HC Update - October 2017

Key Highlights This Month:  

  • DHS announced on 10/5/17 that effective January 1, 2019, the Minnesota contracts for Families and Children Prepaid Medical Assistance Program (PMAP) will no longer include personal care assistance (PCA) and home care nursing (HCN) services.  These services will instead be covered on a fee-for-service basis.
  • The Periodic Data Match (PDM) project is currently developing functionality.  Included is a technical solution (masking) to safeguard Federal Tax Information (FTI) during the PDM process
    • A PDM discrepancy has been defined as follows:  Discrepancies are determined by whether or not the new information we received from the federal hub would move someone from their current program into a different program.  It is not about dollar amounts, but rather program eligibility.  If they claim to earn no income and we received new information stating they now earn $5,000 per year, this would not cause a discrepancy because the new amount we received is not enough to move them out of MA.  However, if they were on the cusp of MA and MCRE, that same difference could cause a discrepancy if it would cause them to move programs.
  • There will be a new project approach for METS Notices and Defects work in 2018 with a goal of delivering more functionality in the long-term
  • Minnesota received approval from the Center for Medicare and Medicaid Services (CMS) for federal funding for the share of costs
  • The METs Executive Steering Committee approved the first two quarterly releases of 2018.  They include:

Spring 2018 Release

  • MMIS Interface (includes Redesign)
  • Notices (includes Redesign)
  • Carrier Integration (MNsure project)
  • Reasonable Opportunity Period (ROP) – Phase 1
  • DEED for Verification of Income
  • Defects

Summer 2018 Release

  • MMIS Interface (includes Redesign)
  • Carrier Integration
  • Curam Instance Alignment (CIA)
  • Annual Curam Upgrade
  • EngagePoint Upgrade
  • Oracle Upgrade

Requested Actions Needed From MACSSA:  

New Trends in This Area:  

Issues/Concerns Regarding This Topic:  

President Trump signed an executive order that will scrap subsidies to health insurance companies that help pay out of pocket costs to low-income people.  This will have a massive impact to insurance markets, who may now pull out of the insurance exchanges.

Legislative Impacts:  

Supporting Materials:  

Official Memo RE: 2019 Families and children Medicaid managed-care contract


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