Minnesota Contract for Care, documented as two separate government systems

Status: Minnesota evidence build reviewed through October 5, 2026. This library separates the intractable-pain statutory agreement from the workers’ compensation written opioid treatment contract, then maps patient protections, monitoring, Medicaid guidance, and each system’s change path.

Use this Minnesota record

What is required Minnesota has two separate government agreement systems: a statutory patient-provider agreement for treatment of intractable pain under §152.125 and a workers’ compensation written opioid-treatment contract under Rule 5221.6110.
Who it applies to The statutory agreement applies within the intractable-pain framework; the workers’ compensation contract applies to covered long-term opioid treatment in that separate system.
Who can change it The Minnesota Legislature controls §152.125. The Department of Labor and Industry controls the workers’ compensation rule/guideline process.
What to do next Choose the correct change route or submit a Minnesota agreement.

System 1 — Intractable-pain statute

Minn. Stat. §152.125 requires a physician, advanced practice registered nurse, or physician assistant and the patient or legal guardian to enter into a signed patient-provider agreement before covered treatment for intractable pain with Schedule II-V controlled substances.

Intractable-pain agreement requirement Minnesota statute
Mutual patient-provider agreement Required before covered treatment.
Signatures Patient/legal guardian and prescriber.
Medical record Agreement retained in the record; copy provided to patient.
Annual review Required.
Treatment-plan change Agreement must be updated and re-signed.
Nonadherence Absent clear diversion, cannot be sole reason to stop scheduled-drug treatment.
MME-only taper Prohibited for stable compliant patients meeting statutory conditions.

System 2 — Workers’ compensation

Minn. R. 5221.6110 requires an injured worker receiving long-term opioid analgesic medication to enter a written treatment contract with the prescribing provider as part of an integrated treatment program.

Workers’ compensation requirement Minnesota rule
Written opioid contract Required for long-term opioid analgesic treatment.
Patient copy and medical record Required.
Lost/stolen medication Rule limits replacement to a first event and provider discretion.
Early refills Contract requires no early renewal.
Other prescriptions Patient must notify providers and opioid prescriber.
PMP At least semiannual review; every follow-up for defined high-risk/high-dose patients.
Urine testing At least twice yearly for defined high-risk/high-dose patients.
Discontinuation Taper schedule and alternative treatment/referral required.

Minnesota state-level records

The 2022 statute paired a mandate with protections

Minnesota’s 2022 reform created the current detailed agreement framework while simultaneously prohibiting agreement nonadherence from being the sole reason for cutoff absent clear diversion, prohibiting MME-only tapering of stable compliant patients, and protecting prescribers and prescriptions from threshold-only consequences.

Intractable pain is a defined legal category

The statutory agreement is not a universal contract for every chronic-pain patient. It applies within §152.125’s intractable-pain framework and its defined prescriber scope, exclusions, and emergency/inpatient exception.

Workers’ compensation is separately prescriptive

The workers’ compensation rule includes detailed contract terms involving lost medication, early refills, illegal substances, testing cooperation, PMP access, outside prescriptions, provider availability, functional monitoring, and tapering. Those terms should not be silently attributed to the separate intractable-pain statute.

PMP and Medicaid guidance are additional layers

Minnesota generally requires PMP access before an initial Schedule II-IV opiate prescription and at least every three months during chronic-pain opioid treatment, subject to statutory exceptions. DHS’s separate Opioid Prescribing Improvement Program created prescribing guidance, provider education, and Medicaid quality-improvement measures but officially ended December 31, 2024. Its final report, outcomes, data, and archived guidance remain relevant evidence.

Two change paths

Removing the §152.125 patient-provider agreement requires legislative amendment. Current health-policy gatekeepers include House Health Finance and Policy Co-Chairs Jeff Backer and Robert Bierman and Senate Health and Human Services Chair Melissa H. Wiklund. Removing or changing the workers’ compensation contract requires Department of Labor and Industry rulemaking; current DLI Commissioner Kate Perushek took office in July 2026. Minn. Stat. §14.09 also allows any person to petition an agency for amendment or repeal of a rule, with a written agency response due within 60 days.

Submit a missing Minnesota agreement

Submit a Minnesota Contract for Care

Primary Minnesota authorities

Reviewed: October 5, 2026.

Evidence boundary: Minnesota has two government Contract-for-Care systems with different scopes and change mechanisms. Statutory intractable-pain agreements, workers’ compensation contracts, PMP duties, Medicaid guidance, and private clinic policies remain distinct evidence layers.