical Access Nursing Facilities.
Section 256R.48 — Publicly Owned Facilities.
Section 256R.481 — Rate Adjustments For Border City Facilities.
Section 256R.50 — Bed Relocations.
Section 256R.51 — Rate Adjustment For Special Dietary Needs.
Section 256R.52 — Nursing Facility Receivership Fees.