144.0723 Client reimbursement classifications; 
  procedures for reconsideration. 

    Subdivision 1.    Client classifications.  The 
 commissioner of health shall establish classifications based 
 upon the assessment of each client in intermediate care 
 facilities for the mentally retarded conducted after December 
 31, 1992, under section 256B.501, subdivision 3g.  The 
 classifications established by the commissioner must conform to 
 section 256B.501, subdivision 3g, and subsequent rules 
 established by the commissioner of human services to set payment 
 rates for intermediate care facilities for the mentally retarded.

    Subd. 2.    Notice of client classification.  The 
 commissioner of health shall notify each intermediate care 
 facility for the mentally retarded of the classifications 
 established under subdivision 1 for each client residing in the 
 facility.  The notice must inform the intermediate care facility 
 for the mentally retarded of the classifications that are 
 assigned and the opportunity to request a reconsideration of any 
 classifications assigned.  The notice of classification must be 
 sent by first-class mail.  

    Subd. 3.    Request for reconsideration.  The 
 intermediate care facility for the mentally retarded may request 
 that the commissioner reconsider the assigned classification.  
 The request for reconsideration must be submitted in writing to 
 the commissioner within 30 days after the receipt of the notice 
 of client classification.  The request for reconsideration must 
 include the name of the client, the name and address of the 
 facility in which the client resides, the reasons for the 
 reconsideration, the requested classification changes, and 
 documentation supporting the requested classification.  The 
 documentation accompanying the reconsideration request is 
 limited to documentation establishing that the needs of the 
 client and services provided to the client at the time of the 
 assessment resulting in the disputed classification justify a 
 change of classification. 

    Subd. 4.    Access to information.  Annually, at the 
 interdisciplinary team meeting, the intermediate care facility 
 for the mentally retarded shall inform the client or the 
 client's representative and case manager of the client's most 
 recent classification as determined by the department of 
 health.  Upon written request, the intermediate care facility 
 for the mentally retarded must give the client's case manager, 
 the client, or the client's representative a copy of the 
 assessment form and the other documentation that was given to 
 the department to support the assessment findings.  

    Subd. 5. Repealed, 1995 c 207 art 7 s 43 

    Subd. 6.    Reconsideration.  The commissioner's 
 reconsideration must be made by individuals not involved in 
 reviewing the assessment that established the disputed 
 classification.  The reconsideration must be based upon the 
 initial assessment and upon the information provided to the 
 commissioner under subdivision 3.  Within 15 working days after 
 receiving the request for reconsideration, the commissioner 
 shall affirm or modify the original client classification.  The 
 original classification must be modified if the commissioner 
 determines that the assessment resulting in the classification 
 did not accurately reflect the status of the client at the time 
 of the assessment.  The intermediate care facility for the 
 mentally retarded shall be notified within five working days 
 after the decision is made.  The commissioner's decision under 
 this subdivision is the final administrative decision of the 
 agency. 

    Subd. 7.    Audit authority.  The department of health 
 may audit assessments of clients in intermediate care facilities 
 for the mentally retarded.  The audits may be conducted at the 
 facility, and the department may conduct the audits on an 
 unannounced basis. 

    Subd. 8.    Rulemaking.  The commissioner of health 
 shall adopt rules necessary to implement these provisions. 

    HIST: 1989 c 282 art 3 s 3; 1995 c 207 art 7 s 1-5