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Community-Based Services Manual (CBSM)

Community-Based Services Manual (CBSM)


AASD eList announcement

Date: Aug. 27 and Sept. 24, 2024
To: Lead agencies, customized living providers and other interested parties
From: DHS Aging and Adult Services Division
Purpose: To announce changes for the Elderly Waiver (EW) customized living disproportionate share program
Application period: Sept. 1 to Sept. 30, 2024
Contact: dhs.aasd.hcbs@state.mn.us

EW customized living services rate floor adjustments for disproportionate share facilities

The 2024 Minnesota Legislature approved changes to the rate floor adjustment (i.e., minimum daily rate) for customized living services providers that are designated as disproportionate share facilities.

Eligible facilities

To be eligible to apply for payments in 2025, the facility must meet all of the following requirements as of Sept. 1, 2024:

  • · The facility was determined eligible for the disproportionate share rate adjustment in application year 2023 and is receiving payments in rate year 2024.
  • · At least 83.5% of the facility’s residents are customized living residents who use EW, BI or CADI waivers.
  • · At least 70% of those customized living residents use EW.
  • As of Oct. 1, 2023, DHS cannot process any new applications for disproportionate share facilities after the Sept. 1 through Sept. 30, 2023, application period.

    Adjustment amount

    The Legislature-approved rate floor adjustment amount is $141 for calendar year 2025.

    Qualified facilities will get adjustments up to the rate floor on claims for people who use EW and receive 24-hour customized living services from Jan. 1 to Dec. 31, 2025. The payment does not apply to claims for residents who use Brain Injury (BI) and Community Access for Disability Inclusion (CADI) waivers.

    How to apply

    Currently approved, eligible facilities may use the following information to apply:

  • · Application link: Disproportionate Share Facility Application, DHS-8157
  • · Submission period: Sept. 1 to Sept. 30, 2024.
  • · More information: Billing section of MHCP Provider Manual EW and Alternative Care Program.
  • After DHS has received the application, we will ask applicants to submit a list of waiver participants in a secure format to verify resident numbers in the application.

    Lead agency information

    EW rate floor adjustments do not affect lead agency:

  • · Processes for support planning and rate setting.
  • · Daily rates.
  • · Case mix budgets.
  • Managed care organizations that serve as lead agencies must apply the rate floor adjustment when eligible providers submit payment claims.

    For more information about lead agency billing, refer to the authorization, rates and billing section of CBSM Customized living (including 24-hour customized living).

    Previous eList announcements

    AASD LEAD AGENCY ARCHIVE

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