HF4355

Purpose

This bill changes how the state pays for certain substance use disorder (SUD) treatment services. It sets specific base payment rates for different types of residential and support services and updates how much providers will be reimbursed starting in 2026 and 2027.

Main Provisions

• Amends Minnesota Statutes 254B.0509 subdivision 1 to define base payment rates for SUD treatment services.
• Effective January 1, 2026:
  • Low-intensity residential services: base rate set at 100% of the modeled rate from the final report required by Laws 2021 First Special Session chapter 7 article 17 section 18.
  • High-intensity residential services: base rate set at 83% of the modeled rate from the same final report.
  • Treatment coordination services: base rate set at 100% of the modeled rate from the final report.
• Effective January 1, 2027:
  • For high-intensity residential services provided by adolescent treatment programs (as described in section 254B.0505 subdivision 1 clause 9), the base rate will be equal to 130% of the base rate for high-intensity services described above (i.e., 130% of the adult high-intensity base rate), after any adjustments made under subdivision 2.
• The rates are tied to the modeled rates in the specified 2021 final report and apply to services under section 254B.0505 subdivision 1.

Effective Dates and Scope

• January 1, 2026: Implement 100% of modeled rate for low-intensity residential, 83% of modeled rate for high-intensity residential, and 100% of modeled rate for treatment coordination.
• January 1, 2027: For adolescent high-intensity residential services (clause 9), set at 130% of the base high-intensity rate, subject to adjustments under subdivision 2.

Significance and Changes to Law

• Creates a defined, rate-based payment framework for three service categories (low-intensity residential, high-intensity residential, and treatment coordination) using rates derived from a prior modeling study.
• Establishes a higher pay level for adolescent high-intensity residential services starting in 2027, improving reimbursement relative to the adult high-intensity base rate.
• Part of a broader update to how Minnesota reimburses SUD treatment services under the referenced statutes and reports.

Notes

• The changes rely on the modeled rates from the final report required by Laws 2021 First Special Session chapter 7 article 17 section 18.
• The 2027 adolescent rate is contingent on adjustments described in subdivision 2.

Relevant Terms - base payment rates - low-intensity residential services - high-intensity residential services - treatment coordination services - modeled rate - final report (Laws 2021 First Special Session chapter 7 article 17 section 18) - adolescent treatment programs - section 254B.0505 subdivision 1 - clause 9 - January 1, 2026 - January 1, 2027 - subdivision 2 - 83 percent - 100 percent - 130 percent