Changes were made to the statutes regarding Informal Dispute Resolution (IDR) and Independent Informal Dispute Resolution (IIDR) during the 2024 legislative session.

The changes to the statutes bring these processes more in line with federal guidelines regarding these appeal procedures.

What is IDR and IIDR?

IDR and IIDR are the informal opportunities for federally certified facilities to challenge deficiencies issued following a survey. The IDR is an internal review performed by MDH staff. The IIDR is a review by an independent entity following the issuance of a civil money penalty (CMP).

Why were changes made?

Changes to the IDR and IIDR statutes were required to create more cohesion between the Minnesota statutes and the federal regulations and guidelines. Minnesota created its IDR and IIDR statutes prior to the federal regulations going into effect, and when the federal regulations were adopted, they did not match the Minnesota statutes. In performing duties as the state survey agency on behalf of the federal Center for Medicare and Medicaid Services (CMS), MDH is held to performance standards based on federal regulations and guidelines. The state statutes limited MDH’s ability to meet those standards.

The changes ensure a progressive appeals structure where an IDR can be requested upon receipt of deficiencies, and then an IIDR can be requested if the IDR is unsuccessful and the challenged deficiency results in a CMP.

What are the changes?

The impacted statutes are Minnesota Statutes, section 144A.10, subdivisions 15 and 16. Subdivision 15, regarding IDRs, has a minor change. Subdivision 16, regarding IIDRs, went through more significant changes regarding timelines and processes.

IDR Timeline

The statute discussing IDR (Minnesota Statutes, section 144A.10, subdivision 15) had a minor change to accurately reflect the timeline for requesting the IDR. Previously, the statute stated the request for IDR must be made within “30 days of the exit date of the facility’s survey.” The updated language sets the timeline at within “ten calendar days of the facility’s receipt of the notice of deficiencies.” This new language more appropriately ties deadlines to date of notice and mirrors federal guidelines.

IIDR — Scope

The amended IIDR statute (Minnesota Statutes, section 144A.10, subdivision 16) now makes the IIDR process available only when a deficiency has resulted in a CMP being issued.

IIDR — Timelines

The statute places time limits at each stage of the IIDR process in order to facilitate MDH meeting the federal obligation to complete the IIDR process within 60 calendar days of receiving the request. Notable timelines include:

• The facility must submit a request for IIDR within 10 calendar days of receiving notice that a CMP will be imposed.

• MDH must submit a docket request to the Office of Administrative Hearings within five calendar days of receipt of the request for IIDR.

• The proceeding shall occur within 30 calendar days of MDH submitting the docket request.

• The facility and MDH must file and exchange all arguments and materials supporting their position five working days in advance of the proceeding.

• The administrative law judge considering the matter must submit a recommendation within 10 working days.

• MDH must submit its recommendation to CMS within 10 calendar days of the judge’s recommendation.

IIDR — Proceeding

The IIDR proceeding is meant to be an informal opportunity for facilities to challenge deficiencies. Therefore, references to statutes governing formal administrative hearings or the Uniform Arbitration Act were removed. In their place, the following language is used:

“The independent informal dispute resolution proceeding shall be informal and conducted in a manner so as to allow the parties to fully present their positions and respond to the opposing party’s positions. This may include presentation of oral statements and arguments at the proceeding.”

This language better reflects the intention of the federal regulation that the IIDRs be informal opportunities for appeal. Formal administrative hearings are afforded through the federal Departmental Appeals Board upon issuance of a CMP.

When does this take effect?

This language is effective for all deficiencies issued on or after Oct. 3, 2024.

Contact information

If you have any questions, please contact IIDR at Health.HRD.IIDR@state.mn.us