Disability Waivers Rate System

In 2007, the Centers for Medicare and Medicaid Services informed Minnesota that its four disability waivers were out of compliance with federal requirements for uniform rate determination methods and standards. The disability waivers are the Brain Injury (BI), Community Alternative Care (CAC), Community Alternative for Disabled Individuals (CADI) and Developmental Disabilities (DD) waivers.

In 2009, DHS established what is now known as the Disability Waivers Rate System. DHS continues to move toward implementation of the system in January 2014.

What will this system accomplish?

Implementation of the system will:

1. Transfer the responsibility of setting service rates from counties and tribes to the state.
2. Restore compliance with federal requirements.
3. Allow federal renewal of the Minnesota disability waivers.

Failure to comply with the federal requirements jeopardizes the services to 37,000 people who rely on disability waiver services.

What are goals of the system?

Goals of the system are to create statewide rate setting methodologies that:

• Are transparent, fair and consistent across the state.

• Comply with federal requirements for administration of waiver programs.

• Establish rates based on a uniform process of structuring component values for service.

• Promote quality and participant choice.

• Recognize a person’s assessed need for particular components within each service.

How do I benefit from the system?

People benefit from increased choice of provider(s) and geographic areas where they receive services.

Lead agencies benefit from use of a Web-based rate-setting calculator and are no longer required to negotiate rates with waiver providers.

Waiver providers benefit from more predictability of rates when the needs of people who receive services increase or people live in different areas of the state and require the same services.

Project documents
DWRS frequently asked questions – FAQs (PDF)

Healthcare Common Procedure Coding System (HCPCS) codes (PDF)

Personal support policy clarification

Project rate component values (PDF)

Project rate frameworks

Rates Management System (RMS) user manual (PDF)

Sort of Services by Methodology Model (PDF)

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