42 C.F.R. 455.101, Minn. Stat. §256B.0659, subd. 13 (c) and subd. 21

DHS is in the process of replacing PCA with CFSS. For more information about this transition, refer to CFSS Manual – Transition from PCA and CSG to CFSS.

Similarities

For both PCA and CFSS, there are training requirements specific to a person’s role within the provider agency.

Differences

DHS is no longer enrolling new PCA providers. CFSS provider agencies still providing services to people using PCA have additional requirements. For more information refer to the additional information for CFSS provider agencies still serving people using PCA section.

Designated billing person: An employee who is responsible to ensure claims are billed according to Minnesota Health Care Programs (MHCP) policies and procedures. A provider agency must have at least one designated billing person. The designated billing person must have a valid certificate from the Agency Resources and MN–ITS Training. They may train others within their provider agency.

Managing employee: An employee who has operational or managerial control or who directly or indirectly conducts the day-to-day operation of PCA/CFSS services for an institution, organization or PCA/CFSS provider agency. The managing employee could be the provider agency’s general manager, business manager, administrator, director or another employee. This role does not include managing employees who only work in non-PCA/CFSS areas of the business.

Owner: A person with an ownership or control interest of 5% or more.

Qualified professional (QP)/supervising professional: An employee who provides oversight and supervision of PCA/CFSS services and staff as they deliver PCA/CFSS services. In PCA, this employee is called the QP. In CFSS, this employee is called the supervising professional.

The CFSS provider agency must identify people in their organization who are required to complete training. These training requirements apply to the following roles:

When additions or changes to these roles occur, the CFSS provider agency must ensure the new people complete the necessary training.

If the CFSS provider agency identifies a change in the designated billing person, the CFSS provider agency must complete Designation of Billing Person for CFSS, DHS-8559 (PDF) and ensure the new designated billing person completes required training.

A board of directors is exempt from the training requirements, unless they meet one of the three definitions above.

New owners and managers

New owners and managers must do both of the following:

Owners or managers who completed PCA/CFSS Steps for Success can use that certificate to complete their enrollment if the certificate is less than three years old.

Timeline

Applying for enrollment (owners and managers)

Owners and managing employees must complete mandatory training before MHCP enrollment.

Additions or changes to positions/roles (managers)

Managing employees newly hired by an enrolled MHCP provider must complete mandatory training within six months of hire.

Transfers of ownership

Prospective new owners of a CFSS provider agency must complete mandatory training prior to receiving ownership of the CFSS provider agency, unless they have completed the training within the past three years. CFSS provider agencies must report all changes of ownership to DHS using Organization – MHCP Provider Profile Change Form, DHS-3535A (PDF).

Designated billing person

A designated billing person must complete PCA/CFSS Agency Resources and MN–ITS Training. To register, refer to DHS – MHCP provider training.

Timeline

Applying for enrollment

After a CFSS provider agency successfully enrolls with MHCP, the designated billing person must complete PCA/CFSS Agency Resources and MN–ITS Training within 30 days of the CFSS provider agency’s successful enrollment and before submitting any claims to MHCP for CFSS services.

Changes to positions/roles

A newly hired designated billing person must complete PCA/CFSS Agency Resources and MN–ITS Training within 30 days of the change. The CFSS provider agency must report the staff change using Designation of Billing Person for CFSS, DHS-8559 (PDF).

Note: If changing owners results in the agency having a new national provider identifier (NPI) number, the designated billing person must attend PCA/CFSS Agency Resources and MN–ITS Training and submit a copy of their training certificate within six months of the completed change through the Minnesota Provider Screening and Enrollment (MPSE) Portal or fax to 651-431-7465.

During a transfer of ownership, the new owner must submit proof of required trainings with their MHCP enrollment application. For more information, refer to the sale or transfer of a provider entity section of MHCP Provider Manual – Provider requirements.

For help with a CFSS agency’s change of ownership, contact the MHCP Provider Resource Center.