Elderly Waiver Customized Living Services Rate Adjustment

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Aging & Adult Services Division

Community Supports for Seniors E-List

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Aug. 1, 2022

Date: Aug. 1, 2022
To: Customized living providers and lead agencies
From: DHS Aging and Adult Services Division
Purpose of E-Mail: To announce a Disproportionate Share Facility application period for the Elderly Waiver customized living services rate adjustment
Effective Date: Application period is Sept. 1-30, 2022
Contactdhs.aasd.hcbs@state.mn.us

Elderly Waiver Customized Living Services Rate Adjustment

Rate floor rate adjustments for disproportionate share facilities

The 2022 Minnesota Legislature approved a rate floor rate adjustment, or minimum daily rate, for providers of customized living services that are designated as disproportionate share facilities. To be designated, a disproportionate share facility must meet both of the following criteria on Sept. 1, 2022:

  1. Have a census of at least 83.5 percent waiver program participants (including Elderly Waiver (EW), Brain Injury Waiver (BI), or the Community Access for Disability Inclusion Waiver (CADI))
  2. At least 70.0 percent of the same waiver participants are on EW

Rate floor rate adjustment amount

The rate floor rate adjustment amount is $119 in calendar year 2022. It will increase on Jan. 1, 2023 as directed by statute. DHS will announce the new rate floor amount when it is determined. Qualified facilities will receive the rate floor rate adjustment on claims for EW participants who receive 24-hour customized living services from Jan. 1 – Dec. 31, 2023.

Applying for the rate floor rate adjustment

Facilities must apply between Sept. 1-30, 2022 using the Disproportionate Share Facility Application (DHS-8157-ENG) to receive this designation and the associated rate adjustment. DHS will request applicants to submit a census list of waiver participants in a secure and encrypted format to verify the resident numbers submitted on the application form.

More information and instructions are available on the application form and in the Billing section of the Elderly Waiver (EW) and Alternative Care (AC) Program page in the Minnesota Health Care Programs (MHCP) Provider Manual. Facilities do not need to act on this information until the application period opens on Sept. 1, 2022.

Guidance to lead agencies

The EW rate floor rate adjustments do not affect lead agency processes or people’s daily rates or monthly case mix budgets. However, managed care organizations (MCOs), as lead agencies, do apply the rate floor rate adjustment when eligible providers submit claims to their organizations for payment.

Further guidance to lead agencies can be found in the Authorization, rates, and billing section of the Customized Living page in the Community Based Services Manual (CBSM).


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