Understanding the State Medical Review Team (SMRT) in Minnesota
If you or a loved one needs to access Medicaid Waiver Services in Minnesota, you may be asked to go through the State Medical Review Team (SMRT) process. This blog provides valuable information about what SMRT is, who it applies to, and how you can use this process to access essential support services.
What is SMRT?
The State Medical Review Team (SMRT) is a team of medical professionals at the Minnesota Department of Human Services who make disability determinations for individuals that are not certified disabled through the Social Security Administration.
A SMRT disability certification is part of determining eligibility for Medical Assistance, Medicaid Waiver Services and other programs. These services provide support for individuals with disabilities or chronic health conditions that require assistance with daily activities and long-term care. Medicaid Waiver Services help cover various services, including personal care, therapy, community support and respite care – services that are critical for individuals with disabilities and those who need additional support.
What does SMRT do?
SMRT evaluates individuals to determine whether they meet the functional and medical criteria required to access Medical Waiver Services in Minnesota. They focus on how an individual’s disability or health condition affects their ability to function in everyday life, such as:
- Performing daily activities like eating, dressing or bathing.
- Managing health conditions or medications.
- Participating in community and social activities.
- Living independently or with support.
Who needs to go through the SMRT process?
You may need to go through the SMRT process if you are applying for Medicaid Waiver Services in Minnesota and require an official determination of disability or functional limitations. If you do not have a Social Security Administration (SSA) disability determination, you will need a SMRT disability certification.
You can request a SMRT certification even if you have already applied to the SSA for disability determination. The SSA process can be lengthy, whereas the SMRT process can be completed more quickly.
However, it is important to note that a SMRT disability determination does not make you eligible for SSA benefits.
If you have already received a disability determination from the SSA, you do not need an additional SMRT certification.
How does the SMRT process work?
The SMRT process consists of several steps:
- Referral: To apply for Medical Assistance, submit your application to your county or tribal human services agency. This agency will assess your eligibility for Medical Assistance. If your application indicates that you have a disability, the agency representative is responsible for sending a SMRT request to the Minnesota Department of Human Services (DHS).
- Application: Paperwork is sent to the individual requesting services or their representative. They must complete the paperwork, sign releases, and provide documentation to prove their disability as required by SMRT. This will include medical history, descriptions of limitations, and evidence of the individual's need for ongoing support.
- Medical Review and Eligibility Determination: SMRT will conduct a medical review of all medical and functional documentation provided in the application.
- Notification of Results: You will receive a disability certification letter with SMRT’s decision. If certified disabled, the individual or their representative should follow up with the county or tribal representative. If your application is denied, you have 30 days to appeal the decision.
- Recertification: SMRT disability recertification is required on an ongoing basis. Applicants will follow the process listed above.
The SMRT process does not include physical meetings, so make sure you provide detailed information when filling out the Children’s or Adult Disability worksheet and when gathering documentation to submit.
While you are waiting for the SMRT determination, talk with your county or tribal representative about services you may be eligible for without disability determination.
How do I get a SMRT request started?
Contact your county or tribal health and human service agency. They will provide you with the necessary paperwork and help you understand the process.
Navigating the process of becoming eligible for Medicaid Waiver Services in Minnesota can feel complex, but for individuals who have not been certified disabled through the SSA or are in the process, understanding the SMRT system and its role is a key step in securing the support you or your loved one needs.
Sources:
https://arcminnesota.org/resource/arc-guide-to-state-medical-review-team-smrt/