05-13-2020 Council Packet - Laserfiche WebLink

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29 relationship. The Borrower does not believe that it will be involved in activities that pose an audit risk under Section 144.6521 or Section 62J.23, Subdivision 5 of the Minnesota Statutes. However, there can be no assurance that such audit will not occur in the future. Minnesota Provider Conflict of Interest Law. Minnesota’s Provider Conflict of Interest Law, which is outlined in Section 62J.23, Subdivision 1 of the Minnesota Statutes, provides that the Commissioner of MDH must adopt rules restricting financial relationships or payment arrangements involving health care providers under which a person benefits financially by referring a patient to another person, recommending another person, or furnishing or recommending an item or service, and that the rules must be no less restrictive than the federal Medicare anti-kickback statute and regulations promulgated thereunder. However, to date, the only rules adopted by the Commissioner of MDH under the Provider Conflict of Interest Law are rules related to the workers’ compensation program. Nevertheless, the Provider Conflict of Interest Law further states that, until rules are adopted by the Commissioner of the Department, the restrictions in the federal Medicare anti-kickback statute and regulations apply to all persons in the State of Minnesota, regardless of whether the person participates in any state health care program. As a result, the Provider Conflict of Interest Law currently has the effect of making federal Medicare anti-kickback rules applicable even if a government program is not a source of payment. While the Borrower does not believe that it will be involved in any activities that pose a risk of sanctions under the Provider Conflict of Interest Law, there can be no assurance that such challenge or investigation will not occur in the future. Food and Lodging Licenses. The Project will be required to obtain food and lodging licenses from MDH. By regulatory definition, the Project are a lodging establishment and a food and beverage establishment. Architectural plans and kitchen design plans must be submitted for regulatory comment and approval prior to commencement of construction. Prior to operations, a license application is submitted to MDH and the completed facility is inspected as a condition for issuance of the food and lodging license. The license is renewed annually. The food license requires that the kitchen be staffed by a qualified food manager. Risk Factors Relating to the Project and also with respect to the Limited Guarantor [COVID-19 DISCUSSION TO BE ADDED AT A LATER DATE] Health Care Law and Reform. The enactment of the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively, “ACA” or the “Affordable Care Act”) represented a significant reform of federal health care legislation. Additionally, Congress continues to consider the adoption of additional laws to modify several aspects of such legislation. The ACA has brought about substantial changes to the delivery of health care services, the financing of health care costs, reimbursement to health care providers, and the legal obligations of health insurers, providers, and employers. Portions of the ACA have already been limited, delayed or nullified as a result of executive action, legislative amendments and judicial interpretations and future actions may further change its impact. The uncertainties regarding the implementation of the ACA create unpredictability for the strategic and business planning efforts of health care providers, which in itself constitutes a risk. Many ACA provisions could have a significant impact on health care providers, including their operations and revenues, and such impact could be negative. For example, expanded health insurance coverage, in particular, could affect the composition of the population enrolled in various public and private health plans, potentially resulting in a capacity strain on provider networks or unanticipated service costs. The ACA attempts to increase competition among private health insurers by providing for transparent state insurance exchanges in which individuals and small employers can purchase health care insurance for themselves and their families or their employees and dependents. The ACA also prevents private insurers from adjusting insurance premiums based on health status, gender, or other specified