MHCP Provider News

September 19, 2016


  • PERM audit: The Minnesota Department of Human Services Program Compliance and Audits section thanks you for your participation and cooperation in the PERM audit for federal fiscal year 2015, October 1, 2014, through September 30, 2015. Your accuracy collecting the specific documents the PERM review contractor A+ Government Solutions requested, and promptly submitting them to support that the sampled claim was filed for the correct service on the correct date of service, helped make the 2015 PERM review’s medical record claim error review component proceed efficiently and effectively. Refer to Payment Error Rate Measurement (PERM) on the Centers for Medicare & Medicaid Services (CMS) website for more information. If you have questions or comments about the audit, contact our medical record reviewer Eileen Dejdar at 651-431-3994 or eileen.dejdar@state.mn.us or Laurie Grussing at 651-431-3959 or laurie.grussing@state.mn.us weekdays 6:30 a.m.–4:00 p.m.
  • First Annual School Mental Health Conference: Registration is open for the 2016 Minnesota School Mental Health Conference. The conference dates are November 2 through November 4, 2016. Refer to the announcement for more information and a link to the registration page.
  • Self-directed services training: The Department of Human Services (DHS) is seeking your input about training for workers in self-directed support services. Refer to a request for information (RFI) in the August 8, 2016, edition of the Minnesota State Register, page 141 (PDF) and the announcement RFI about in-person training for paid caregiving and independent living for more information.
  • Proposed rule repeal: The Department of Human Services (DHS) is proposing the repeal of a small part of its Surveillance and Integrity Review Section (SIRS) program rules about publishing notice in a general circulation newspaper. Read more information on the web page. Submit written or oral comments on possible repeal of this rule until 4:30 p.m. on October 21, 2016, by emailing vanessa.vogl@state.mn.us, by mailing to Vanessa Vogl, Rulemaking Attorney at the Minnesota Department of Human Services, PO Box 64254, Saint Paul, MN 55164-0254, or by calling 651-431-3168. TTY users may call the Department of Human Services at 800-627-3529.
  • • See grants and requests for proposal (RFPs) for current grants available or RFPs in which you may be interested.
  • Review recent Provider Updates

    Training and VideoPresence Opportunities

    Refer to the Provider Training page for information about new and ongoing training or to the list below for details on additional training sessions on special topics.


    MN–ITS

    Announcements and availability: Watch the 5010/D.0 Announcements page for information about MN–ITS functionality, technical information, scheduled downtimes and other notifications.

    Electronic Health Records (EHR)

    The Minnesota Department of Health (MDH) by legislative mandate* seeks input from the public, including health care providers, on both patient impact and costs associated with requirements** related to patient consent for release of health records for the purposes of treatment, payment and health care operations. MDH encourages individuals, health care providers, payers and related organizations to respond.

    The complete request for information (RFI) and instructions for responding are available here:
    http://www.health.state.mn.us/e-health/privacy/
    . Responses are due October 17, 2016.

    MDH will summarize the findings from this RFI in a report to the Minnesota Legislature due in February 2017. The findings may be used for planning, policy development and decision making. They may also inform additional studies on health information exchange and future work on e-health topics related to health information privacy, security and consent.

    * See Minnesota Session Laws 2016, Regular Session, Chapter 189, Article 20, Section 5.

    ** See Minnesota Statutes, section 144.293, subdivision 2.

    Refer to the Minnesota Electronic Health Records Incentive Program (MEIP) web pages for complete information about EHR.

    Chemical Health

    High intensity treatment services rate increase: The 2015 Minnesota Legislature authorized a new rate of payment for high intensity treatment services effective for dates of service on and after October 1, 2015. The new high intensity residential treatment rate is $150 over the base rate. This enhanced rate will be added as a separate line on the service agreement. Contact the placing authority for any questions you have about service agreement adjustments. Effective immediately, bill the additional rate enhancement using procedure code H2036 and modifier HK on a separate line from lines billed with H2036 and any other modifier. Billing modifier HK on the treatment line with other rate enhancement modifiers will result in incorrect claim processing. Refer to e-Memo #15-51, Committed and Complex Level of Care, for coverage information.

    County and Tribal Human Services

    DHS created a person-centered practices web page as a resource for person-centered, informed choice and transition planning. The new page offers the following:

  • • Policy guidance
  • • Answers to frequently asked questions
  • • Tools and instructions 
  • • Links to resources and training

  • We urge lead agencies to use the resources on this page as they build their person-centered practices.

    Federally Qualified Health Centers

    Supplemental payment settlement deadline: The deadline for federally qualified health centers (FQHC) and rural health clinics (RHC) supplemental payment settlement is December 31, 2016. Submit your detailed requests and supporting claims data immediately for all dates of service through December 31, 2014. We must have your detailed request and supporting claims data by the deadline or we will consider all supplemental payments settled. (Minnesota Session Laws 2014, Chap 312, Art. 24, Sec. 35(i))

    For questions about the deadline and submitting information, please contact: Jo Ann Sharkshnas, 651-431-2537, joann.sharkshnas@state.mn.us and Patricia Kimmes, 651-431-2539, patricia.kimmes@state.mn.us.

    Group Residential Housing Supplemental Services

    MHCP enrollment: Most providers of group residential housing (GRH) need to enroll as an MHCP provider to receive supplemental services payments from MHCP. GRH supplemental service rate payments are any payments MHCP makes to GRH providers in excess of the maximum room and board rate of $891.

    If you are a GRH provider and you are not sure if this change applies to you, here is how you can tell: Add the amount that a resident pays you each month for room and board to the amount you receive from the state for GRH for that resident. If those two amounts together are $891 or less, then you are only receiving GRH base-rate room and board payments. If you are only receiving GRH base-rate room and board payments for all GRH residents in your setting, you are not receiving GRH supplemental service rate payments and do not need to enroll.

    If your total GRH payment is more than $891 per month for one or more of your residents, you need to enroll with MHCP to continue receiving supplemental service payments. Beginning January 1, 2017, you will bill GRH supplemental services through MHCP.

    MHCP Provider Enrollment must receive all paperwork for your enrollment by October 31, 2016, to ensure we can process your enrollment by the December 31, 2016, deadline.

    Before you enroll, you must watch the recorded webinar. A link to the webinar is on the GRH Supplemental Services training web page. After watching the recorded webinar, complete the Group Residential Housing (GRH) Supplemental Services – Provider Enrollment Application (DHS-5924) (PDF) and fax all required forms to MHCP Provider Enrollment. If you have any questions about GRH supplemental services, call the MHCP Provider Call Center at 651-431-2700 or 800-627-3529.

    Enrollment Assistance: MHCP is offering in-person or online help to GRH supplemental services providers to meet the December 31, 2016, enrollment deadline. If you need help completing your enrollment application, we invite you to attend a provider enrollment assistance session. Check the web page for available sessions and registration information.

    Hearing Aid Providers

    The 2016 Hearing Aid Volume Purchase Contract, effective September 1, 2016, is now available online. The 2015 contract expired August 31, 2016. Providers have a 30-day grace period for dispensing instruments purchased, but not delivered before the contract expired. You must dispense hearing aids obtained under the 2015 contract before the end of the grace period, by September 30, 2016. This includes hearing aids with approved authorizations.

    Medical Supply

    Enteral nutrition: DHS previously instructed providers about the reprocessing of enteral nutrition (HCPCS codes B4149 through B4155) claims. Please disregard those instructions. We will issue updated claims replacement and reprocessing information soon.

    Rate changes for durable medical equipment, prosthetics, orthotics and supplies (DMEPOS): Effective for dates of service on or after July 1, 2015, we will apply increases to the following categories:

  • • 9.5 percent increase to durable medical equipment codes that were subject to the competitive bidding Medicare rate reduction in 2009
  • • 2.94 percent increase to all DMEPOS
  • By-report codes do not receive the 9.5 percent or 2.94 percent increases. We will implement these rate increases on October 12, 2016.

    For DMEPOS provided on or after January 1, 2016, the MHCP fee schedule base rate will reflect the 2016 Medicare rates for non-competitive bidding codes. We will update the fee schedule in mid-October

    Pharmacy

    Follow-up To Previous Request for Information (RFI): DHS has received useful input in response to Request for Information, Changes to Outpatient Pharmacy Reimbursement Methodology. We are now scheduling three webinar meetings for additional input on specific topics from stakeholders, including enrolled health care providers, managed care organizations, trade groups, experts in pharmacy reimbursement policy, and members of the public potentially affected or otherwise concerned with pharmacy reimbursement policy. We invite any member of the public to participate in the webinars. See Changes to Outpatient Pharmacy Reimbursement for Ingredients and Dispensing for information about the webinars.

    Rural Health Centers

    Supplemental payment settlement deadline: The deadline for federally qualified health centers (FQHC) and rural health clinics (RHC) supplemental payment settlement is December 31, 2016. Submit your detailed requests and supporting claims data immediately for all dates of service through December 31, 2014. We must have your detailed request and supporting claims data by the deadline or we will consider all supplemental payments settled. (Minnesota Session Laws 2014, Chap 312, Art. 24, Sec. 35(i))

    For questions about the deadline and submitting information, please contact: Jo Ann Sharkshnas, 651-431-2537, joann.sharkshnas@state.mn.us and Patricia Kimmes, 651-431-2539, patricia.kimmes@state.mn.us.

    Vision

    Online eyeglass orders: Effective September 1, 2016, Classic Optical has a new online system for eyeglass orders. You may submit orders through the new system at https://www.classicoptical.com or continue to submit orders by fax or mail. For help with placing orders, call Classic Optical at 888-522-2020 between 7 a.m. and 7 p.m. CST.

    Waiver and Alternative Care (AC) Programs

    Service authorization issue with waiver transportation code: As of September 16, 2016, we have resolved the service authorization issue with the following codes:

  • • Waiver transportation code T2003 UC
  • • Alternative Care code T2003

  • Lead agencies no longer need to close the line item to June 30, 2016, and add a new line beginning July 1, 2016, (the temporary solution explained in the previous provider news message September 6, 2016). The edit will continue to post correctly if there is a period on the service agreement line item during which the service was discontinued. (Updated 9/21/16) 

    Training and VideoPresence Opportunities

    Information about most new and ongoing training is on the Provider Training page. Any information listed in this section is for additional training sessions on special topics.

    Grants and RFPs

    See the Grants and requests for proposals web page for more information.

    Related Links

    Visit our Provider website for more comprehensive information, including these pages:

  • Latest Manual Revisions
  • • Previously published Provider News items
  • Provider Updates (we also place newly published Provider Updates in your MN–ITS Mailbox, as appropriate)

  • This page includes news and resources for providers enrolled to serve Minnesota Health Care Programs (MHCP) recipients. Get notices of Provider News through our free Provider Email Lists.

    If you have questions about this information, call the MHCP Provider Call Center at 651-431-2700 or 800-366-5411.

    Sign up to receive Provider Updates and other MHCP notices in your email account.


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