Waiver/AC Provider Record Review Deadline Extension

June 3, 2013 – MHCP Provider Update WAV-13-07

Effective immediately, MHCP is extending the deadline for providers to complete and submit enrollment documents for the waiver and Alternative Care (AC) programs provider record review to September 30, 2013.

Follow instructions in the record review section of the MHCP Provider Manual for the forms and documents needed to complete the review.

MHCP will work with providers who submit record review documentation until the provider completes the process. If enrollment information is not complete, MHCP will place a Request for More Information (RFMI) letter into the PRVLTR folder of the provider’s MN–ITS mailbox to request the missing information.

Record Review Disclosures

When completing the Disclosure of Ownership and Control Interest of an Entity (DHS-5259), providers must disclose the identifying information (date of birth, social security numbers, etc.) of all who have ownership or control interest, including paid or volunteer board members, or for-profit or non-profit entities. Review the MHCP Data Privacy Notice for information about why entities must disclose this information.

County and tribal human services lead agencies: See the record review section of the MHCP Provider Manual for additional instructions when completing this form.

Non-Responsive Providers

MHCP has the authority to terminate a provider’s enrollment if the provider does not respond to a request to update provider enrollment information. Instead of terminating the record, MHCP will end the provider’s ability to be paid for waiver or AC services by ending the category of service on their provider file effective October 1, 2013.

When a category of service is ended, the claims for the waiver or AC services will deny. The provider can contact the MHCP Provider Call Center to inform us if they want to continue to provide services through the end of the year, or ongoing after January 1, 2014.

Providers who want to provide services only through December 2013 do not have to complete the review and may request to have the category of service reopened to receive payment for dates of service through December 2013.

Providers who want to continue to provide services after January 1, 2014, must complete the provider record review and obtain any necessary credentials by December 31, 2013, or they will not be paid for waiver or AC services.

The Call Center representative can help the provider with:

  • • Completing the record review process
  • • Options for providing documentation
  • • New waiver provider standards effective for dates of service January 1, 2014
  • • Explaining the need to obtain licenses, registrations or certification to continue to be qualified to provide some services, beginning January 1, 2014
  • • Where to locate resources, when appropriate

  • Providers who do not complete the waiver or AC provider record review process and do not obtain the necessary credentials to keep providing services after December 31, 2013, will not be authorized to provide the service or receive payment for any dates of service during which their credentials were not in effect.

    Additional Resources

    Provider Record Review – Waiver/AC Program Services (WAV-12-01)

    If you have questions about this information, call the MHCP Provider Call Center at 651-431-2700 or 1-800-366-5411.

    Sign up to receive Provider Updates and other MHCP notices in your e-mail account.

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