Minnesota Minnesota

MMIS Long-Term Services and Supports Manual

MMIS Long-Term Services and Supports Manual

Home and community-based services (HCBS) program management reports

Page posted: 8/3/26

This page includes a list of reports lead agencies commonly access to support HCBS program management. You can view the reports described on this page online using Infopac.

Report ID

Report name

Description

Labeled “Report”

PERSON ELIGIBILITY CHANGES

Infopac generates this report on a weekly basis each Friday for people with a change in one or more of the following:

  • · Medical Assistance (MA) major program begin date, end date or county of financial responsibility (CFR).
  • · Alternative Care (AC) major program begin date, end date or CFR.
  • · Medicare Part A and or Part B begin or end date.
  • · Prepaid health plan (PPHP) enrollment begin date, end date, health plan, product ID or disenrollment reason.
  • · Living arrangement type, begin or end date.
  • · Long-term care (LTC) ineligibility type, begin date or end date.
  • · Waiver type, begin date or end date.
  • · Date of death.
  • This report is one tool to provide information about changes in eligibility. It is important for case managers and care coordinators to receive timely notification of eligibility changes for people receiving case management services. Changes in eligibility have an impact on HCBS, care planning and service delivery.

    This report:

  • · Does not replace Communication of LTSS Eligibility Form, DHS-5181.
  • · Is not cumulative.
  • · Is sorted by the case manager or care coordinator provider number.
  • · Includes a page to explain data and suggest possible actions.
  • This report is labeled “Report” and is placed in the CML folder of the following MN–ITS accounts:

  • · Provider type 23 case managers: Sent to the county or Tribal Nation’s MN–ITS mailbox.
  • · Provider type 27 health care coordinators: Sent to the individual MN–ITS mailbox.
  • MW2083

    SERVICE AGREEMENT/PROCEDURE CODE RATE CHANGE

    Infopac generates this report whenever it automatically changes a service rate. There are three versions:

  • · Report R2083A shows changes to Brain Injury (BI), Community Alternative Care (CAC), Community Access for Disability Inclusion (CADI), Elderly Waiver (EW) and AC service agreements.
  • · Report R2083B shows changes to Developmental Disabilities (DD) Waiver program service agreements.
  • · Report R2083H identifies changes to Essential Community Supports (ECS) service agreements.
  • Use this report to identify changed service agreements due to a cost of living adjustment (COLA) rate change mandated by the legislature. You must check line items for accuracy and reapproval.

    MW2086

    SA'S FOR PROVIDERS W/ CAT-OF-SVC ENDED - DHS

    Infopac generates this report every day to identify service agreements that have a line item with no supporting category of service, specialty and/or license code for the provider on the line item. This report is not cumulative. There are four versions:

  • · The “A” report is for the AC, BI, CAC, CADI, and EW programs.
  • · The “B” report is for the DD program.
  • · The “G” report is for the Moving Home Minnesota (MHM) program.
  • · The “H” report is for the ECS program.
  • This report is sorted by the SACTAD field or, if blank, by the county of case manager. If there is no case manager on the service agreement, the report is sorted by the county of service for EW and AC programs or CFR for the disability programs.

    Case managers must check the PCOS screen (for COS code), the PPGM screen (for specialty code) or the PLIC screen (for license codes) in the provider subsystem and/or contact the provider to determine if they need to adjust or deny the line item period. Future line items automatically change the line item status from “approved” to “pend”.

    For more information, refer to MMIS LTSS Manual – MMIS automated changes to service agreements.

    MW2216

    WAIVER SLOT ALLOCATION MASTER LIST

    Infopac generates this report every day for EW case managers or other staff to check that the people they support are listed on the report, and people who have left the EW program no longer show on the report. This report is sorted by the CFR or Tribal Nation.

    Each person on the report has a waiver “slot.” A person with a “Y” in the Delete Column will keep their slot until the beginning of the new waiver year on July 1. If the person has not returned to EW, MMIS will release the slot for use. For more information, refer to MMIS LTSS Manual – EW slot allocation report.

    MW2453

    NOTICE OF OPEN CASES

    Infopac generates this report every month for screening documents approved within the reporting period for the certified assessor/case manager/care coordinator listed on the screening document. This report is not cumulative.

    This report is sorted by the LTCC county field from the LTC screening document, then by the case manager, certified assessor or care coordinator name when the case manager field is populated.

    Use this report to track when:

  • · Screening documents are entered and approved in MMIS.
  • · A service agreement is entered using the screening document's effective date.
  • MW2455

    LTC UNACCEPTED SCRNG DOCUMENT RPT - COUNTY

    Infopac generates this cumulative report every week to identify the screening documents that are in suspense for more than two weeks and the number of days since they were entered. The report can be used by case managers or the lead agency (based on the lead agency identified in the LTCC county field if the case manager field is blank).

    You must either delete the screening document or enter a new document that corrects the problem that is keeping the document in suspense.

    For instructions to find these documents, refer to MMIS LTSS Manual – Use inquiry mode with LTC screening documents.

    MW2457

    LTC CUMULATIVE SVC ENCUM AND PMTS

    Infopac generates this monthly report for people with a service agreement. It is sorted by:

  • · CFR for all people using waiver and AC programs.
  • · MCO for people using ECS.
  • This report lists the cumulative encumbrance and payments of each procedure code as of the service date. Each program has a section for the current and past year.

    Use this report to:

  • · Determine the total encumbered and/or paid amounts for each service during the reporting period.
  • · Compare your agency’s average with the state’s average amounts.
  • MW2460

    LTC CUMULATIVE ENCUMBRANCE AND PAYMENTS

    Infopac generates this monthly report for people by program with a service agreement. It is sorted by:

  • · CFR for all people using waiver and AC programs.
  • · MCO for people using ECS.
  • This report lists the cumulative encumbrance and payments by person and by program as of the service date. Each program has a section for the current and past year.

    Use this report to track the total encumbrance for each person against the total amount of claims that were paid on their behalf.

    MW0504

    PPHP CURRENT ENROLLMENT REPORT - FOR COUNTY

    Infopac generates this report after capitation to report data for the next month. It is sorted by financial worker service location and financial worker ID.

    Use this report to identify people in the servicing county who enroll in an MCO.

    MW0506

    PPHP POTENTIAL ENROLLMENT REPORT

    Infopac generates this report after capitation to report data for the next month. It is sorted is by financial worker service location and financial worker ID.

    This report identifies:

  • · People in the financial worker’s caseload who are not currently enrolled in an MCO and do not have an enrollment exclusion reason.
  • · People with an exclusion reason of YY (delayed or pending decision) or WW (delayed enrollment – new conversion counties only) for over 90 days.
  • This report helps enrollment staff provide enrollment materials and assistance.

    MW0507

    PPHP NEW ENROLLEE REPORT (SORT BY COUNTY OF SERVICE)

    Infopac generates this report after capitation and identifies people who are enrolled in the following MCO programs for the following month:

  • · Minnesota Senior Health Options (MSHO).
  • · Minnesota Senior Care Plus (MSC+).
  • · Special Needs BasicCare (SNBC).
  • It is sorted by the service location and then by MCO.

    Use this report to identify new enrollees who are also on a waiver or ECS.

    Note: The MnDHO managed care product is discontinued.

    MW0510

    RECIPIENT CAPITATION ERROR REPORT

    Infopac generates this report to identify people whose enrollment spans will be closed by MMIS for the upcoming month. It is sorted by the county of service and then by financial worker ID.

    Financial workers must review the cases before enrollment cutoff or capitation to make the necessary updates for cases that should continue.

    MW0535

    PPHP COUNTY ELDERLY DISENROLLMENT REPORT

    Infopac generates this report after capitation to report data for the following month. It is sorted by financial worker service location and financial worker ID.

    This report shows people age 65 and older who disenrolled from managed care and the reason of disenrollment.

    Use this report to determine if the person may be eligible for AC, ECS or EW. Note that some people may have disenrolled due to death.

    Additional resources

    Communication of LTSS Eligibility Form, DHS-5181
    MMIS LTSS Manual – EW slot allocation report
    MMIS LTSS Manual – MMIS automated changes to service agreements
    MMIS LTSS Manual – Use inquiry mode with LTC screening documents

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