DHS is in the process of replacing personal care assistance (PCA) and the Consumer Support Grant (CSG) with Community First Services and Supports (CFSS). For more information about this transition, refer to CFSS Manual – Transition from PCA and CSG to CFSS.

For a Medicaid Management Information System (MMIS) transition summary, refer to DSD MMIS Reference Guide – MMIS transition from PCA and CSG to CFSS.

Similarities

There are no similarities between PCA and CFSS on the ASA3 screen for CFSS failed background studies.

Differences

In PCA, a person does not use a financial management services (FMS) provider. The ASA3 screen for CFSS failed background studies only applies to CFSS.

In PCA, the county/tribal nation used the UA modifier to authorize PCA worker supervision/training (T1019 – UA). In CFSS, the county/tribal nation uses the UA modifier on the failed background studies (T2040 – UB, UA and U6) line.

The county/tribal nation enters lines for the person’s specific services on the ASA3 screen. This page describes how to enter a CFSS failed background studies (T2040 – UB, UA and U6) line for a person who uses the CFSS budget model and has a worker fail a background study. For information and instructions about other ASA3 line types, refer to DSD MMIS Reference Guide – ASA3 screen overview.

CFSS budget model

For a person who uses the CFSS budget model, the county/tribal nation can only enter a failed background study (T2040 – UB, UA and U6) line if the person’s SA also has both:

If the county/tribal nation enters a failed background study line without both the FMS provider fee (T2040 – UB and UA) line and the personal care (T1019 – UB) line, MMIS posts an exception code the county/tribal nation must resolve.

CFSS agency model

For a person who uses the CFSS agency model, the county/tribal nation does not enter a failed background study (T2040 – UB, UA and U6) line. If the county/tribal nation enters a failed background study (T2040 – UB, UA and U6) line, MMIS posts an exception code the county/tribal nation must resolve.

In the optional LI COMMENTS field, the county/tribal nation enters additional clarifying information, if desired. This comment appears in the person’s letter and the provider’s letter.

In the PROC field, the county/tribal nation enters the failed background study procedure code (T2040).

Note: MMIS posts an exception code the county/tribal nation must resolve if the county/tribal nation enters a failed background study (T2040 – UB, UA and U6) line and either of the following are true:

1. There are any other lines with the agency model modifier (U9).

2. The SA does not have both the following line types:

In the MOD1-4 field, the county/tribal nation enters all three modifiers UB, UA and U6 to provide additional information needed for authorization and billing.

In the START/END DT fields, the county/tribal nation enters start and end dates in MMDDYY format. Start and end dates indicate when the line starts and ends. The dates must be within the agreement start and end dates (AGMT START/END DT fields) on the ASA1 screen.

In the REQ RATE/UNIT field, the county/tribal nation enters the requested reimbursement rate for a CFSS failed background study found on DHS – CFSS codes and rates.

In the REQ TOT UNITS field, the county/tribal nation enters the total number of failed background studies.

MMIS auto-populates the REQ TOT AMT field when the county/tribal nation presses function key F9. This field lists the total amount the county/tribal nation authorizes for this service based on the entries in the REQ RATE/UNIT and REQ TOT UNITS fields.

In the PROV NBR field, the county/tribal nation enters the FMS provider’s National Provider Identifier (NPI) number or Unique Minnesota Provider Identifier (UMPI) number.

The provider number entered on the failed background study (T2040 – UB, UA and U6) line must match the provider number entered on the following line types with overlapping dates, if applicable:

If the county/tribal nation enters a provider number that does not match the provider number entered in any of the above lines with overlapping dates, MMIS posts an exception code the county/tribal nation must resolve.

If the person has not selected a provider, the county/tribal nation enters:

For more information, refer to DSD MMIS Reference Guide – Finalize a type B service agreement for PCA/CFSS.

Find a provider number in MMIS

If the person’s service delivery plan does not list the provider number, refer to Instructions for Completing and Entering the LTCC Screening Document and Service Agreement into MMIS, DHS-4625 (PDF).

MMIS auto-populates the PROV NAME field when the county/tribal nation presses function key F9. This field lists the provider name based on the provider number the county/tribal nation enters in the PROV NBR field. The county/tribal nation cannot edit this field.

MMIS auto-populates the SHR field. If the county/tribal nation edits this field, MMIS overwrites their entry.

The county/tribal nation cannot edit the FREQ field.

In the RSN CD field, the county/tribal nation enters legal notice language to add to the SA when needed. If the county/tribal nation makes changes specific to a failed background study, they enter the appropriate reason codes in this field. For more information, refer to DSD MMIS Reference Guide – ASA3 screen overview.

MMIS reason code text

For a list of MMIS reason codes, refer to DSD MMIS Reference Guide – Type B home care service agreement MMIS reason codes.

If the county/tribal nation needs to enter more lines, they press function key F11 to display the next blank line. MMIS displays only two lines per page.

After the county/tribal nation enters all lines, they press a transmit key to advance to the AHC1 screen.