Proposed Rules
The following are summaries and other information related to Proposed Rules that the Department of Social Services has submitted to the Secretary of State for Publication in the Missouri Register. These rules will not go into effect until the public has had an opportunity to submit written comments, and to attend a public hearing if one is scheduled.
Any person may offer comments on a Proposed Rule. The instructions for submitting comments, and the location and date of a hearing if one is scheduled, are located after the text of each rule. And, you may email comments on a Proposed Rule to Rules.Comment@DSS.mo.gov. Please note that the official text of a Proposed Rule is the version that appears in the Missouri Register, not the draft copy on this site. Refer to the official copy if you wish to submit comments.
We hope you find this site helpful and informative.
| Proposed Rule | Summary | Fiscal Note |
Link to Missouri Register | Date Posted |
|---|---|---|---|---|
| 13 CSR 70-10.020 | PURPOSE: Effective for dates of service beginning July 1, 2025, this amendment amends the cost report total Case Mix Index (CMI), clarifies the MDS Review process and the resulting rate and payment adjustments, provides for replacement facilities to be designated as new or existing consistent with the criteria used for other new or existing nursing facilities, updates the value-based purchasing (VBP) quality measures and the corresponding per diem adjustments, clarifies the base rate for new facilities having their initial prospective rate set, and provides for the multiple component incentive to be recalculated with the semi-annual and annual rate updates. These revisions correspond to the state fiscal year (SFY) 2026 appropriation for nursing facilities and are contingent upon approval by the Centers for Medicare & Medicaid Services (CMS). | Yes | Missouri Register – January 2, 2026 Volume 51, Number 1 (23-30) Missouri Register |
1/2/2026 |
| 13 CSR 70-10.040 | This amendment updates the requirements around the screening and evaluation process for Medicaid participants to a nursing facility and adds the incorporation by reference language in paragraph (9). | No | Missouri Register – December 15, 2025 Volume 50, Number 24 (1841-1844) Missouri Register |
12/15/2025 |