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Minnesota Legislature

Office of the Revisor of Statutes

256B.4913 PAYMENT METHODOLOGY DEVELOPMENT.

Subdivision 1.

[Repealed, 2013 c 108 art 13 s 14]

Subd. 2.

[Repealed, 2013 c 108 art 13 s 14]

Subd. 3.

[Repealed, 2013 c 108 art 13 s 14]

Subd. 4.

[Repealed, 2013 c 108 art 13 s 14]

Subd. 4a.Rate stabilization adjustment.

(a) For purposes of this subdivision, "implementation period" shall mean the period beginning January 1, 2014, and ending on the last day of the month in which the rate management system is populated with the data necessary to calculate rates for substantially all individuals receiving home and community-based services.

(b) For purposes of this subdivision, the banding value for all service recipients shall mean the individual reimbursement rate for a recipient in effect on December 1, 2013, except that:

(1)(i) for day training and habilitation pilot program service recipients, the banding value shall be the authorized rate for the provider in the county of service effective December 1, 2013, if the recipient: was not authorized to receive these waiver services prior to January 1, 2014; added a new service or services on or after January 1, 2014; or changed providers on or after January 1, 2014; and

(ii) for all other unit or day service recipients, the banding value shall be the weighted average authorized rate for each provider number in the county of service effective December 1, 2013, if the recipient: was not authorized to receive these waiver services prior to January 1, 2014; added a new service or services on or after January 1, 2014; or changed providers on or after January 1, 2014; and

(2) for residential service recipients who change providers on or after January 1, 2014, the banding value shall be set by each lead agency within their county aggregate budget using their respective methodology for residential services effective December 1, 2013, for determining the provider rate for a similarly situated recipient being served by that provider.

(c) The commissioner shall adjust individual reimbursement rates determined under this section so that the unit rate is no higher or lower than:

(1) 0.5 percent from the banding value for the implementation period;

(2) 0.5 percent from the rate in effect in clause (1), for the 12-month period immediately following the time period of clause (1);

(3) 1.0 percent from the rate in effect in clause (2), for the 12-month period immediately following the time period of clause (2);

(4) 1.0 percent from the rate in effect in clause (3), for the 12-month period immediately following the time period of clause (3); and

(5) 1.0 percent from the rate in effect in clause (4), for the 12-month period immediately following the time period of clause (4).

(d) This subdivision shall not apply to rates for recipients served by providers new to a given county after January 1, 2014.

Subd. 5.Stakeholder consultation.

The commissioner shall continue consultation on regular intervals with the existing stakeholder group established as part of the rate-setting methodology process and others, to gather input, concerns, and data, to assist in the full implementation of the new rate payment system and to make pertinent information available to the public through the department's Web site.

Subd. 6.Implementation.

(a) The commissioner shall implement changes on January 1, 2014, to payment rates for individuals receiving home and community-based waivered services after the enactment of legislation that establishes specific payment methodology frameworks, processes for rate calculations, and specific values to populate the disability waiver rates system.

(b) On January 1, 2014, all new service authorizations must use the disability waiver rates system. Beginning January 1, 2014, all renewing individual service plans must use the disability waiver rates system as reassessment and reauthorization occurs. By December 31, 2014, data for all recipients must be entered into the disability waiver rates system.