Purpose

• Adjust how the disability waiver rate system handles inflationary adjustments and make conforming changes to related Minnesota statutes.

Main Provisions

• Screening and authorization

  • Recipients must be screened and authorized for services following the federally approved waiver application and any amendments.

• Oversight by lead agency supervisors

  • Lead agency supervisors must review and accept all service agreements entered by lead agency staff into the Medicaid Management Information System (MMIS) before the commissioner approves the agreement.

• Manual review for large increases

  • If a proposed service agreement would raise the total authorized amount beyond the recipient’s prior agreement by more than the value of enacted rate increases, the commissioner must manually review and approve the agreement in MMIS. The “prior service agreement” is the one in effect 12 months before the new start date.

• Information required for approvals

  • Lead agencies must submit, for all service agreements that require commissioner approval:
  • Changes in the number of units authorized
  • New services authorized
  • Changes in values used to calculate service rates (with specified exceptions)
  • Changes in the person’s level of need requiring more services
  • Documentation showing why the previous amount isn’t sufficient
  • Anticipated impact if the total service amount isn’t increased

• Conditions for approving service agreements

  • Except for certain rate increases and rate changes authorized by the 2025 legislature, the commissioner cannot approve service agreements that are not the result of either:
  • a documented change in a person’s assessed needs, or
  • documented evidence that the previous service level was insufficient to meet the person’s assessed needs.

• Expiration and implementation note

  • This provision expires when waiver reimagine is fully implemented. The commissioner must inform the state’s official publisher (the Revisor of Statutes) when waiver reimagine is fully implemented.

Significance / What this changes

• Creates tighter control over increases in disability waiver services to ensure any growth is justified by a real change in needs.
• Requires formal review steps by lead agencies and the commissioner for larger or more costly service authorizations.
• Adds detailed reporting requirements to justify changes in services and costs.
• Ties many of the approval requirements to the ongoing process of “waiver reimagine” and marks a sunset/date of expiration tied to that implementation.

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Relevant Terms - waiver - disability waiver rate system - inflationary adjustments - Minnesota Statutes 256B.4914 - Minnesota Statutes 2025 Supplement 256B.092 subdivision 3b - 256B.49 subdivision 17a - MMIS (Medicaid Management Information System) - lead agency - service agreement - prior service agreement - total authorized amount - units - services authorized - rate calculation - levels of need - assessed needs - documented change - waiver reimagine - federally approved waiver application - rate increases - commissioner (state official)