MHCP Provider News

July 10, 2017


  • Submit all claims electronically: Minnesota Health Care Programs (MHCP) cannot accept claims or claims appeals by fax or mail. According to the MHCP billing policy, you must submit all claims electronically through MN–ITS, including claim voids and claim replacements. Submit only the AUC Fax Cover Sheet for Health Care Claims as found on the Electronic Claim Attachments webpage. Do not use the AUC Appeals Cover Sheet. Beginning August 1, 2017, the MHCP claims processing staff will no longer contact you to request your claims electronically. We will no longer research and process the appeal form. The appeal form and other correspondence will be destroyed if faxed or mailed to us. Call the Provider Call Center with any questions about claim denial or submit a new claim and attach the appropriate documentation. (Added 7/20/17)
  • Home health services documentation requirements: Effective July 1, 2017, requirements for Minnesota Health Care Programs payment of home health services are amended to comply with the federal regulation that requires documentation of a face-to-face encounter (including via telehealth) with a physician or a non-physician practitioner. The encounter must be related to the primary reason the person requires home health services and must occur within the 90 days before or the 30 days after the start of home health services. Home health services include skilled nurse visits, home health aide visits, and all rehabilitation therapy services provided by a Medicare-certified home health agency. This requirement applies to people receiving home health services through fee-for-service Medical Assistance and through waivers and Alternative Care. It will apply to managed care enrollees effective January 1, 2018. Medicaid home health services are not limited to home settings and may be provided in the community where normal life activities take the person other than an institutional setting. (Added 7/13/17)
  • Documentation required for face-to-face encounters: Effective July 1, 2017, a physician, physician assistant, nurse practitioner, or clinical nurse specialist (excluding certified mid-wives, audiologists, and podiatrists) are required to maintain documentation of face-to-face encounters for certain medical equipment, appliances, and supplies within six months before the start of service (initial dispensing date). A list of durable medical equipment (DME) items subject to the face-to-face rule is on the Centers for Medicare & Medicaid Services (CMS) website: DME List of Specified Covered Items (PDF). We will update the MHCP Provider Manual with the details of this rule soon and will update this message when we do.
  • • See grants and requests for proposal (RFPs) for current grants available or RFPs in which you may be interested.
  • 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 and other system information

    Announcements and availability: Watch this space for information about MN–ITS functionality, technical information, scheduled downtimes and other systems notifications.

    RESCHEDULED System Maintenance: All functions of MN–ITS will be unavailable from Saturday, August 5 at 6 a.m. until Monday, August 7 at 6 a.m. while we do system maintenance. During this time all of MN–ITS will be unavailable, 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
  • • The MPSMISC file will not be available for uploads or downloads
  • Batch transaction processing – All batch transactions will be unavailable, including secure FTP servers. You will not be able to submit any files during this time.

    Child & Teen Checkups

    Fluoride varnish application (FVA) code change: Effective July 1, 2017, primary care providers or those under the supervision of a treating primary care provider, may no longer use code D1206 for FVA. CPT code 99188 will be the only code for billing for FVA in the primary care provider setting.

    Early Intensive Developmental and Behavioral Intervention (EIDBI)

    UMPI number required for Level III providers: As of January 1, 2018, all Early Intensive Developmental and Behavioral Intervention (EIDBI) Level III providers must enroll with Minnesota Health Care Programs (MHCP). MHCP will assign the Level III providers a Unique Minnesota Provider Identifier (UMPI) number at the time of enrollment. The UMPI number is required when submitting a claim for EIDBI Level III services.

    New Autism 101 training available: All Early Intensive Developmental and Behavioral Intervention (EIDBI) Level III providers are required to take Autism 101 training. As of July 1, 2017, ASD Strategies in Action replaces the current Autism 101 training curriculum. DHS has partnered with the Ohio Center for Autism and Low Incidence (OCALI) to offer this training for providers, found at autismcertificationcenter.org. This is an online video training program that describes characteristics of autism spectrum disorder (ASD) and highlights simple strategies and skills for families and service providers.

    Contact ASD.DHS@state.mn.us for free subscription access to all courses for the Level III service providers at your EIDBI agency. A 90-minute free course titled “Many Faces of Autism” is available to families and community members.

    EIDBI agencies currently enrolled as Children’s Therapeutic Services and Supports (CTSS) agencies, will still be allowed to submit their current CTSS training curriculum to DHS for consideration as a replacement to the required training until March 1, 2018. If DHS approves the agency’s CTSS training curriculum based on the outlined requirements, all Level III providers must complete the training by June 30, 2018. After June 30, 2018, all EIDBI Level III providers must complete the ASD Strategies in Action training as a part of the EIDBI individual provider training requirements.

    Mental Health

    Stakeholder discussion about diagnostic assessment requirement: The DHS Mental Health Division will host two stakeholder discussion opportunities pertaining to the WHODAS 2.0 as the current functional status component required in diagnostic assessment. DHS drafted a proposal in response to recent feedback obtained through a survey we sent. We would like to continue discussion and receive feedback about the drafted proposal. DHS encourages providers, payers, and recipients to attend; changes to the functional status requirement of the diagnostic assessment broadly impact mental health stakeholders.

    Register through the DHS TrainLink. Click on Class Schedules/Registration, then select Adult Mental Health-07/14/17 or 08/04/17 – Diagnostic Assessment Stakeholder Opportunity. Discussion opportunities will be on the dates indicated from 10:00 a.m. to 12:00 p.m. in room 5137 at 444 Lafayette Rd., St. Paul, MN or at one of the videoconference sites listed. See more information on the TrainLink site. For more information, email Lucas Peterson at Lucas.Y.Peterson@state.mn.us.

    Intensive Treatment in Foster Care Training Sessions: Are you interested in providing intensive treatment in foster care? If you are, you need to be certified and attend one of the “Intensive Treatment in Foster Care (ITFC) Applicant Provider Information Sessions.” You can read more in the bulletin Children’s Mental Health Announces New Service: Intensive Treatment in Foster Care.

    Sign up for the training through TrainLink. Session dates are August 22 and November 14, 2017, from 9:00 a.m.–12:00 p.m.

    Personal Care Assistance

    Rate changes for certain long-term services and supports: The 2017 Minnesota Legislature authorized a 1.642 percent rate increase for budgets in the Consumer Directed Community Supports (CDCS) and Consumer Support Grant (CSG) programs and personal care assistance services (PCA). See MN Legislature Authorizes Rate Changes for Certain Long-Term Services and Supports (DHS Bulletin 17-25-03) for rate and limit changes for services provided on or after August 1, 2017.

    PCA Choice and fiscal support entities (FSE) requirements: We added a new section under Personal care assistant on the Home and community-based services page for Requirements for PCA Choice and fiscal support entities (FSE). Review the resources available through this site.

    Transportation Services

    Reprocessing ambulance provider claims for enhanced rate: We have identified the ambulance providers who are eligible for the 5 percent enhanced rate for ground and air ambulance services. Beginning with the warrant dated June 27, 2017, we will reprocess and pay at the enhanced rate any eligible claims for dates of service on and after July 1, 2016. We will continue to pay ongoing claims at the enhanced rate.

    Waiver and Alternative Care Programs

    Public comment period for amendments to disability waiver plans: DHS seeks public comments for federal waiver plan amendments (PDF) before submitting to the Centers for Medicare & Medicaid Services (CMS) for approval. Comment period begins at 8 a.m., July 13, 2017, and ends at 4 p.m., Aug. 11, 2017. Submit comments to DSD.PublicComments@state.mn.us. See full announcement at Public comment period for amendments to disability waiver plans. (Added 7/13/17)

    Provider signature requirements for HCBS support plans: As of Jan. 6, 2017, the lead agency must obtain a signature from each home and community-based services provider (waiver and alternative care) for all new and updated support plans. The provider’s signature indicates their acknowledgement of the services and supports in the plan and their agreement to deliver those services and supports as outlined. In response to questions from lead agency staff and service providers DHS created the Community-Based Services Manual (CBSM) page, Provider-signature requirements for HCBS support plans, and updated the associated FAQ page.

    Training and VideoPresence Opportunities

    Information about most new and ongoing training is on the Provider Training page.

    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
  • 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.

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