Healthcare Update - June 2018
Key Highlights This Month:
A PDM Field Test is still under consideration to begin at the end of July. The effort is being led by the AMC METS Workgroup and the field test assessment criteria is currently under development. Details will be shared once it if finalized.
There is a Security, Organization and Location Structure project that is focused on updating security and the METS framework. It also includes a security role analysis to ensure all roles meet business and security requirements. Clean-up analysis has started
Medicare recipients will start getting their new cards with their new Medicare ID number this month.
DHS is seeking public feedback on 2016 Medicaid Managed Care Comprehensive Quality Strategy. The document is currently posted for a public review period and can be found here: https://mn.gov/dhs/partners-and-providers/news-initiatives-reports-workgroups/minnesota-health-care-programs/managed-care-reporting/quality.jsp
In order to contain managed care mailing costs and improve the enrollees’ experience, DHS is proposing a change for the enrollment packets sent out by the counties for PMAP and the Elderly. Beginning July 1, you will not be required to send out the Primary Care Network Lists (PCNLs) in the packets sent to potential enrollees for the health plans in your county. DHS is currently modifying the cover letter that is inserted with the packets and will send it out to counties once it is final.
Requested Actions Needed From MACSSA: None.
New Trends in This Area:
Issues/Concerns Regarding This Topic: Several counties have discussed/reported billing issues and impacts to revenue due to duplicate PMIs. DHS recently released some guidance on Duplicate PMI numbers that includes information on how to report duplicates, urgent requests, how the duplicate PMI merge process works, what happens after they are merged, and who to contact for questions. See link below.
Duplicate PMI Numbers Guidance Doc
Contact(s): Kari Ouimette