2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256B — Medical Assistance For Needy Persons › Section 256B.5013 — Payment Rate Adjustments.

256B.5013 PAYMENT RATE ADJUSTMENTS.
Subdivision 1.
Variable rate adjustments.
(a) When there is a documented increase in the needs of a current ICF/DD recipient, the county of financial responsibility may recommend a variable rate to enable the facility to meet the individual's increased needs. Variable rate adjustments made under this subdivision replace payments for persons with special needs for crisis intervention services under section 256B.501, subdivision 8a. Once approved, variable rate adjustments must continue to remain in place unless there is an identified change in need. A review of needed resources must be done at the time of the individual's annual support plan meeting. Any change in need identified must result in submission of a request to adjust the resources for the individual. Variable rate adjustments approved solely on the basis of changes on a developmental disabilities screening document will end June 30, 2002.
(b) The county of financial responsibility must act on a variable rate request within 30 days and notify the initiator of the request of the county's recommendation in writing.
(c) A variable rate may be recommended by the county of financial responsibility for increased needs in the following situations:
(1) a need for resources due to an individual's full or partial retirement from participation in a day training and habilitation service when the individual: (i) has reached the age of 65 or has a change in health condition that makes it difficult for the person to participate in day training and habilitation services over an extended period of time because it is medically contraindicated; and (ii) has expressed a desire for change through the developmental disability screening process under section 256B.092;
(2) a need for additional resources for intensive short-term programming that is necessary prior to an individual's discharge to a less restrictive, more integrated setting;
(3) a demonstrated medical need that significantly impacts the type or amount of services needed by the individual;
(4) a demonstrated behavioral or cognitive need that significantly impacts the type or amount of services needed by the individual; or
(5) a demonstrated increased need for staff assistance, changes in the type of staff credentials needed, or a need for expert consultation based on assessments conducted prior to the annual support plan meeting.
(d) Variable rate requests must include the following information:
(1) the service needs change;
(2) the variable rate requested and the difference from the current rate;
(3) a basis for the underlying costs used for the variable rate and any accompanying documentation; and
(4) documentation of the expected outcomes to be achieved and the frequency of progress monitoring associated with the rate increase.
Subd. 2.
[Repealed, 2009 c 159 s 112]
Subd. 3.
[Repealed, 2009 c 159 s 112]
Subd. 4.
[Repealed, 1Sp2003 c 14 art 3 s 60]
Subd. 5.
[Repealed, 2009 c 159 s 112]
Subd. 6.
Commissioner's responsibilities.
The commissioner shall:
(1) make a determination to approve, deny, or modify a request for a variable rate adjustment within 30 days of the receipt of the completed application;
(2) notify the ICF/DD facility and county case manager of the determination; and
(3) modify MMIS II service agreements to reimburse ICF/DD facilities for approved variable rates.
Subd. 7.
Rate adjustments; short-term admissions; crisis or specialized medical care.
Beginning July 1, 2003, the commissioner may designate up to 25 beds in ICF/DD facilities statewide for short-term admissions due to crisis care needs or care for medically fragile individuals. The commissioner shall adjust the monthly facility rate to provide payment for vacancies in designated short-term beds by an amount equal to the rate for each recipient residing in a designated bed for up to 15 days per bed per month. The commissioner may designate short-term beds in ICF/DD facilities based on the short-term care needs of a region or county as provided in section 252.28. Nothing in this section shall be construed as limiting payments for short-term admissions of eligible recipients to an ICF/DD that is not designated for short-term admissions for crisis or specialized medical care under this subdivision and does not receive a temporary rate adjustment.
History:
1999 c 245 art 3 s 34; 2000 c 474 s 14-16; 2001 c 203 s 13; 2002 c 220 art 14 s 14-18; 2002 c 374 art 10 s 7; 1Sp2003 c 14 art 3 s 49; 2005 c 56 s 1; 2009 c 159 s 103,104; 2013 c 125 art 1 s 107; 2016 c 158 art 1 s 130; 1Sp2021 c 7 art 13 s 45,46