Express state of application to the county-administered rural medical assistance (CARMA) program required for a medical assistance modification to apply to the CARMA program, and estimate of local fiscal impacts to counties or groups of counties administering CARMA required.

This bill requires that any changes to Minnesota's medical assistance program must explicitly state if they apply to the county-administered rural medical assistance (CARMA) program, ensuring rural counties are not inadvertently affected by state-level modifications. It also mandates that the state commissioner publish written estimates of how proposed changes would financially impact counties or groups of counties running CARMA before those changes take effect. Additionally, the bill establishes a payment system for CARMA that includes full monthly payments for services, risk-sharing mechanisms, and provisions allowing counties to retain savings after three years of operation. These measures aim to provide greater transparency and financial stability for rural counties administering the program while maintaining consistency with state medical assistance requirements.