Individual Education Program (IEP) Services Providers

Revised: January 9, 2025

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· Eligible Providers

· Noneligible Providers

· Provider Responsibilities

· Electronic Funds Transfer (EFT)

· Billing Agents and Consultants

· Provider Information and Resources

· MHCP Provider Resource Center

· DHS IEP Services Contacts

· IEP Provider Contact List

· Legal References

· Resources

Eligible Providers

Minnesota schools, school districts, charter schools and tribal schools must be a Minnesota Health Care Programs (MHCP)-enrolled IEP services provider to bill Medical Assistance (MA) for the federal share of covered IEP health-related services.

Refer to Individualized Education Program (IEP) Services enrollment for MHCP enrollment information.

Noneligible Providers

· Out-of-state (not in Minnesota) schools and schools and school districts that are not enrolled with MHCP.

· Private schools – MA pays the public school district for the covered IEP health-related services that are provided by a private school. Private schools are not directly reimbursed by MA.

Provider Responsibilities

· Training, licensing and certifications: Schools and school districts must ensure that school employees or people contracted by the school are properly trained, licensed, certified and qualified to perform the services they provide. Schools must comply with protocols and processes that are established by the Minnesota Department of Human Services (DHS) and the Minnesota Department of Education (MDE). Contact MDE for compliance and DHS for third party reimbursement. Refer to IEP Provider Contact List for more information.

· Excluded providers: MHCP cannot enroll or pay for services provided by individuals or entities that are identified on the Office of Inspector General List of Excluded Individuals/Entities (LEIE) or the MHCP Excluded Providers Lists. School districts are required to conduct a search of the excluded provider lists before they hire staff who will work with children on MHCP; and conduct that search on a monthly basis thereafter. Do not allow an individual or entity that is on the list to provide services to children on MHCP.

Electronic Funds Transfer (EFT)

IEP services providers must have a vendor number from the Minnesota Management and Budget (MMB) Department to receive MHCP payments. MHCP uses EFT to pay providers for services.

Register for a vendor number and EFT through the Minnesota Supplier Portal.

When you get the vendor number and EFT activation notification from MMB, fax a completed and signed EFT Supplier ID Notification (DHS-3725) (PDF) to MHCP Provider Eligibility and Compliance at 651-431-7462. You can also complete the EFT vendor number notification the Minnesota Provider Screening and Enrollment (MPSE) portal.

MHCP Provider Eligibility and Compliance staff will update the district’s provider records with the vendor number within 30 days of receiving the completed EFT Supplier ID Notification or the change request through the MPSE portal.

To change banking information to an existing vendor number, submit the EFT Bank Change Request (PDF) to MMB.

Billing Agents and Consultants

Minnesota Rules allow billing MHCP through a billing agent or business agent only if the agent’s compensation adheres to the following:

· Is related to the cost of processing the billing and is not related on a percentage (or other basis) to the amount that is billed or collected

· Is not dependent on collection of the payment

Payment for any covered service given to a child or youth may not be made to or through a factor, either directly or indirectly. A factor is an individual or organization that advances money to providers for their accounts receivable for an added fee or a deduction of the accounts receivable worth.

Refer to Billing Organizations/Responsibilities under Provider Basics in the MHCP Provider Manual for more information.

Districts that use a billing agent must also complete and submit the Electronic Remittance Advice (RA) Request (DHS-4087) (PDF). Fax the completed and signed form to the Provider Enrollment unit to add or delete billing agent in the district’s provider file.

Enrolled IEP services providers must bill covered IEP services as IEP services and are responsible for the non-federal share of Medicaid payments.

Provider Information and Resources

The IEP section of the MHCP provider types webpage provides links to forms, documents and other information specific to IEP services.

MHCP Provider Resource Center

Call the MHCP Provider Resource Center at 651-431-2700 or 800-366-5411 to get answers to billing, payment and enrollment questions.

If you enter an invalid NPI or UMPI or do not have an NPI or UMPI, select option 3 for IEP services.

· Press 5 for Provider Enrollment

· Press 6 for questions about MN–ITS registration, MN–ITS administrator or password resets

· MN–ITS users: Review the online MN–ITS Troubleshooting Guide for suggested resolutions

DHS IEP Services Contacts

· For policy questions: Kathleen Stewart, IEP Services Consultant, 651-431-6947 or kathleen.stewart@state.mn.us

· For IEP rate questions: Jacquie L. Vang, IEP Rates Consultant, 651-431-2519 or dhs_rates_iep@state.mn.us

· For the Tax Equity Fairness and Responsibility Act (TEFRA) Parental Fees unit: 651-431-2670 or 800-657-3729

IEP Provider Contact List

DHS maintains the IEP provider contact list to distribute IEP updates and other important information. You can be added to this list or update your information, by emailing dhs.iep.contactlistupdate@state.mn.us with the following information or updates to the information previously submitted for your district:

· District name and school district number, NPI, address, phone and fax numbers

· Superintendent or administrator name, phone number and email address

· Special education director’s name, phone number and email

· Third-party billing coordinators, phone number and email

If your district uses a billing agency, software vendor or person that submits claims on behalf of your district and you want them to be added to the contact list, provide the following information:

· Billing agency’s name

· Vendor or person

· Street address

· Name of a contact person

· Email address

· Phone number

Sending us a change for the contact list will not automatically change your provider file in our system. You will need to submit a change for the provider file separately.

Legal References

Minnesota Statutes, 125A.08 (Individualized Education Programs)
Minnesota Statutes, 125A.21 (Third Party Payment)
Minnesota Statutes, 125A.74 (Medical Assistance Payment to School Districts)
Minnesota Statutes, 125A.744 (Statewide Data Management System to Maximize Medical Assistance Reimbursement)
Minnesota Statute, 256B.0625, subdivision 26 (Covered Services)
Code of Federal Regulations, title 34, section 300.154: Education Part 300 (Assistance to States for the Education of Children with Disabilities - Methods of ensuring services)
Code of Federal Regulations, title 42, section 1001.1901(b) (Effect of exclusion on excluded individuals and entities)
Code of Federal Regulations, title 42, section 1003.102(a)(2) (Basis for civil money penalties and assessments)

Resources

State Medicaid Director Letter (SMDL #09-001) (PDF)