HC Update - April 2018
Key Highlights This Month:
Estate Recovery Refunds
Due to a change in law, counties over collected on estate recovery funds in the past. Credits for these over collected funds are currently being processed and distributed as planned to correct the issue. The total amount owed to the counties to be refunded to estates was $1,333,690.91.
DHS FOD began crediting the affected county accounts for the federal and state share of the over-recoveries on the county’s February MMIS Health Care Programs Invoice (60% returned to the counties by way of credit offsets). The remaining amounts will be manually credited to counties in upcoming months to refund to the estates.
If you have questions regarding Estate Recoveries please contact the DHS Special Recovery Unit at (651) 431-3152. If you have questions regarding the county billing process and the credits you will receive, please contact DHS Health Care Accounting Supervisor, Becky Path at (651) 431-3771 or email@example.com
Long Term Care Claims – Reprocessing
Decisions to correct any long-term care (LTC) claims denied in error on the remittance advice (RA) dated December 27, 2017, are still being made at DHS. We will continue to update the county on this and the effect the reprocessing has on county billing. Provider relations is the best source of information on this. The last update provided was February 6-19, 2018 in MCHP provider news and updates archive.
If you have questions regarding Long term Care Claims Reprocessing affecting county billing, please contact DHS Health Care Accounting Supervisor, Becky Path at (651) 431-3771 or firstname.lastname@example.org
Change of Federal Financial Participation for Not Newly Eligible - Medical Assistance MMIS Recipient Claims for Calendar Year 2018
For CY 2018, it was previously communicated to counties that the Federal Financial Participation rate was 90% for Not Newly Eligible NA eligibility type group. It was confirmed by CMS that the Federal Financial Participation rate is actually 89.6%. The correction to the funding code file was made as of the 2/21/18 warrant and no claims needed to be reprocessed. For questions about the Federal Financial Participation on claims, please contact Financial Operations Health Care Accounting Supervisor, Becky Path at (651) 431-3771 or email@example.com
Effective April 1, 2018, DHS updated the late payment process for Medical Assistance for Employed Persons with Disabilities (MA-EPD). With implementation of the new process, SIR email reminders will no longer be sent when late payments are received; however, they will continue to send agency liaisons the monthly report of MA-EPD case closures.
18.1.1 release was deployed on April 7th. Below are some highlights of the work completed:
- Reasonable Opportunity Period - Beginning April 9, 2018, METS tracks the ROP for new applications and case reentry when the system determines eligibility for a public program with posteligibility items to verify. This new functionality systematically ends an enrollee’s eligibility if the items are not verified within the ROP.
- Interface Redesign – More streamlined procedure for an address change, overlapping spans and duplicate spans no longer appear on the RELG screen
- Renewals – DEED wage and unemployment data is now available to METS at renewal…METS now uses DEED data to determine whether a case should autorenew, and DEED information has also been incorporated into renewal notices
- Annual Changes – The Federal Poverty Level (FPL) rate table was updated with the July 1, 2018 MA rates
- Notices – Several formatting changes and language updates
Medicare is removing social security numbers from Medicare ID cards. Existing and new Medicare recipients will receive a new card with a unique number as their Medicare ID number. Existing recipients will not receive their new cards until June 2018 or later.
Requested Actions Needed From MACSSA: None at this time
New Trends in This Area:
There are many data collection efforts happening across counties related to current proposed legislation. The Council of Health Plans recently finished compiling county-specific health insurance information. The information primarily focuses on changes in Medicare coverage, Medicare payment, and various policies impacting how people buy coverage on their own. This county-specific information is available on their website here: https://mnhealthplans.org/all-care-is-local-data/.
The Minnesota Management and Budget office is doing an analysis of the impact of Medical Assistance work requirements on counties. The office is asking a sampling of counties to complete a survey in order to provide estimates of additional county costs. They are focusing on four primary impacts to county budgets:
1) Processing and monitoring enrollee exemptions
2) Updating medical assistance benefits based on work requirements
3) Providing employment and training services
4) Managing appeals of exemption determinations and loss of MA benefits
The AMC METS workgroup has been re-constituted and will be meeting on April 18th. County Director representation includes Hennepin, Olmstead, Dakota, Stearns, MN Prairie, Pope, St. Louis, Scott and Anoka.
Issues/Concerns Regarding This Topic:
The future of Periodic Data Match remains uncertain. DHS and MNIT sent a letter to the legislature that was shared with membership. The letter suggests the METS governance structure will explore options for piloting PDM functionality. More information to come.
Legislative Impacts: HF3722 and SF3611 that propose work requirements for Medical Assistance recipients are still moving through the process and testimony was heard at the Health and Human Services committee.
Topic Owner(s)/Content Expert(s): Kari Ouimette (Scott), Kathy Johnson (Kittson), John Glisczinski (Sibley), Deborah Huskins (Hennepin)