In 2009, the Minnesota Legislature passed legislation that changes the criteria for those being served in nursing facilities. The effect of this provision was to relocate individuals who did not need that level of care into alternative settings. It meant that there would be fewer people would be eligible for services funded by Medical Assistance, Minnesota’s version of the Medicaid program. In March of 2010, the federal government passed the Patient Protection and Affordable Care Act, the law implementing federal health care reform. That law extended the maintenance of effort requirements for states originally established as part of the federal stimulus law, not allowing them to reduce enrollment or spending in their Medicaid programs below certain levels. The final state budget in 2009 relied on savings in the FY 12-13 biennium from changing the nursing facility care criteria that was no longer allowable under federal law.
To remedy this, the final health and human services budget from the 2011 Special Session directs the Department of Human Services to apply for a federal waiver to allow the state to implement the changes effective July 1, 2012. If federal approval isn’t granted, there would be a 1.67 percent reduction made to long-term care rates to ensure the state budget remains balanced if the waiver is not approved.
The department submitted this waiver application to the federal government on November 28th. You can view the announcement and associated documents here. There will be ongoing discussions between state and federal staff, but department staff has indicated they expect approval. Rates will not change unless approval is not granted or we reach July 1 of 2012 without an answer.
ARRM has been monitoring this issue and participating in a stakeholder group for implementing this policy. We will continue to update members as new developments as they occur. As always, if you have any questions, contact Craig Wieber at cwieber@arrm.org or 651-291-1086, extension 9.
--Craig Wieber, Chief Fiscal Analyst