Make payments to providers unless the provider cares for children in the children’s own home. Care provided in the child’s home must be approved by the Department of Children, Youth, and Families. Payment must be made directly to the family when care is provided in the child’s home. This applies whether the provider is licensed or legal nonlicensed. See Chapter 9.6 (Payments to Families).

You must:

· Make payments within 21 days after receipt of the bill when the provider submits a complete bill.

· Provide notice to both the family and provider of the payment amount and how and when the payment will be made.

Payment begin date

Pay the provider (or parent, if care in the home is approved) after the provider is registered by DCYF, retroactive to the later of the date that:

· The child’s authorization began. See Chapter 9.1 (Child Care Authorization)

OR

· The provider’s DCYF registration began. See Chapter 11.12 (Provider Registration)

OR

· The family became eligible. See Chapter 4.18 (Date of Eligibility)

OR

· The family began using a licensed provider

OR

· The family began using a legal nonlicensed provider and the provider completed training required based on the age of the child. See Chapter 9.1.18 (Authorizing Care with a Legal Nonlicensed Provider).

OR

· The family began using a certified license exempt center. See Chapter 11.6 (Certified License Exempt Centers).

Timeline to submit bills

If a provider has received an authorization of care and been issued a billing form for an eligible family, the billing form must be submitted within 60 days of the last date of service on the bill. You may pay a bill submitted more than 60 days, but not more than one year, from the last date of service if the provider shows good cause for the delay. Good cause includes agency error and applies for one full year from the last date of service on the billing form. Good cause criteria other than agency error is defined in your County and Tribal Child Care Fund Plan.

Do NOT pay a bill submitted more than a year after the last date of service on the bill, even if the provider shows good cause.

Do NOT require participants to pay providers in advance of receiving payment from the child care fund as a condition for receiving child care assistance.

Receiving an incomplete or incorrect bill

A complete bill must include the provider’s signature and the date the bill was signed, unless the bill meets the good cause criteria defined in the CCAP agency’s Child Care Fund Plan. Electronic bills are electronically signed and dated.

When a provider submits an incomplete bill or the provider notifies you after the bill is submitted that the bill was completed incorrectly, the provider must submit corrections in writing. How the provider submitted the bill originally (either a paper bill or submitted electronically through MEC² PRO) determines how the corrections are made.

· If your agency identifies an error(s):

· Inform the provider what they need to correct;

· Keep a copy of anything you send to the provider for the provider’s file; and

· Follow instructions below for resubmitting a paper or electronic bill.

· If the provider identifies an error(s):

· Keep a copy of the provider’s request for their file and/or document the communication in Provider Notes; and

· Follow instructions below for resubmitting a paper or electronic bill.

If your agency has program integrity concerns about a provider’s billing practices, follow guidance in Chapter 13.3 (Fraud Referrals) for referring or notifying the Office of Inspector General (OIG) Child Care Audits and Investigations Unit.

Resubmitting a paper bill

If your agency receives an incomplete/incorrect paper bill, the provider has three options to submit a correction:

· Make a copy of the submitted bill and return the original bill to the provider. The provider makes the changes to the original bill and resubmits to the agency.

OR

· Resend the bill to the provider from the provider Notice Activity window. The provider completes the bill and resubmits to the agency. See MEC² User Manual Resend Notice.

OR

· Send the provider the Child Care Assistance Billing Form (DHS-5523). The provider completes the paper bill and resubmits to the agency.

Resubmitting an electronic bill

Once a bill is submitted through MEC² PRO, the provider user cannot make changes. The provider has two options to submit a correction:

· The provider user prints the bill from the “Submitted” window in MEC² PRO, marks the changes and resubmits to the agency

OR

· Your agency sends the provider the Child Care Assistance Billing Form (DHS-5523), and the provider completes the paper bill and resubmits to the agency.

Ending payment for provider non-compliance

The state of Minnesota may end or deny a provider’s registration, stop payment issued to a provider, or refuse to pay a bill submitted by the provider if the provider violates one or more of the following clauses:

· Clause 1: The provider admits to intentionally giving materially false information on the billing forms.

· Clause 2: The agency finds by a preponderance of evidence that the provider intentionally gave materially false information on the billing forms and/or attendance records.

· Clause 3: The provider violates CCAP rules, until the violations have been corrected.

· Clause 4: The provider is operating after receipt of a licensing order of suspension, revocation, or decertification from the State of Minnesota (this occurs when providers are appealing the revocation, suspension, or decertification).

· Clause 5: The provider submits false attendance reports or refuses to provide attendance records upon request.

· Clause 6: The provider gives false child care price information.

· Clause 7: The provider fails to report on the billing form when a child’s attendance in child care falls to less than half of the child’s authorized hours or days for a four-week period.

Implementation

Only the state of Minnesota can implement these policies:

· Office of Inspector General (OIG) staff implement clauses 1 – 3 and 5 – 7.

· The DCYF CCAP Provider Support Team implements clause 4 based on a provider’s license or certification status.

When state staff:

· Immediately stop a provider’s payments under clauses 1 or 2, the registration closes without a 15-day notice. Continue entering all bills received for service dates before the registration closes. MEC² will:

· Allow agencies to enter and save bills for service dates before the registration closes.

· Prevent agencies from approving bills for all dates, including service dates before the payment stop took effect. This includes manual payments.

· Close a registration for clauses 3 through 7, this allows for a 15-day notice. Continue entering and approving payments for service dates through the notice period as usual. Standard eligibility, authorization, billing, and payment policies apply. For example, care must be available, and the provider must remain open to receive payment.

Notification

Refer or notify the Office of Inspector General (OIG) Child Care Audits and Investigations Unit of providers you have program integrity concerns about, such as concerns about record keeping practices, and/or providers you suspect of fraud. CCAP agencies are encouraged to use the Child Care Provider Investigations Communications DHS-6811 (PDF) form to inform the OIG of all child care provider investigations. See Chapter 13.3 (Fraud Referrals).

The Office of Inspector General (OIG) Child Care Audits and Investigations Unit will notify your agency if they are taking action to stop payment and/or close or deny a provider’s registration under clauses 1 – 3 and 5 - 7. When DCYF CCAP staff close or deny a provider’s registration for clause 4, CCAP agencies with active Service Authorizations will not get a separate notification beyond any applicable MEC² Provider Notes and/or Alerts.

Clauses One and Two

Clauses one and two, often referred to as “payment stops,” occur when state staff temporarily suspend payments, including for past service dates, while an investigation or disqualification is pending because a provider intentionally violates CCAP policies.

State staff may issue a payment stop:

· As a stand-alone action, for example when criminal charges are pending, or an administrative disqualification notice hasn’t been issued yet;

OR

· At the same time as an administrative disqualification notice. See Chapter 13.9 (Disqualification for Wrongfully Obtaining Child Care Assistance – Providers).

The provider’s registration stays closed and payments are stopped until:

· The department determines there is insufficient evidence to continue the action;

OR

· The department or a CCAP agency decides not to pursue further administrative remedy under Minnesota Statutes, chapter 245E or section 256.98;

OR

· All criminal, civil, or administrative proceedings related to the alleged misconduct have concluded and all appeal rights have been exhausted.

A provider that has their payments stopped under clauses 1 or 2 may request an administrative review. See Chapter 15.6 (Family and Provider Appeal Rights).

Lifting payment stops

If the department determines a payment stop can be lifted:

· Payments may be made for services provided before the payment stop took effect, if the provider bills timely and accurately. See information in the section titled “Timeline to submit bills” above about the provider’s timeline for submitting bills.

· The provider must complete a new registration to receive CCAP again. Registration does not guarantee a child’s authorization or payment.

Assuming all other registration requirements are met, the new registration may go back to the later of:

· The date the registration closed previously

OR

· The date set in a legally binding settlement agreement.

For service dates after the new registration opens, standard eligibility, authorization, and payment policies for families apply. For example, see:

· Chapter 4.18 (Date of Eligibility) for retroactive eligibility limits.

· Chapter 9.1 (Authorizing Child Care) for information about the earliest date care can be paid if a provider provided care without receiving a Service Authorization and billing form.

Clause Four

If a child care provider appeals a registration closure under clause four, the provider’s:

· Registration must stay closed, and payments cannot continue for service dates after the registration closes, while an appeal is pending;

AND

· Child care assistance fair hearing will happen after a final decision is reached about their license or certification. See Chapter 15.6 (Family and Provider Appeal Rights) and Chapter 15.15 (Continuation of Benefits).

Once a provider’s registration is closed or denied under clause four, it remains inactive until Department of Human Services (DHS) or Department of Children, Youth, and Family (DCYF) Licensing confirms the provider’s suspension, revocation, or decertification has been reversed. If the Licensing decision is reversed, the provider must complete a new registration to receive CCAP again.

Assuming all other registration requirements are met, the new registration cannot start before the date the provider’s license or certification status is Active AND no longer “Subject to or Under Appeal.”

Clauses Three, Five, Six, and Seven

For clauses 3, 5, 6, and 7, CCAP may withhold a provider’s registration or payment for a period of time not to exceed three months beyond the time that the condition has been corrected.

Once a provider’s registration closes or is denied, the provider must serve the penalty period and complete a new registration to receive CCAP again.

A provider that has their registration closed under clauses 3, 5, 6 or 7 may request a fair hearing. See Chapter 15.6 (Family and Provider Appeal Rights).

Employee/employer relationship

Receipt of federal, state, or local funds by a child care provider either directly or through a child care assistance recipient does NOT establish an employee-employer relationship between the provider and the county or state.

Provider tax forms

Providers are self-employed. The provider’s federal tax classification determines whether they will receive a yearly 1099 form to use for tax purposes.

If a provider has any questions about their 1099 form, have the provider contact the DCYF CCAP Provider Support team at CCAP.Providers.DCYF@state.mn.us or 651-431-4848. Messages will be returned within two business days.

Below is more information about the process of issuing 1099’s:

· The 1099 form is sent to the address displayed on the Provider Tax Info page.

· If care is done in child’s home, the 1099 form is sent to the provider, not the parents.

· During tax season (January – June), 1099 forms are printed every Friday night and mailed on Monday.

· Replacement 1099 forms are mailed once a week on Mondays.

Legal authority

Minnesota Statutes 142E.01, subd. 24
Minnesota Statutes 142E.10
Minnesota Statutes 142E.16
Minnesota Statutes 142E.17
Minnesota Statutes, 142E.18
Minnesota Statutes 142E.19
Minnesota Rules 3400.0110
Minnesota Rules 3400.0120, subps. 1(C) & 1a
Minnesota Rules 3400.0185
Minnesota Rules, 3400.0230
Minnesota Statutes 256.983, subd. 5