Minnesota § 256.9685 - ESTABLISHMENT OF INPATIENT HOSPITAL PAYMENT SYSTEM
Full text of Minnesota Minnesota Statutes § 256.9685 — ESTABLISHMENT OF INPATIENT HOSPITAL PAYMENT SYSTEM, with citation guidance and answers to common questions.
§ 256.9685. ESTABLISHMENT OF INPATIENT HOSPITAL PAYMENT SYSTEM
Subdivision 1.Authority.
The commissioner shall establish procedures for determining medical assistance payment rates under a prospective payment system for inpatient hospital services in hospitals that qualify as vendors of medical assistance. The commissioner shall establish, by rule, procedures for implementing this section and sections 256.9686, 256.969, and 256.9695. Services must meet the requirements of section 256B.04, subdivision 15, to be eligible for payment.
Subd. 1a.Administrative reconsideration.
Notwithstanding section 256B.04, subdivision 15, the commissioner shall establish an administrative reconsideration process for appeals of inpatient hospital services determined to be medically unnecessary. A physician, advanced practice registered nurse, physician assistant, or hospital may request a reconsideration of the decision that inpatient hospital services are not medically necessary by submitting a written request for review to the commissioner within 45 calendar days after the date the notice of the decision was mailed. The request for reconsideration must be reviewed by at least one medical review agent that is independent of the case under reconsideration. The medical review agent shall make a recommendation to the commissioner. The commissioner's decision on reconsideration is final and not subject to appeal under chapter 14.
Subd. 1b.Appeal of reconsideration.
The commissioner's decision under subdivision 1a is appealable by petition for writ of certiorari under chapter 606.
Subd. 1c.
MS 2022 [Repealed, 2023 c 70 art 17 s 63]
Subd. 1d.
MS 2022 [Repealed, 2023 c 70 art 17 s 63]
Subd. 2.Federal requirements.
If it is determined that a provision of this section or section 256.9686, 256.969, or 256.9695 conflicts with existing or future requirements of the United States government with respect to federal financial participation in medical assistance, the federal requirements prevail. The commissioner may, in the aggregate, prospectively reduce payment rates to avoid reduced federal financial participation resulting from rates that are in excess of the Medicare limitations.
History:
1989 c 282 art 3 s 36; 1991 c 292 art 4 s 22; 1992 c 513 art 7 s 22; 1Sp1993 c 1 art 5 s 17; 1995 c 207 art 6 s 16-18; 1997 c 187 art 1 s 19; 1998 c 407 art 4 s 8; 1999 c 245 art 4 s 24; 2002 c 277 s 7; 2014 c 312 art 24 s 3,4; 1Sp2017 c 6 art 4 s 5,6; 2020 c 115 art 4 s 105-107; 2022 c 58 s 128-130; 2023 c 70 art 17 s 37,38
Official Publication of the State of Minnesota
Revisor of Statutes
Source: official Minnesota text · Last verified 2026-08-27
Frequently Asked Questions About Minnesota § 256.9685
What does Minnesota Statutes § 256.9685 cover?
Section 256.9685 ("ESTABLISHMENT OF INPATIENT HOSPITAL PAYMENT SYSTEM") is part of the Minnesota Statutes, the codified statutory law of Minnesota. It sets out the legal rule or procedure described in the text above. Statutes are amended regularly, so always verify against the official source.
How do I cite Minnesota § 256.9685?
A common citation format is "Minnesota Statutes § 256.9685" (Minnesota). Legal writing may require the code abbreviation, section number, and year or edition. Match the style required by your court, professor, or publisher.
Is this the official text of Minnesota law?
No. This page is for research and education and may not include the most recent amendments. For official current law, check the Minnesota official source linked on this page or consult a licensed Minnesota attorney.
How does Minnesota § 256.9685 apply to my situation?
Statutes are interpreted in context, and application depends on your specific facts. Only a licensed attorney in Minnesota can advise on how this section applies to you. Contact your state or local bar association for a referral.
Sources & Verification
Not legal advice. Verify against the official source and consult a licensed attorney in Minnesota.