Federally approved BI, CAC, CADI and DD waiver plans, Minn. Stat §256B.4914

Disability Waiver Rate System (DWRS): An initiative that determines individualized payment rates for certain Brain Injury (BI), Community Access for Disability Inclusion (CADI), Community Alternative Care (CAC) and Developmental Disabilities (DD) waiver services. The DWRS divides disability waiver services into three categories:

Rate Management System (RMS): A web-based application that determines rates for residential, day and unit-based services.

In 2007, the Centers for Medicare & Medicaid Services (CMS) informed Minnesota its four disability waivers did not comply with federal requirements. Minnesota had to develop a uniform rate determination method and standards. In January 2014, DHS established what is now known as the DWRS.

Implementation of the system:

Failure to comply with the federal requirements jeopardizes the services of people in Minnesota who use disability waiver services.

Payment structures

The DWRS has three types of payment structures.

Framework services

The following services are framework services:

Market rate services

The following services are market rate services:

For more information, refer to CBSM – Market rate services.

Pre-determined rate services

The following services are pre-determined rate services:

Enrollment-required and approval-option services

For lists of enrollment-required and approval-option services, refer to CBSM – Waiver/AC service provider overview.

Alternative Care (AC) and Elderly Waiver (EW)

AC and EW service rates are not calculated using the DWRS.

RMS

Lead agency workers use the RMS tool to calculate payment rates for framework services and enter the rates into MMIS. For more information about the tool, refer to CBSM – RMS.

The RMS User Manual provides users with operational information to use the tool effectively.

Exceptions

People with exceptional needs that cannot be met by a DWRS framework rate may request an exception. For more information, refer to CBSM – DWRS exception requests.