Subdivision 1. Elderly waiver plan eligibility requirements. In addition to the requirements of this section, applicants and participants must meet all eligibility requirements in the elderly waiver plan.
Subd. 2. Nursing facility level of care determination required. Notwithstanding other assessments identified in section 144.0724, subdivision 4, only assessments conducted according to section 256B.0911 that result in a nursing facility level of care determination at initial and subsequent assessments shall be accepted for purposes of a participant's initial and ongoing participation in the elderly waiver and a service provider's access to service payments under this chapter.
Subd. 3. Maintenance needs allowance. Notwithstanding section 256B.056, when applying posteligibility treatment of income rules to the gross income of an elderly waiver participant, unless the participant's income is in excess of the special income standard according to Code of Federal Regulations, title 42, section 435.236, the participant's maintenance needs allowance is the sum of the MSA equivalent rate, as defined in section 256I.03, subdivision 5, plus the medical assistance personal needs allowance, as described in section 256B.35, subdivision 1, paragraph (a). Each participant's maintenance needs allowance must be adjusted each July 1.
Subd. 4. Spousal impoverishment policies. For the purposes of eligibility for elderly waiver services, the commissioner shall apply the spousal impoverishment criteria as authorized under United States Code, title 42, section 1396r-5, and as implemented in sections 256B.0575, 256B.058, and 256B.059, except that a participant with income at or below the special income standard according to Code of Federal Regulations, title 42, section 435.236, shall receive the maintenance needs allowance in subdivision 3.
Subd. 5. Managed care elderly waiver services. A participant who is enrolled in a managed care organization is not eligible to receive county-administered fee-for-service elderly waiver services.
2019 c 54 art 1 s 5; 1Sp2021 c 7 art 6 s 25; 2022 c 98 art 17 s 22
Structure Minnesota Statutes
Chapters 245 - 267 — Public Welfare And Related Activities
Chapter 256S — Medical Assistance Elderly Waiver
Section 256S.02 — Definitions.
Section 256S.03 — Administration By Tribes.
Section 256S.04 — Limits Of Elderly Waiver Cases.
Section 256S.05 — Eligibility.
Section 256S.06 — Assessments And Reassessments.
Section 256S.07 — Case Management Administration.
Section 256S.08 — Case Management Provider Qualifications And Standards.
Section 256S.09 — Case Management Activities.
Section 256S.10 — Support Plans.
Section 256S.11 — Approval Required For Certain State Plan Home Care Services.
Section 256S.12 — Adult Day Services.
Section 256S.13 — Individual Community Living Supports.
Section 256S.14 — Termination Of Elderly Waiver Services.
Section 256S.15 — Establishment Of Elderly Waiver Service Rates And Service Rate Limits.
Section 256S.16 — Authorization Of Elderly Waiver Services And Service Rates.
Section 256S.17 — Costs Excluded From Elderly Waiver Service Rates.
Section 256S.18 — Monthly Case Mix Budget Caps; Generally.
Section 256S.19 — Monthly Case Mix Budget Caps; Nursing Facility Residents.
Section 256S.20 — Customized Living Services; Policy.
Section 256S.201 — Customized Living Services; Rates.
Section 256S.202 — Customized Living Services; Rate Limits.
Section 256S.203 — Customized Living Services; Managed Care Rates.
Section 256S.204 — Alternative Rate System For 24-hour Customized Living Services.
Section 256S.205 — Customized Living Services; Disproportionate Share Rate Adjustments.
Section 256S.21 — Rate Setting; Application.
Section 256S.2101 — Rate Setting; Phase-in.
Section 256S.211 — Rate Setting; Rate Establishment.
Section 256S.212 — Rate Setting; Base Wage Index.
Section 256S.213 — Rate Setting; Factors.