Home and Community-Based Services (HCBS) Programs Enrollment Criteria and Forms
Overview
Minnesota Health Care Programs (MHCP) requires providers to enroll for the services they provide to MHCP members for each location that is providing services and receiving reimbursement.
The steps and instructions in this section apply to services for any of the following HCBS programs:
To enroll or revalidate for additional Moving Home Minnesota (MHM) services, refer to Moving Home Minnesota (MHM) Enrollment Criteria and Forms.
Newly enrolling day support services providers must obtain a needs determination authorization letter from the Department of Human Services - Disability Services Division (DHS-DSD) prior to completing the following enrollment steps. The needs determination letter approves the county or tribe lead agencies and the day support services provider’s needs determination application request. For more information, contact your local county agency or tribe. The needs determination authorization letter is not applicable for providers who were already enrolled in Adult Day Care, Day Training and Habilitation, or Structured Day prior to Jan. 1, 2021.
Heightened Scrutiny
The instructions in this Heightened Scrutiny section apply to adult day service, adult foster care and customized living for any of the following programs:
Effective March 18, 2023, newly enrolling adult day service, adult foster care and customized living providers must comply with all home and community-based settings standards before they enroll with Minnesota Health Care Programs.
Important: MHCP must assess providers who provide services in settings in or adjacent to an institution (hospital, nursing facility, intermediate care facility for people with developmental disabilities [ICF/DD], institution for mental disease [IMD]) to determine compliance with all HCBS standards through the heightened-scrutiny process. To initiate a heightened-scrutiny review for a new setting, email the Aging and Adult Services HCBS unit and include “Heightened Scrutiny” in the subject line. Include the setting’s name, address, contact information and license number, if available. Refer to the Requirements for new HCBS settings webpage for more information.
How to Enroll
Pay the application fee if a federal employer identification number (FEIN) is used, or attach proof that the fee was paid to either Medicare or another state for the same location and for the same services. Use the MHCP Provider Screening Fee Collections System to pay the fee online. The fee must be paid before applying to MHCP.
Review the MHCP Service Combinations for HCBS (DHS-8371) (PDF) for a list of different HCBS enrollment record types.
Providers who wish to enroll or reenroll with MHCP, can do so in one of the following ways:
Enroll Using the Online MPSE Portal
Use the Minnesota Provider Screening and Enrollment (MPSE) portal by following the Registration Instructions. Also, upload the following in the MPSE portal:
or
Submit Forms via Fax
Fax the following documents for each location providing services to MHCP Provider Eligibility and Compliance at 651-431-7493.
Review and retain a copy of the MHCP Data Privacy Notice (DHS-6287) (PDF) for your records.
MHCP Provider Eligibility and Compliance will process documents in order of date received. Whether enrolling using the MPSE portal or by fax, allow 30 days for processing. If more information is needed to complete the enrollment, a request for more information letter will be sent via U.S. mail (or in the provider’s MN–ITS mailbox, if one has been created) listing what needs to be done to complete the request.
Waiver and AC Resources and MN–ITS Training
The owner or managing employee must complete the Waiver and AC Resources and MN–ITS Training within six months of a new enrollment for HCBS Waiver and AC program services.
Providers must upload a copy of their certificate of completion in the MPSE portal by starting a Global Request and updating the Owner or Authorized Person. Or, providers can fax a copy of the certificate of completion to MHCP Provider Eligibility and Compliance at 651-431-7493.
See HCBS Waiver and AC Training Requirements for requirements and providers exempt from one or both trainings.
HCBS Waiver and AC Provider Training 101 Proof of Completion
The owner or managing employee for the organization must complete the required HCBS Waiver and AC Provider Training 101 and competency test. Print proof of completion to submit with the application request. Proof of completion must show the name of the owner or managing employee who completed the training and date of completion.
Proof of completion may be any of the following:
See HCBS Waiver and AC Training Requirements for requirements and exemptions. Upload proof of completion via the MPSE portal or fax to MHCP Provider Eligibility and Compliance at 651-431-7493.
Background Study
If the provider is requesting to provide one of the following unlicensed services, the Request for Licensing Agency ID Number (DHS-3891) (PDF) form must be completed and a background study needs to be submitted for all owners and managers identified on the Disclosure of Ownership and Control Interest of an Entity (DHS-5259) (PDF) form or in the Owner/Authorized Person section of the MPSE portal. The provider must wait until receiving notice from the Department of Human Services (DHS) licensing before allowing the person to provide direct care services to an MHCP member.
General Liability Insurance Certificate
If any of the following services are provided, the provider must submit a copy of the general liability insurance certificate covering the requested start date of services with the physical address listed, unless the service is exempt from insurance.
Services that require a copy of the general liability insurance certificate:
The certificate must also list “DHS Provider Eligibility and Compliance” as the certificate holder with the following address listed: PO Box 64987, St. Paul, MN 55164-0987.
Services provided that are exempt from the general liability insurance requirement are:
Providers Enrolling with a DBA
For providers opting to use a DBA (Doing Business As) name on their application, please note that MHCP pays the license holder. Therefore, if a DBA is used with licensing and the application lists that name, payment will be addressed to the DBA name. This may mean that the provider will be unable to cash or deposit the check to any other named account. Be sure to register the correct name with the Office of the Minnesota Secretary. Failure to do so will result in a rejection of the application and MHCP Provider Eligibility and Compliance will send the provider a request for more information.
Exceptions for Lead Agencies
Lead agencies (county and tribal human services) must do the following when completing the enrollment documentation:
Remote Support
If a provider chooses to provide services remotely, a completed Waiver Services Remote Support Provider Assurance Statement (DHS-8059) (PDF) must be submitted for the following remote support waiver services:
Revalidation
MHCP is required to follow the Centers for Medicare & Medicaid Services (CMS) final federal provider screening regulations.
MHCP will notify you when you are due for revalidation. When you are notified, you must submit a revalidation request through the MPSE portal or fax all required forms and documents listed in the How to Enroll section to DHS.
We recommend using the MPSE portal and following the Revalidation Instructions in the MPSE user manual to revalidate your record. Log in to your MN–ITS account on the MN–ITS: Home webpage and choose the Minnesota Provider Screening and Enrollment (MPSE) portal link. If you have not registered your MN–ITS account, your login information is on your original “Welcome” letter. Call the MHCP Provider Resource Center at 651-431-2700 or 800-366-5411 if you do not have your Welcome letter.
Refer to Revalidation in the Provider Screening Requirements section of the MHCP Provider Manual for important information, including timelines, about the revalidation process and impacts to your enrollment. Providers who do not meet the revalidation timelines will have their enrollment terminated.
Review the Frequently Asked Questions for HCBS Revalidation available for providers.
Adding Services to Current Enrollment Record
Because there are multiple service options for HCBS programs, providers may add additional services after they have enrolled. Review the MHCP Service Combinations for HCBS (DHS-8371) (PDF) to ensure that the new services can be added to the existing waiver enrollment record. To add additional waiver or AC programs services to a current waiver enrollment record:
Include the appropriate assurance statements (see the HCBS Programs Service Request (DHS-6638) (PDF) to determine which services require an assurance statement and for a link to the appropriate assurance statement for that service.
Reporting Changes
The provider must notify MHCP Provider Eligibility and Compliance any time a change occurs. Refer to Changes to Enrollment in the Enrollment with Minnesota Health Care Programs (MHCP) section of the MHCP Provider Manual for details.
MHCP Provider Eligibility and Compliance will process the change information in the order received and will notify the agency if any more documentation is necessary to continue or maintain enrollment with MHCP in relation to the changes. Please allow 30 days for processing.
Additional Resources
Minnesota Statutes, 245C (Human Services Background Studies)
Minnesota Statutes, 245.814 (Liability Insurance for Licensed Providers)
Minnesota Statutes, 256B.4912 (Home and Community-Based Waivers; Providers and Payment)
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