MHCP Provider News

November 28, 2016


December 2, 2016
MN–ITS may be intermittently unavailable or users may get an error message the weekend of December 2 through December 4, 2016, because of a technical issue. We are working to resolve this issue as soon as possible.

The following services are currently available, but may experience intermittent outages until all issues have been resolved:

  • • Eligibility verifications through our automated phone system and Real-Time or CORE 270/271 transactions
  • • Point of sale pharmacy claims
  • • Batch file submission through secure FTP file transfer. Batch files submitted via FTP will be held and processed when the system is fully available. Please do not submit files more than once.

  • Reporting pregnancy: If you provide services to an MHCP member who is pregnant, remind her to report the pregnancy to her county, tribal or state servicing agency. Pregnant women receive enhanced benefits under Medical Assistance (MA), including exemption from cost sharing, and a higher income standard for the family, which may allow other household members to become eligible for MA. A pregnant woman remains eligible for MA until the last day of the month following the 60-day postpartum period. A baby who is born to a woman enrolled in MA at the time of birth is eligible for MA until the last day of the month of his or her first birthday, regardless of changes in household income or size. See the Member Evidence of Coverage for more detail.
  • Claim denials for ordering or referring providers: MHCP identified medical supply claims that denied in error with the remark code N265 on the October 18 and November 1, 2016, remittance advices. We are working to fix the error and reprocess claims within the next two payment cycles.
  • • 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.

    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.

    Hospital

    Outpatient hospital

    Ambulatory Payment Classification (APC) Status Indicator J1 for comprehensive APC (C-APC): MHCP completed system programming for C-APC on October 31, 2016. We will reprocess affected claims that have dates of service on or after January 1, 2015. When we identify these claims, we will post notice of the reprocessing schedule.

    Indian Health Services

    Inpatient and outpatient rates: As published in the Federal Register on March 9, 2016, the following rates for inpatient and outpatient medical care provided by Indian Health Service facilities for calendar year 2016, are:

  • • $2,655 Inpatient hospital per diem
  • • $368 Outpatient per visit
  • MHCP will reprocess Indian Health Service claims with dates of service and adjudication dates of January 1, 2016, through March 31, 2016, to reflect the change in calendar year 2016 rates.

    Mental Health

    Early Intensive Developmental and Behavioral Intervention (EIDBI) Comprehensive Multi-Disciplinary Evaluation (CMDE) system changes: The time limit for completing a CMDE increased to five days, effective October 6, 2016. You may now take up to five days within 30 calendar days of the initial service to complete the CMDE. Each day is one unit. MHCP will adjust claim submissions until the system is updated with this change. If you provide CMDE services across two different months, you must bill them on separate claims.

    MHCP has updated the system and adjusted CMDE non-consecutive day claim denials. If you have an outstanding claim denial for non-consecutive days, call the MHCP Provider Call Center at 651-431-2700 or 800-366-5411.

    Minnesota Family Planning Program (MFPP)

    MFPP changes for December 2016: The way income is calculated for people applying for MFPP is changing beginning December 1, 2016. MFPP will begin following modified adjusted gross income (MAGI) methodology. This change does not affect how providers perform or bill for services.

    We also revised several question in the MFPP application to reflect the policy change. Begin using the new version of the application on December 1, 2016. The application is not fillable at this time. Print the application to complete it and then fax it to the number on the first page. If you have printed copies from DHS of the previous version of the application, you may still use them.

    We will post a revised MFPP Provider Training Guide soon with more information about the new application, the application process and how income is calculated for MFPP. Additional changes are effective January 1, 2017. We will provide more information about those changes soon.

    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.

    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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