Healthcare Update - March 2019

Key Highlights This Month:  

DHS has posted two RFPs, proposals due on May 17, 2019: 

  • To provide prepaid health care to Greater Minnesota’s eligible Families and Children and MinnesotaCare individuals
  • To provide prepaid health care and long-term-care services to seniors enrolled in Medical Assistance under Minnesota Senior Health Options (MSHO) and Minnesota Senior Care Plus (MSC+) programs

 MNIT conducted a pilot system sustainability assessment on MMIS (the Medicaid Management Information System) as a part of the broader modernization efforts.  This was done per a request of the Enterprise Architecture Board (EAB).  EAB has asked MNIT to define an action plan for the high priority MMIS assessment results.

 METS Health Care Program Management Team (PMT) continues prioritizing and planning for the FFY20 Advanced Planning Document (APD)

 The METS Spring 2019 19.1.1 release is scheduled for 4/7/19 and will include the following work:

  • METS to MMIS Interface (defects and enhancements)
  • Notices
  • METS Improvement Project
  • Defects
  • Verify Lawful Presence (VLP)
  • Reasonable Opportunity Period (ROP) Phase 2

Requested Actions Needed From MACSSA:  

New Trends in This Area:  

Periodic Data Matching (PDM) Monthly Totals for MA and MinnesotaCare Enrollees in METS


PDM Month

Enrollees Selected for PDM Process

Enrollees with a Discrepancy

Enrollees Closed at end of PDM Month (i)

September 2018

(Field Test)

64,901 MA enrollees

6,659 MA enrollees

2,340 as of 10/2/18 (ii)

February 2019

51,954  MA enrollees

5,192 MA enrollees

This information will not be available until early March

March 2019

47,749 MA enrollees

1,639 MCRE enrollees

4,619 MA enrollees

154 MCRE enrollees

This information will not be available until early April

(i)                Closing may be due to failure by the enrollee to respond to the discrepancy notice or ineligibility based on updated information from the enrollee.

(i)                Some enrollees may have returned information resulting in their MA eligibility being restored.  Based on the data from the field test, approximately 30% of MA enrollees closed at the end of the PDM month had their eligibility restored.  There are a small number of additional closures in subsequent months due to counties granting extensions to enrollees to complete the PDM process.

Issues/Concerns Regarding This Topic:  

Legislative Impacts:  

Supporting Materials:  

Contact(s):  Kari Ouimette

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