Medical assistance capitation payment withhold related to verification of coverage established.

This bill requires Minnesota's Department of Human Services to withhold five percent of payments to managed care plans and county-based purchasing plans until those plans meet specific performance targets related to coverage verification. The withheld funds are intended to ensure that health plans properly verify enrollee coverage before receiving full payment, with the money returned no earlier than July of the following year if targets are achieved. The law mandates that performance targets be quantifiable, measurable, and developed with input from external clinical experts and stakeholders, including the plans and providers themselves. Additionally, the bill updates administrative requirements for managed care plans, including standardized processes for personal care services and new reporting obligations regarding rate increases. These changes directly affect prepaid health plans serving medical assistance recipients and the state agencies that manage public health care programs.