ARRM learned late last week that CMS has officially denied Minnesota’s legislative mandated request for a 7th year of banding within the Disability Waiver Rate System.
With this announcement, banding will officially end at the close of 2019. Individuals who currently have banded rates will see banding come off their rate on a rolling basis through 2020 as their service authorizations are renewed.
Below, please find the official announcement from DHS. If you have any questions, please feel free to contact Sara Grafstrom at sgrafstrom@arrm.org or Ken Bence at Kbence@arrm.org.
With the end of banding confirmed, this raises the importance of completing the "pre-exception" rate exception process for individuals with banded rates (more from the latest Friday's With DHS webinar here) ARRM will send out more information to members outlining additional educational offerings and training throughout the year to continue to prepare members for the end of banding.
Banding end-date decision by the Centers for Medicare & Medicaid Services
On Jan. 23, 2019, the federal Centers for Medicare & Medicaid Services (CMS) notified DHS it was unable to approve the waiver amendment to add a seventh year of banding in 2020.
Background
Implementation of the Disability Waiver Rate System included a rate-stabilization period, also referred to as “banding,” in which the amount rates could change were tied to historical rates for people and providers who had services in 2013.
The 2017 Minnesota Legislature approved a seventh year of banding (through Dec. 31, 2020) contingent on federal approval from CMS. DHS submitted a waiver amendment to update the rate stabilization (banding) schedule by adding an additional year of banding per the 2017 legislative requirements.
What does this mean?
For DWRS framework services with a start date of Jan. 1, 2020, or later, rates will not be banded to an individual or weighed average historic rate. All rates will be at the Rate Management System framework rate for the service. This change will occur on a rolling basis as service authorizations either renew or change.
How does this affect lead agencies and providers?
DHS will include the changes in the Rate Management System within the MnCHOICES Support Plan application. Also, as previously communicated by DHS, lead agencies, service providers, service recipients and DHS will begin to identify people with banded service rates who may receive rate exceptions. See guidance and additional information at https://mn.gov/dhs/partners-and-providers/news-initiatives-reports-workgroups/long-term-services-and-supports/disability-waiver-rates-system/