new text begin Certified community behavioral health clinic services. new text end

new text begin (a) Medical assistance covers certified community behavioral health clinic (CCBHC) services that meet the requirements of section 245.735, subdivision 3. new text end

new text begin (b) The commissioner shall establish standards and methodologies for a prospective payment system for medical assistance payments for services delivered by a CCBHC, in accordance with guidance issued by the Centers for Medicare and Medicaid Services. The commissioner shall include a quality bonus payment in the prospective payment system based on federal criteria. new text end

new text begin (c) To the extent allowed by federal law, the commissioner may limit the number of CCBHCs for the prospective payment system in paragraph (b) to ensure that the projected claims do not exceed the money appropriated for this purpose. The commissioner shall apply the following priorities, in the order listed, to give preference to clinics that: new text end

new text begin (1) provide a comprehensive range of services and evidence-based practices for all age groups, with services being fully coordinated and integrated; new text end

new text begin (2) are certified as CCBHCs during the federal section 223 CCBHC demonstration period; new text end

new text begin (3) receive CCBHC grants from the United States Department of Health and Human Services; or new text end

new text begin (4) focus on serving individuals in tribal areas and other underserved communities. new text end

new text begin (d) Unless otherwise indicated in applicable federal requirements, the prospective payment system must continue to be based on the federal instructions issued for the federal section 223 CCBHC demonstration, except: new text end

new text begin (1) the commissioner shall rebase CCBHC rates at least every three years; new text end

new text begin (2) the commissioner shall provide for a 60-day appeals process of the rebasing; new text end

new text begin (3) the prohibition against inclusion of new facilities in the demonstration does not apply after the demonstration ends; new text end

new text begin (4) the prospective payment rate under this section does not apply to services rendered by CCBHCs to individuals who are dually eligible for Medicare and medical assistance when Medicare is the primary payer for the service. An entity that receives a prospective payment system rate that overlaps with the CCBHC rate is not eligible for the CCBHC rate; new text end

new text begin (5) payments for CCBHC services to individuals enrolled in managed care shall be coordinated with the state's phase-out of CCBHC wrap payments; new text end

new text begin (6) initial prospective payment rates for CCBHCs certified after July 1, 2019, shall be based on rates for comparable CCBHCs. If no comparable provider exists, the commissioner shall compute a CCBHC-specific rate based upon the CCBHC's audited costs adjusted for changes in the scope of services; and new text end

new text begin (7) the prospective payment rate for each CCBHC shall be adjusted annually by the Medicare Economic Index as defined for the federal section 223 CCBHC demonstration. new text end