How to Become a Medicaid Waiver Provider in Minnesota

Minnesota is closed, and it is closed on purpose, with a stated end date. DHS implemented a temporary 245D licensing moratorium effective January 1, 2026 with an anticipated duration of 24 months, ending December 31, 2027. Under it, DHS stops issuing new 245D licenses, stops accepting new applications, stops adding new service lines to currently licensed providers, and cancelled the applications already in the queue. The reason is capacity, not fraud on your part: between the two five-year periods ending in state fiscal 2019 and 2024, the average annual number of HCBS waiver participants grew 24.7 percent, while active 245D licenses rose 55.3 percent and new applications grew 283.3 percent. As of mid-November 2025 there were 2,549 active licenses against 2,314 pending applications — issuing them all would nearly double licensed capacity beyond what the waiver population needs. There is one route in during the moratorium: an exception requested by a lead agency — a county, Tribe, or managed care organization responsible for waiver case management. If your application was cancelled, apply for a refund of the $500 fee; refunds are available until December 31, 2026.

During the moratorium there is no open application path. A lead agency must request an exception; if one is granted, the standard 245D application and review process applies, followed by MHCP enrollment.

Application system: DHS — Licensing for Home and Community-Based Services (245D)

1. Check the moratorium status before doing anything else

   The moratorium took effect January 1, 2026 with an anticipated end of December 31, 2027. DHS said it would publish the criteria and process for exceptions before the moratorium began.

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2. If your application was cancelled, request your fee back

   DHS began issuing refunds of application fees for cancelled applications, available through December 31, 2026.

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3. Ask a lead agency whether an exception fits your situation

   Exceptions are requested by counties, Tribes, and managed care organizations responsible for waiver case management — the entities that can document an unmet service need.

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4. If an exception is granted, run the standard 245D application

   An exception does not lower the bar. The application follows the standard review process and must meet all licensing requirements.

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5. Enroll with Minnesota Health Care Programs

   Licensure and Medicaid enrollment are separate. MHCP enrollment covers the services you provide, for each location that provides services and receives reimbursement.

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Minnesota does not publish these in a form we could verify, so we have not guessed at them. Ask directly — and if an answer here would help other providers, tell us and we will add it with its source.

• What are the published criteria for a lead-agency exception, and how does a county, Tribe, or MCO submit one?

  Ask: DHS 245D License Help Desk, dhs.245dlicensehelpdesk@state.mn.us

• Has DHS changed the anticipated end date of December 31, 2027, or announced the post-moratorium application process?

  Ask: DHS 245D License Help Desk, dhs.245dlicensehelpdesk@state.mn.us

• What will the 245D application require when it reopens — pre-application worksheet, interview, policies, training, background studies — and will the $500 fee change?

  Ask: DHS 245D License Help Desk, dhs.245dlicensehelpdesk@state.mn.us

• What does MHCP enrollment require for a newly licensed 245D provider, and how long does it take?

  Ask: Minnesota Health Care Programs provider enrollment