Personal care assistance is available to eligible people enrolled in a Minnesota Health Care Program. PCA helps a person with day-to-day activities in their home and community to help a person maximize their independence. The PCA program offers options to allow the service to be consumer-directed.
To find a specific PCA-related form, visit the PCA forms page.
Provider revalidation and termination notices
March 1, 2016
The Centers for Medicare & Medicaid Services (CMS) require Minnesota Health Care Programs (MHCP) enrolled providers to revalidate their enrollment record(s) at least once every five years. Revalidation currently is underway for PCA providers and all other MHCP provider types. Because of the volume of documents received for this and other initiatives, MHCP Provider Enrollment is taking longer than 30 days to process enrollment documents.
MHCP Provider Enrollment currently is issuing termination notices to PCA providers whose revalidation is incomplete. The termination notices provide appeal rights and specific information about the corrections the provider needs to make to complete revalidation.
If a provider or provider organization receives a termination notice, it has 60 days to submit remaining corrections, missing or incomplete documents before the termination date. If the provider submits all requested information before the termination date,
MHCP Provider Enrollment retroactively will reinstate enrollment once the documents are processed.
If the provider also submits an appeal request within the same 60-day timeframe, MHCP Provider Enrollment will reinstate the provider’s record to an active status so it may continue to operate while awaiting the review of its documents during the appeal process.
County and tribe actions
County and tribal staff should encourage providers to:
Filing an appeal has the advantages of:
County and tribal staff should follow the processes below for service authorizations that involve PCA providers who have received termination notices.
Type B service agreements
Edit 415 will post to the service line that starts after the termination date. Add 580 in the OVR LOC to route the service agreement to the Disability Services Division MMIS Resource Center after resolving all other edits.
The Resource Center will approve the first six-month service line and pend the second six-month service line. If the PCA provider’s file is updated and the termination date is removed, the PCA provider should send a PCA Technical Change Request form, DHS-4074A (PDF) to the Resource Center so it can approve the pended line item.
Waiver service agreements
Edit 415 will post to the service line that starts after the termination date. Counties and tribes may either:
Providers who have questions about revalidation should contact the Provider Call Center at 651-431-2700 or 800-366-5411 (toll free). For more information, see the section on revalidation on the Provider Screening Requirements page in the Provider Manual.
Counties and tribal staff member with questions should contact DHS.PCAappeals@state.mn.us.
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