The 2027 legislative session adjourned sine die at midnight last night, bringing to a close what has been a very challenging biennium.
In addition to the more than $1 billion in cuts to Human Services enacted last session, the committee was tasked this year with identifying an additional $300 million in savings across the current and upcoming biennia.
Over the past several days, the Human Services conference committee met to craft its final bill, although no public hearing was held. The final language was released to the public around 10 p.m. last night, with final passage occurring on the House and Senate floors approximately one hour later.
ARRM will be working over the next few days to prepare a comprehensive summary of the changes included in the final package. Below are highlights of several provisions we have been tracking closely:
- Prepayment Review: Beginning April 1, 2027, the commissioner must conduct enhanced prepayment review of at least 65 percent of all fee-for-service claims.
- Surety Bonds: The commissioner must require a provider to purchase a surety bond as a condition of initial enrollment, reenrollment, revalidation, reinstatement, or continued enrollment.
- Upon new enrollment, or if the provider's Medical Assistance revenue is less than $300,000 in the previous calendar year, the provider must purchase a surety bond of $50,000.
- If the provider’s Medical Assistance revenue is greater than $300,000 in the previous calendar year, the provider must purchase a surety bond of $100,000.
- Electronic Visit Verification: Electronic Visit Verification will now be required for additional services, including ICS and any service reimbursed at an hourly or minute increment.
- Billing Limits: Multiple service billing caps were included in the bill, including one-to-one staffing caps for Community Residential Settings. The new acuity-based caps will be effective July 1, 2027, and an exception process will be established.
- IHST Service Cap Changes: ARRM’s proposal to establish a monthly billing cap of 182.5 hours for IHST and to remove the three-hour consecutive limit for IHST and IHS with Family Training was included in the final proposal. The new limits will be effective January 1, 2027, or upon federal approval.
- Interpretive Guidance Requirements: ARRM’s proposal to require the commissioner to publish guidance within 120 days of federal approval of any statutory changes or waiver plan amendments was included in the final bill with a later effective date of July 1, 2028.
- ICS Service Changes: ICS will be divided into 2 services effective 10/1/27. ICS access services will be a residential service with a fixed base of 8 hours of shared service, much like the current service. The new hours limits based on case mix for residential services will apply. ICS unit-based services will be under the UBS with programming (intensive) service bucket as a 15-minute unit with hours limits based on case mix. There are some differences in the component value rates compared to other UBS. The service definition defines it as incidental, unplanned support and specifies that staff can be on-site or on-call with a 30-minute max response time. Staff can only be assigned to 1 setting, and there are documentation requirements.
- Family Residential Service Rate Changes: Despite strong support from many legislators, changes to the Family Residential Service rate tiers were not included in the final bill language.
Please reach out with any specific questions, and watch for our full analysis coming out in the next few days.
--Sara Grafstrom, Senior Director of State and Federal Policy