2000 MERC Legislative Summary
There were several MERC provisions that passed into law during the 2000 session, including a technical amendment to the MERC application process, a technical corrections bill allowing for MERC administrative funds, and a bill eliminating, through January, 2002, the non-metropolitan PMAP carveout:
Temporary PMAP carveout reduction and distribution of PMAP funds
The omnibus Health and Human Services Bill included a provision that eliminated, for two years, the nonmetropolitan PMAP carveout. As a result, until January 1st, 2002, the PMAP carveout pool will consist only of funds removed from rates for Hennepin county and other metropolitan counties. Capitation rates will be reduced 6.3% in Hennepin County and 2% in remaining metropolitan counties. After January 1st, 2002, 1.6% will be carved out of nonmetropolitan county capitation rates, and will be pooled with the Hennepin and other metro carveout funds. This legislation did not make any changes to the current statutury distribution formula for PMAP funds, which remains an additive formula equally weighting public program volume and medical education volume. The bill also mandated that the Commissioner of Health convene a group of stakeholders to evaluate the appropriateness of the current PMAP distribution formula and to consider alternative distribution formulas. This group is to report their recommendations to the Legislature by January 15th, 2001.
MERC Technical Amendments Bill
This bill made modifications to the MERC application process and to the statutory language relating to accrediting organizations:
The deadline for receipt of MERC applications was changed from September 30 to October 31st.
MN Statute 62J.692, subdivision 1 was modified to state that the accrediting body for each clinical training program that is eligible for MERC funding must be recognized by the Department of Education, HCFA, or another national body who reviews the accrediting organizations for multiple disciplines and whose standards for recognizing accrediting organizations are reviewed and approved by the Commissioner of Health in consultation with the medical education and research advisory committee.
Each clinical training program must submit information on clinical training costs per trainee, along with current sources of revenue received for the purposes of clinical training, for three consecutive years. After that time, training programs are only required to submit this information every other year (in the first year of each biennium) rather than with every application.
MERC Administrative Funds
This bill allows MDH to use $150,000 from the general fund appropriation for FY 2000 and FY 2001 to cover MERC administrative costs.
CHAPTER 494-H.F.No. 3642
An act relating to health; modifying provisions for application for and distribution of medical education funds; amending Minnesota Statutes 1999 Supplement, section 62J.692, subdivisions 1, 3, and 4.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Section 1. Minnesota Statutes 1999 Supplement, section 62J.692, subdivision 1, is amended to read:
Subdivision 1. [DEFINITIONS.] For purposes of this section, the following definitions apply:
(a) "Accredited clinical training" means the clinical training provided by
a medical education program that is accredited through an organization recognized
by the department of education or, the health care financing administration
as the official accrediting body for that program, or
another national body who reviews the accrediting organizations for multiple
disciplines and whose standards for recognizing accrediting organizations
are reviewed and approved by the commissioner of health in consultation with
the medical education and research advisory committee.
(b) "Commissioner" means the commissioner of health.
(c) "Clinical medical education program" means the accredited clinical training of physicians (medical students and residents), doctor of pharmacy practitioners, doctors of chiropractic, dentists, advanced practice nurses (clinical nurse specialists, certified registered nurse anesthetists, nurse practitioners, and certified nurse midwives), and physician assistants.
(d) "Sponsoring institution" means a hospital, school, or consortium located in Minnesota that sponsors and maintains primary organizational and financial responsibility for a clinical medical education program in Minnesota and which is accountable to the accrediting body.
(e) "Teaching institution" means a hospital, medical center, clinic, or other organization that conducts a clinical medical education program in Minnesota.
(f) "Trainee" means a student or resident involved in a clinical medical education program.
(g) "Eligible trainee FTEs" means the number of trainees, as measured by full-time equivalent counts, that are at training sites located in Minnesota with a medical assistance provider number where training occurs in either an inpatient or ambulatory patient care setting and where the training is funded, in part, by patient care revenues.
Sec. 2. Minnesota Statutes 1999 Supplement, section
62J.692, subdivision 3, is amended to read:
Subd. 3. [APPLICATION PROCESS.] (a) A clinical medical education program conducted in Minnesota by a teaching institution is eligible for funds under subdivision 4 if the program:
(1) is funded, in part, by patient care revenues;
(2) occurs in patient care settings that face increased financial pressure as a result of competition with nonteaching patient care entities; and
(3) emphasizes primary care or specialties that are in undersupply in Minnesota.
(b) Applications must be submitted to the commissioner by a sponsoring
institution on behalf of an eligible clinical medical education program and
must be received by
September 30 October 31 of each year
for distribution in the following year. An application for funds must contain
the following information:
(1) the official name and address of the sponsoring institution and the official name and site address of the clinical medical education programs on whose behalf the sponsoring institution is applying;
(2) the name, title, and business address of those persons responsible for administering the funds;
(3) for each clinical medical education program for which funds are being sought; the type and specialty orientation of trainees in the program; the name, site address, and medical assistance provider number of each training site used in the program; the total number of trainees at each training site; and the total number of eligible trainee FTEs at each site; and
audited clinical training costs per trainee for each clinical
medical education program where available or estimates of clinical training
costs based on audited financial data;
(5) a description of current sources of funding for clinical medical
education costs, including a description and dollar amount of all state and
federal financial support, including Medicare direct and indirect payments;
(6) other revenue received for the purposes of clinical training;
(7) other supporting information the commissioner deems
necessary to determine program eligibility based on the criteria in paragraph
(a) and to ensure the equitable distribution of funds.
(c) An application must include the information specified in clauses (1) to (3) for each clinical medical education program on an annual basis for three consecutive years. After that time, an application must include the information specified in clauses (1) to (3) in the first year of each biennium:
(1) audited clinical training costs per trainee for each clinical medical education program when available or estimates of clinical training costs based on audited financial data;
(2) a description of current sources of funding for clinical medical education costs, including a description and dollar amount of all state and federal financial support, including Medicare direct and indirect payments; and
(3) other revenue received for the purposes of clinical training.
(d) An applicant that does not provide information requested by the commissioner shall not be eligible for funds for the current funding cycle.
Sec. 3. Minnesota Statutes 1999 Supplement, section 62J.692, subdivision 4, is amended to read:
Subd. 4. [DISTRIBUTION OF FUNDS.] (a) The commissioner shall annually distribute medical education funds to all qualifying applicants based on the following criteria:
(1) total medical education funds available for distribution;
(2) total number of eligible trainee FTEs in each clinical medical education program; and
(3) the statewide average cost per trainee as determined by the application information provided in the first year of the biennium, by type of trainee, in each clinical medical education program.
(b) Funds distributed shall not be used to displace current funding appropriations from federal or state sources.
(c) Funds shall be distributed to the sponsoring institutions indicating the amount to be distributed to each of the sponsor's clinical medical education programs based on the criteria in this subdivision and in accordance with the commissioner's approval letter. Each clinical medical education program must distribute funds to the training sites as specified in the commissioner's approval letter. Sponsoring institutions, which are accredited through an organization recognized by the department of education or the health care financing administration, may contract directly with training sites to provide clinical training. To ensure the quality of clinical training, those accredited sponsoring institutions must:
(1) develop contracts specifying the terms, expectations, and outcomes of the clinical training conducted at sites; and
(2) take necessary action if the contract requirements are not met. Action may include the withholding of payments under this section or the removal of students from the site.
(d) Any funds not distributed in accordance with the commissioner's approval letter must be returned to the medical education and research fund within 30 days of receiving notice from the commissioner. The commissioner shall distribute returned funds to the appropriate training sites in accordance with the commissioner's approval letter.
Sec. 4. [EFFECTIVE DATE.]
Section 1 is effective the day following final enactment.
Presented to the governor May 19, 2000
Signed by the governor May 30, 2000, 2:16 p.m.