§ 256S.202 — Customized Living Services; Rate Limits
Plain-Language Summary
This section sets rate limits for customized living services, capping how much can be paid per month. The limits vary based on the participant's level of need.
256S.202 CUSTOMIZED LIVING SERVICES; RATE LIMITS.
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Subdivision 1.Customized living monthly service rate limits.
(a) Except for a participant assigned to case mix classification L, as described in section 256S.18, subdivision 1, paragraph (b), the customized living monthly service rate limit shall not exceed 50 percent of the monthly case mix budget cap, adjusted at least annually in the manner described under section 256S.18, subdivisions 5 and 6.
(b) The customized living monthly service rate limit for participants assigned to case mix classification L must be the monthly service rate limit for participants assigned to case mix classification A, reduced by 25 percent. §
Subd. 2.24-hour customized living monthly service rate limits.
(a) The 24-hour customized living monthly service rate limit is the 95th percentile of statewide monthly authorizations for 24-hour customized living services in effect and in the Medicaid management information systems on March 31, 2009, for each case mix resident class under Minnesota Rules, parts 9549.0051 to 9549.0059, to which elderly waiver service participants are assigned, adjusted at least annually in the manner described under section 256S.18, subdivisions 5 and 6.
(b) If there are fewer than 50 authorizations in effect in the case mix resident class, the commissioner shall multiply the calculated 24-hour customized living monthly service rate limit for case mix classification A by the standard weight for that classification under Minnesota Rules, parts 9549.0051 to 9549.0059, to determine the applicable 24-hour customized living monthly service rate limit.
History:
2019 c 54 art 1 s 22; 2023 c 50 art 1 s 33
History: History: 2019 c 54 art 1 s 22; 2023 c 50 art 1 s 33