Minnesota Minnesota

Minnesota Provider Screening and Enrollment Manual

Minnesota Provider Screening and Enrollment Manual

Manage Limiting Caseload

Revised: June 6, 2024

Overview

Minnesota Health Care Programs (MHCP) caseload limits allow providers to limit their acceptance of new patients who are MHCP members while remaining in compliance with Rule 101. Rule 101 requires providers who want to be paid for other state-sponsored health care programs to participate in MHCP and accept new patients who are MHCP members on a continuous basis. All providers are required to notify MHCP before limiting their acceptance of new members.

Non-dental providers may limit acceptance of new MHCP members if members make up at least 20 percent of their active caseload.

Dental providers with practice locations within the seven-county metro area (Anoka, Carver, Dakota, Hennepin, Ramsey, Washington, and Scott) may limit acceptance of new MHCP members if members make up at least 10 percent of their annual active caseload, and if they continue to accept new MHCP members who are children with special health care needs. Dental providers with practice locations outside the seven-county metro area are not subject to these requirements.

To review how to calculate your MHCP caseload, the criteria for children with special health care needs, and additional information on Rule 101 and MHCP caseload limits, go to the Rule 101 page of the MHCP provider manual.

There are two limiting MHCP caseload assurance statements:

  • · Non-dental providers – Limiting MHCP Caseload Assurance Statement (DHS-5078A) (PDF)
  • · Dental providers – Limiting MHCP Caseload Assurance Statement (Dental) (DHS-5078) (PDF)
  • Use this page to add or update a Limiting MHCP Caseload (Rule 101) Provider Assurance Statement in your enrollment record.

    Portfolio/Profile Information

    This is a recurring section that appears on multiple MPSE pages for informational purposes only. See Portfolio/Profile Information on the Recurring Items page of the Minnesota Provider Screening and Enrollment (MPSE) User Manual.

    Enrollment Record Information

    This is a recurring section that appears on multiple MPSE pages for informational purposes only. See Enrollment Record Information on the Recurring Items page of the MPSE User Manual.

    Limiting Caseload

    Under Limiting Caseload, complete and upload your Limiting MHCP Caseload (Rule 101) Provider Assurance Statement. A link to the appropriate form will appear on this page based on your enrollment record type.

    Document Link

    Non-dental providers: Click Limiting MHCP Caseload (Rule 101) Provider Assurance Statement (DHS-5078A) (PDF) to go to the form. You must complete the form electronically or print and scan it to your computer and then you can upload the form in the MPSE portal

    Dental providers: Click Limiting MHCP Caseload (Rule 101) Provider Assurance Statement (DHS-5078) (PDF) to go to the form. You must complete the form electronically or print and scan it to your computer and then you can upload the form to the MPSE portal.

    Limiting Caseload Documentation

    The Limiting Caseload Documentation field shows your uploaded Limiting MHCP Caseload Provider Assurance Statement. Click the page icon to open your document in a new tab.

    Remove Upload
    Check the Remove Upload field to remove the document that is currently uploaded. This will happen automatically if there is an existing document and you upload a new document. This field will not appear if there is no document uploaded in the Limiting Caseload Documentation field.

    Upload Limiting Caseload Documentation

    Use the Upload Limiting Caseload Documentation field to upload documentation you have to support your request to change your profile identifier. This field is required if you need to limit your caseload for this enrollment record. Click on Upload Limiting Caseload Documentation or click on the icon shaped like an eye to open a dialogue box on your computer. This will allow you to select a document to upload. MPSE only allows the following document types to be uploaded: PDF, JPG, and PNG.

    Digital Signature

    Type the full name of the person uploading the Limiting MHCP Caseload (Rule 101) Provider Assurance Statement in the Digital Signature field. Go to the Digital Signature section on the Recurring Items page of the MPSE User Manual for more information.

    Signers Title

    Type the professional title of the person uploading the Limiting MHCP Caseload (Rule 101) Provider Assurance Statement in the Signers Title field. Go to the Digital Signature section on the Recurring Items page of the MPSE User Manual for more information.

    Signature Date

    Type the date you are uploading the Limiting MHCP Caseload (Rule 101) Provider Assurance Statement in the Signature Date field. Go to the Digital Signature section on the Recurring Items page of the MPSE User Manual for more information.

    Continue

    Click Continue to save your changes and go to the next page.

    Cancel

    Click Cancel to go back to the previous page.

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