• System Upgrade: DHS completed upgrades to MN–ITS March 14 – 16, 2015, that included creating new fields on claim transaction screens. Refer to Provider Update, New Fields Added to MN–ITS Screens (MHP-15-01) for information about changes in MN–ITS.
• ApplySmart: MHCP will no longer accept applications through the Minnesota Credentialing Collaborative’s (MCC’s) ApplySmart web application as of March 21, 2015. Refer to Provider Requirements on the MHCP Enrolled Providers web page to access enrollment documents.
• Medicare or TPL payment: Authorization is not required for services when Medicare or a third party liability (TPL) payer has paid 60% or more of the MHCP allowable rate. Submit your claim to MHCP and report the prior payment in the coordination of benefits (COB) information. However, authorization is required in order to provide services that exceed a member’s benefit limit, regardless of prior payment. (Example: mental health services with yearly benefit limits.)
• Family deductible: The family deductible amount that providers are responsible for collecting from recipients changed to $2.85 effective Jan. 1, 2015. Refer to Billing the Recipient in the Provider Manual for information about this cost sharing.
Mental Health Services Claims
We will reprocess mental health services claims that were originally processed from Jan. 14, 2015, through Feb. 11, 2015. During this time, the mental health critical access add-on did not apply correctly. Reprocessed claims will appear in the next warrant cycle, for remittance date March 24, 2015.
MHCP Rate Changes Effective Jan. 1, 2015
On Feb. 5, 2015, we completed system changes to update rates for dates of service on or after Jan. 1, 2015. We have updated the MHCP Fee Schedule with the most current rates.
We will replace claims processed between Jan. 1, 2015, and Feb. 5, 2015, for rates that were changed. We will update this messge when a replacement date is determined.
Rates were processed correctly effective Jan. 1, 2015, and claims for the following will not require replacement:
• Inpatient hospital services
• Medicare Part A claims
• Dental services
• Nursing facilities
• Intermediate Care Facilities for Persons with Developmental Disabilities (ICF/DD)
• Medicare long-term care facilities
Training and VideoPresence Opportunities
Refer to the session for registration and session details.
• DHS is hosting a Minnesota electronic health record incentive program (MEIP) webinar series in March 2015. Professionals and hospitals must register for each webinar. To learn more, see the schedule and registration information.
On Sunday, March 29, from 8 p.m. until Monday, March 30 at 6 a.m., all functions of MN–ITS will be unavailable while we conduct system maintenance. During this time the following applications will not be available:
• The entire MN–ITS system, including:
• All Direct Data Entry (DDE) transactions
• All applications and systems that require users to log in to MN–ITS
• All eligibility verification transactions, including phone verifications
• Pharmacy Point of Sale (POS) transactions
Pharmacies: Please use the MHCP NDC search online to determine if a drug is covered, requires prior authorization, or has quantity limits.
Batch transaction processing: We will hold batch transactions submitted during this time and begin processing when the systems are available. Submit each file only once. You will receive transaction responses after processing resumes.
Refer to the 5010/D.0 Announcements page for information about MN–ITS functionality, technical information, scheduled downtimes and other notifications.
This Industry Initiatives section gives you quick, easy access to current federal and state industry initiatives that potentially impact your business. Please review these pages on a regular basis. We will note changes to the right of the initiative as we update the pages.
EHR Incentive Program Submission Deadline
Program year 2014 is the last year for an eligible professional to receive the first payment in the Medicare EHR Incentive Program. Health care professionals enrolled in the Medicare EHR Incentive Program may transfer to the Medicaid EHR Incentive Program (MEIP).
Eligible professionals will be considered for future incentive payments based on a review of your previous payments. Maximum total payments from the Medicare incentive program are $43,720, while maximum total payments from the Medicaid incentive program are $63,750.
The Medicaid EHR Incentive Program, which Minnesota administers, is open for first year enrollment through program year 2016 without any reduction in incentive payment amounts. An eligible health care professional may receive incentive payments based on the ability to meet program requirements. In the first year providers can receive an incentive payment for adopting, implementing or upgrading EHR technology.
DHS is conducting internal testing for system changes required for ICD-10 implementation. As internal testing nears completion, we will provide more information about external testing opportunities on our ICD-10 web page.
MHCP will reprocess CD claims submitted between Dec. 30, 2014, and Feb. 10, 2015. These reprocessed claims will appear on the March 10, 2015, remittance advice. The reprocess is to correct a system issue and does not impact claim payments.
Starting on Mar. 09, 2015, we added a batch upload feature to the HCH Tier eTool. Users can now upload Excel spreadsheets with up to 5,000 patients for tier assessments. Refer to the HCH Batch screen help text for instructions on creating and uploading your batch files through the eTool. Refer to the help links in the upper right corner on each eTool screen for more information. Refer to the Health Care Homes section in the MHCP Provider Manual for general information about the program and the Tier eTool.
The HIV/AIDS Unit of the Minnesota Department of Human Services announces that the income criterion for Program HH eligibility has increased from 300% to 400% of Federal Poverty Guidelines (FPG) effective Feb. 4, 2015.
The new income limit for Program HH eligibility is $46,680 annually ($3,890 per month) for an individual. This change provides the potential to help more people living with HIV access affordable medication and insurance. The income limit is increasing only for the drug, insurance and basic programs of Program HH. Ryan White eligibility for support services, including Medical Case Management, remains at 300% of FPG.
The Department of Human Services (DHS) Disability Services Division (DSD) updated the Supported Employment Services page in the Community-Based Services Manual (CBSM) and would like your input on the changes. Is there information that needs to be added or that needs further clarification?