Probate & Trust Law Section Conference Manual ... - Minnesota CLE

control eligibility for entitlement programs. The States complain about the
lack of “flexibility” in many of these requirements. This is code for the
frustrated desire of the States to cut medical assistance benefits and
eligibility for medical assistance programs.
D. Minnesota operates a number of health care programs authorized and
controlled by federal waivers. 1 These programs are not entitlement
programs. They are funded at levels approved by the Legislature.
Minnesota cannot cut these programs under the terms and conditions of
current waivers, but the State can limit the expansion of these programs to
save money.
E. Since 2009, the strategy to contain future increases in the cost of medical
assistance has been dependent on the possibility that the federal government
will approve several waiver reqests to allow Minnesota to redesign its
medical assistance programs. These waiver requests are designed to
achieve substantial savings in health and human service expenditures. To
balance the State budget for the 2011-2012 biennium, the 2011 Legislature
passed the Omnibus Health and Human Services Finance Act of 2011,
(2011 Omnibus HHS Act) Laws of Minnesota 2011, Ch. 41. In the 2011
Omnibus HHS Act, the Legislature directed the Commissioner of Human
Services to continue requesting waivers from the Center for Medicare and
Medicaid Services (CMS) 2 to allow a complete redesign of all the medical
assistance programs in Minnesota. These waiver requests will be discussed
in more detail below. The projected savings from these waivers would be
possible, of course, only if the State receives the requested waivers in a
timely manner. If the waivers are not received in a timely manner, the
2011 Omnibus HHS provided for cuts in reimbursement rates for health
care providers are scheduled to be implemented. In effect, the health care
providers were being held hostage to reimbursement cuts until CMS
approves the requested waivers. With the change of control of the
Legislature as a result of the November 2012 election, the 2013 Legislature
1 Waivered Home and Community Based Services (HCBS) programs include Elderly Waiver
(EW), Brain Injury (BI), Community Alternatives for Disabled Individuals (CADI),
Community Alternative Care (CAC), the Developmental Disabilities program (DD), and MA
for Employed Persons with Disabilities (MA-EPD). These programs and MA for nursing
home care (LTC-MA) comprise the Minnesota “Health Care Programs.”
2 The Center for Medicare and Medicaid Services (CMS) is the name of the federal agency
formerly known as the Health Care Financing Administration (HCFA). This agency is the
federal agency charged with administration of the federal Medicare and Medicaid programs.
2