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Federal waivers allow states to test new ways to deliver and pay for health care services. Changes to the state’s Medicaid and Children’s Health Insurance Program often require waivers approved by the federal Centers for Medicare & Medicaid Services (CMS) to continue receiving federal Medicaid funding. The following are waivers that the Minnesota Department of Human Services (DHS) has applied for or received.
On Feb. 11, 2016, CMS approved Minnesota’s request to renew the PMAP+ waiver through Dec. 31, 2020.
The Department of Human Services holds an annual forum to provide the public with an opportunity to comment on the progress of the PMAP+ waiver. The next public forum will be held:
Date: Aug. 3, 2017
Time: 1-2 p.m.
Location: Department of Human Services, Elmer L. Andersen Human Services Building
540 Cedar St.,
St Paul, MN 55164, Room 2222
You may attend the forum by phone or in person; please email Section1115WaiverComments@state.mn.us for the call-in information.
The PMAP+ waiver special terms and conditions require the state to provide updates to CMS on the program’s implementation. We submit reports quarterly and annually. Reports from prior demonstration years have been archived and can be made available by request via dhs.waiver.comments@state.mn.us.
The MFPP was implemented beginning July 1, 2006, as a federal waiver demonstration project approved by CMS. The MFPP waiver gave Minnesota the authority to receive federal matching funds for family planning services delivered to men and women, ages 15 to 50, who have family incomes at or below 200 percent of the federal poverty level and who are not enrolled in Medical Assistance or MinnesotaCare. The 2014 Minnesota Legislature directed DHS to seek federal authority to operate the MFPP under the Medicaid state plan. Effective Jan. 1, 2017, the program was converted to state plan authority under the Family Planning State Plan Option.
Under the Family Planning State Plan Option, the following MFPP benefits and other criteria will remain unchanged:
Please see Bulletin #16-21-13 (PDF) for more information regarding changes to certain eligibility rules for the MFPP under the Family Planning State Plan Option.
The MFPP waiver special terms and conditions require the state to provide updates on the program’s implementation to CMS. Reports are submitted on a quarterly and annual basis. Reports from prior demonstration years have been archived and can be made available by request via dhs.waiver.comments@state.mn.us.
In October 2013, CMS approved Minnesota’s Reform 2020 section 1115 demonstration project through June 30, 2018.
The five-year demonstration provides federal support for the Alternative Care program, which provides supports to help seniors at risk of nursing home placement to stay in their homes. The Reform 2020 demonstration waiver will also provide access to expanded self-directed options under the Community First Services and Supports (CFSS) program for people who would not otherwise be eligible for these services. Implementation of this part of the demonstration is contingent upon federal approval of additional state plan and waiver authority.
The following documents provide additional information:
On July 10, 2017, DHS submitted a request to CMS to renew the Reform 2020 Section 1115 waiver. The current waiver expires June 30, 2018. The renewal request seeks to continue the current waiver for another three-year period, through June 30, 2021.
Reform 2020 Renewal Application (PDF)
A 30-day public comment period from May 22, 2017, to June 21, 2017, was held by DHS to provide the public the opportunity to weigh in on the proposed waiver renewal.
CMS will hold a federal comment period soon. At that time, you may submit comments directly to CMS.
Minnesota’s Comprehensive Quality Strategy is an overarching and dynamic continuous quality improvement strategy integrating processes across Minnesota’s Medicaid program. Measures and processes related to the programs affected by the Reform 2020 waiver were included in the Comprehensive Quality Strategy.
An initial draft of Minnesota’s Comprehensive Quality Strategy DHS-3832 (PDF) was submitted to CMS in February 2015. DHS is currently updating the strategy in an effort to further streamline quality measurement across all Medicaid populations served under Minnesota’s managed care and fee-for-service delivery systems.
The Reform 2020 waiver special terms and conditions require the state to provide updates on the program’s implementation to CMS. Reports are submitted on a quarterly and annual basis. Reports from prior demonstration years have been archived and can be made available by request via dhs.waiver.comments@state.mn.us.
A 30-day comment period on the revised Indian Health Board of Minneapolis (IHB), section 1115 Medicaid waiver application, began on April 17. The IHB waiver application was initially submitted to the Centers for Medicare & Medicaid Services (CMS) on Jan. 13, 2017. Key changes can be found on page 5 of the application, which has been revised to include information on the research hypothesis and evaluation parameters related to the demonstration’s proposed goals. DHS plans to submit the revised request in May of 2017.
Comments received will be posted on the DHS website. To ask for a paper copy of the waiver request, please contact Elizabeth Bonnell at 651-431-2836. Written comments may be submitted to dhs.waiver.comments@state.mn.us or by mail to the address below. DHS would like to provide copies of comments received in a format that is accessible for people with disabilities. Therefore, we request comments be submitted in Microsoft Word documents or incorporated within the email text. If you would like to provide a signed copy of the comment letter, you may submit a second copy in Adobe PDF format or mail it to the address below. Comments must be received by May 16, 2017.
Revised IHB Waiver Application (PDF)
Attachment D: Evaluation Plan (PDF)
Marie Zimmerman
Medicaid Director
Minnesota Department of Human Services
P.O. Box 64983
St. Paul, Minnesota 55164-0983
CMS will hold a federal comment period following DHS’ submission of the IHB waiver request. At that time you may submit comments directly to CMS by going to http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/Waivers.html and entering Minnesota in the search box.
The 2016 Minnesota State Legislature directed DHS to seek federal waiver authority to allow tribal organizations to receive the Indian Health Services encounter rate for Medicaid services provided to American Indian and Alaskan Native populations. Only organizations that are dually certified as Urban Indian Health Programs and Federally Qualified Health organizations qualify. The Legislature also asked DHS to seek authority for the state to be eligible for 100 percent federal financial participation for such services. (See Minn. Stat. § 256B.0625, specifically subdivisions 30 and 34.)
On Jan. 13, 2017 DHS submitted the Indian Health Board of Minneapolis Section 1115 waiver request to the Centers for Medicare & Medicaid Services (CMS). Currently, the Indian Health Board of Minneapolis (IHB) is the only entity eligible under this waiver authority, should it be granted by CMS. As a demonstration project under section 1115 of the Social Security Act, DHS plans to test new ways to help urban American Indians served by the IHB to access quality health care. This approach includes the use of an abbreviated application process for American Indians eligible for Medicaid and targeting additional funding for the IHB into enhanced care coordination and application assistance for this population.
The 2013 Minnesota Legislature required the Commissioner of Human Services to seek authority from CMS to allow Minnesota to continue existing eligibility policy for people receiving services under the Brain Injury (BI) waiver, Community Alternative Care (CAC) waiver, Community Alternatives for Disabled Individuals (CADI) waiver and Developmental Disabilities (DD) waiver. This would allow Minnesota to continue the current practice of disregarding the income and assets of community spouses instead of implementing the anti-spousal impoverishment provisions under the ACA. On June 30, 2014, DHS submitted a Section 1115 Medicaid waiver request to CMS to retain the current home and community-based waiver eligibility criteria allowing spousal income and asset disregards.
On Dec. 15, 2015, the DHS Disability Services Division issued a notice updating the public on changes in financial eligibility rules impacting married applicants and married people enrolled in the CADI, CAC, BI and DD waiver programs. See the agreement with CMS regarding spousal impoverishment notice.
The MSC+ waiver allows Minnesota to require seniors to enroll in managed care to receive Medicaid services. This includes people who are dually eligible for both Medicaid and Medicare and who have not opted to enroll in Minnesota Senior Health Options (MSHO). The waiver operates in combination with Minnesota’s existing Elderly Waiver to enable the integration of community-based long-term care services into the managed care service delivery system.
The CCDTF waiver allows recipients to be directed to a provider designated by the locality. The restriction on the recipient’s choice of provider helps direct recipients to the most appropriate and cost-effective providers based on their assessed needs.
CCDTF waiver renewal request and CMS approval letter (PDF)
The Case Management waiver allows Minnesota to continue to limit case management providers for the home and community-based waivers to counties and tribes under contract with DHS or their subcontractors. The waiver applies only to enrollees whose waiver services are covered fee-for-service and who receive services under one of the following Section 1915(c) home and community-based waiver programs:
The current Case Management waiver expires March 31, 2017.
Case Management waiver renewal request (PDF)
The CFSS Consultation and Financial Management Services waiver allows the state to selectively contract with financial management services contractors and consultation services providers to be used by recipients of the reformed PCA benefit under the CFSS program.
This is a free email subscription service that allows you to receive one-way email notification when new information is available about Medicaid waivers, such as the Reform 2020 waiver, the Prepaid Medical Assistance Plus (PMAP+) waiver, the Minnesota Senior Care Plus waiver and new waiver applications. Subscribers will receive emails when DHS is seeking public comment on items that will be submitted for federal approval, when requests for federal authority are submitted to the federal government, and when waiver requests have been approved or denied.
Information on Minnesota's federal Medicaid waivers also is available on the CMS website at https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/waivers_faceted.html (enter Minnesota in the search box).
