MHCP Provider News

Feb. 8, 2016

  • MSOCS report available and input sought about future: Review the report Transitioning MSOCS Residential to a Safety Net Service: Community Based Steering Committee Recommendations (PDF) and a cover letter (PDF) from Commissioner Johnson Piper about Minnesota State Operated Community Services (MSOCS). The commissioner welcomes your comments and questions about the report, and your input about the future of MSOCS. Your input will be most useful if received during February 2016, as DHS continues to plan and finalizes the DHS legislative agenda for 2016. Refer to Commissioner Johnson Piper’s letter for more information, who to contact with your comments and questions about the report, or who to contact about MSOCS residential services operations.
  • Primary Care and VFC Incentive Program: MHCP discovered an error in the calculation of enhanced rates we authorized to be paid by the managed care organizations (MCOs) for the Primary Care and Vaccines for Children (VFC) Incentive program. We corrected this amount with the MCOs; final payments reflect all payments owed for 2013–2014. Because of this correction, the MCOs will have to take back overpaid incentive amounts from some providers. Contact the MCO for information about any specific recoupments or adjustments based on this correction.
  • Training and technical assistance program applications sought: DHS, along with the University of Minnesota's Institute on Community Integration seek lead agencies, case management agencies and providers to apply for a yearlong training and technical assistance program. The program will help groups implement the organizational changes required for more person-centered supports. We will accept up to eight agencies for the program, which starts in April 2016. Applications are due Feb. 29, 2016. For more information on the program and how to apply, review the University of Minnesota's Application for Technical Assistance and Training: Organizational Implementation of Person-Centered and Positive Support Practices page.
  • Information about transportation for MHCP members: The Minnesota Department of Transportation (MnDOT) Office of Transit has started a five-year update of the Greater Minnesota Transit Investment Plan. This plan will identify the transportation vision and investment priorities for greater Minnesota, especially where there is little to no transit. We encourage providers, especially transportation providers to share this information with people who rely upon transit throughout the state so they have an opportunity for input. For more information, visit the MnDOT Greater Minnesota Transit Investment Plan page.
  • Minnesota Employment Learning Community: The Minnesota Employment Learning Community (ELC) is recruiting four new members. The ELC is a group that focuses on learning about and promoting best practices for improving competitive work outcomes for people with disabilities. The ELC will accept applications from Jan. 20 until Feb. 8, 2016, at 4 p.m. We will notify successful applicants during the week of Feb. 22, 2016. For more information on the ELC and how you can apply, visit the Minnesota Employment Learning Community web page.
  • 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.


    Announcements and availability
    Watch the 5010/D.0 Announcements page for information about MN–ITS functionality, technical information, scheduled downtimes and other notifications.

    Electronic Health Records

    Refer to the Minnesota Electronic Health Records Incentive Program (MEIP) web pages for complete information about this program.

    Day Training and Habilitation (DT&H)

    To improve guidance for lead agencies that do needs determination for day training and habilitation services (DT&H), DHS changed the application and procedure. Review the 30-day public comment period for updated DTH needs determination process for more information and to submit your public comments.

    Early Intensive Developmental and Behavioral Intervention (EIDBI)

    Information session for counties and providers
    DHS is hosting an information session about the new Early Intensive Developmental and Behavioral Intervention (EIDBI) benefit. The webinar and call-in session will be Wednesday, March 2, 2016, 9:00 a.m.–12:00 p.m. Refer to the EIDBI Provider Information Session (PDF) announcement for more information.

    Provider Directory
    To find a list of EIDBI providers, go to the MHCP Provider Directory. We update this directory regularly and add newly enrolled EIDBI providers as they are approved. You will also find a link to the directory in the right-hand column of most MHCP Provider web pages. Follow these steps:

    1) Click on Select in the Type field.

    2) Choose Autism–Early Intensive Developmental and Behavioral Intervention, then click Next.

    3) In the Sub Type field, choose either Autism Agencies or CMDE Assessments, then click the Search button. (If you know the name of a specific provider, you can search for that provider by entering the name in the Name field.)

    4) Contact providers on the list directly to learn more about their availability and the specific services they offer.

    Provider Call-In Q&A
    DHS is hosting monthly call-in sessions for questions, answers and technical assistance for providers enrolled in the new Early Intensive Developmental and Behavioral Intervention (EIDBI) benefit. For information about dates, time and dial-in instructions see the Q&A Session Announcement (PDF).

    Federally Qualified Health Centers

    Federally qualified health centers and rural health clinics prospective payment method (PPS) and Minnesota alternative payment method (MAPM II) rate notices will be in your MN–ITS mailbox in early January 2016, along with an alternative payment methodology (APM) election form.  If you have not completed an Alternative Payment Methodology Election form (DHS-3903) (PDF) for 2016 or past years back to 2013, please do so. If you have an APM I rate, email your most recent Medicare cost reports to the DHS payment policy area to either or

    Hospital – Outpatient

    Off-Campus Provider-Based Hospital Department Services
    Effective for dates of service on or after Jan. 1, 2016, outpatient services furnished at an off-campus provider-based department that are billed on either of the following may deny with group code CO and claims adjustment reason code of “4” (The procedure code is inconsistent with the modifier used or a required modifier is missing):

  • • 837P professional claim must include place of service 19 and modifier PO (section 20.6.11)
  • • 837I facility claim must include modifier PO

  • Call the MHCP Provider Call Center if your claims with the PO modifier deny with claims adjustment reason code = CO 4.

    APC Claims Reprocessing
    Some APC (Ambulatory Payment Classification) outpatient claims with dates of service on or after Jan. 1, 2016, billed Jan. 1–15, 2016, denied stating the procedure code or procedure rate count cannot be determined, or is not on file for the date of service. MHCP will identify and reprocess all APC outpatient claims that were denied with this remittance advice remark. Watch for an updated message indicating the remittance advice payment date for these reprocessed claims. APC outpatient claims billed on or after Jan. 16, 2016, are not affected.

    Mental Health

    Family Psychoeducation
    Providers can now bill for Family Psychoeducation services with dates of service on or after Jan. 1, 2015, if the service meets the coverage criteria for service delivery. You may bill retroactively only for a date of service that has existing progress note documentation. You may not create documentation now for a service provided in the past.

    Review the MHCP Provider Manual section on Family Psychoeducation for coverage and documentation requirements.


    Computed Tomography (CT) Scans Reported with Modifier CT
    The Centers for Medicare & Medicaid Services (CMS) announced a reimbursement reduction for CT scans acquired on technology that does not meet the new National Electrical Manufacturers Association (NEMA) standards. Rates will be reduced as follows:

  • • Rates for dates of service on or after January 1, 2016, through December 31, 2016, will be reduced by 5 percent.
  • • Rates for dates of service on or after January 1, 2017, will be reduced by 15 percent

  • Do not send certificates of compliance to MHCP at this time. While CMS requires providers to send certificates of compliance for scanners that meet these technology standards, MHCP is not requesting or requiring this information.

    Report modifier CT on all CT scans provided on scanners that do not meet the NEMA standards. MHCP is working to implement the reimbursement reduction and plans to retroactively reprocess claims with dates of service on or after January 1, 2016.

    We will post a message when we have an implementation date and the date of the remittance advice that will include the affected claims.

    Waiver and AC Program Providers

    Public comment request for BI, CAC, CADI and DD waiver plans
    DHS requests comments on proposed changes to the BI, CAC, CADI and DD waiver plans.

    In August 2015, DHS sent a package of amendments (PDF) out for public comment. However, we were not able to submit at that time because a previous amendment package was awaiting CMS approval. After reviewing the comments received in August, we made changes and updated some of the amendments.

    The current 30-day comment period begins 8:00 a.m. Monday, Feb. 8, 2016 and ends 4:00 p.m. Wednesday, March 9, 2016. Review the 30-day public comment period for updated federal waiver plan amendments for additional information and how to submit comments.

    Aging and disabilities survey
    The Minnesota Department of Human Services is participating in the National Core Indicators aging and disabilities survey. We use the results of this optional, independently conducted survey to improve home and community-based services and supports for older adults and people with physical disabilities.

    See more information in the National Core Indicators survey for older adults and people with physical disabilities announcement page.

    Study of non-wage costs incurred by HCBS providers
    DHS has commissioned Truven Health Analytics (Truven Health), an independent consultant, to perform a study of the non-wage costs incurred by Home and Community-Based Services (HCBS) providers in administering Medicaid services. This study includes evaluation of existing non-wage costs and payment methodologies in order to recommend the best ways to reflect these costs within current payment frameworks.

    The results of this study may have significant impacts for the rates and methods by which we reimburse non-wage costs. A significant component of this study will be a Truven-administered survey in January 2016 of the HCBS provider experience. Your participation in the survey is critical to develop a full understanding of the costs. Follow this two-step process to access and complete the survey:

  • 1. Click on the survey link [] and enter your email address. Use one email address per provider organization. You will receive an email within one business day from Survey Monkey with a unique link specific to your organization for completing the survey.
  • 2. Open the survey from the email you receive. You will be able to save your progress as you go and can share it with others in your organization so they can also contribute. You will have until Feb. 19, 2016, to complete the survey.

  • For information on the disability waivers rate system (DWRS), including research results, go to the Disbility waivers rate system web page. For questions on the Non-Wage Cost Study, email Truven Health will monitor this email; response time will vary based on the complexity of the questions asked.

    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.

    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.

    Rate/Report this page   Report/Rate this page