Healthcare Update - October 2018
Key Highlights in this topic/WORKGROUP for the PREVIOUS month:
2020 MA and MinnesotaCare Managed Care Procurement – bids for the 2020 contract year will be for Greater Minnesota counties outside the metro region. The metro includes Anoka, Carver, Dakota, Hennepin, Ramsey, Scott and Washington counties. The metro counties will be procured for the contract year 2021. An invite to a webinar went out on 10/3 to county directors from the 80 counties procuring in 2020. Questions can be sent to DHS.PSD.Procurement@state.mn.us or contact PJ Weiner at 651.431.3487
The METS Program Management Team (PMT) is working to finalize a list of candidates for 2019 projects.
The METS PMT is also finalizing the "Operationally Efficient" list of functionality as directed by the Enterprise Architecture Board (EAB). The list is now with MNIT to determine high levels of effort. The final document will be presented to EAB sometime in November.
In 2016, Minnesota began using spousal impoverishment protection rules rather than deeming waiver rules for determining Medical Assistance (MA) eligibility for certain married people applying for home and community –based services (HCBS) waivered programs. Beginning January 1, 2019, Minnesota will return to the previous rules to determine eligibility for these programs. Only the income and assets of the person applying for MA and long-term care services count when determining financial eligibility. See DHS Bulletin #18-21-08 for more details.
On October 2nd, MMIS implemented new functionality that continues to improve the interface from METS to MMIS. The new functionality includes a change in the hierarchy of major programs to reduce errors in the interface, prevention of IM eligibility spans from being overwritten by new coverage that interfaces from METS, MMIS is now able to handle MinnesotaCare eligibility spans that begin 60 days or more in the future.
Beginning October 22nd, the Appeals Division at DHS will enter appeal cases into METS. Many ONEsource procedures have been updated to reflect this change.
Requested Actions needed from MACSSA in the next month:
APPARENT TRENDS IN THIS TOPIC AREA:
The Periodic Data Matching (PDM) Field Test is nearing conclusion, as October 1st was the first day of ineligibility for enrollees who did not respond to their PDM notice. The assessment workgroup has been meeting regularly to share and discuss County experience during the field test. Some issues have been reported, but overall, the workgroup agrees that the work and call volume has been less than anticipated. The workgroup is currently working on the final report that will be presented to the METS PMT, METS Executive Steering Committee (ESC) and the Enterprise Architecture Board (EAB) by the end of November.
Issues/Concerns regarding this topic this month:
Information continues to be communicated about changes to Medicare in 2019. As mentioned in the September update, Medicare Cost Plans will not be available in some counties in 2019. These are counties in which there are two or more Medicare Advantage plans that meet enrollment numbers. See Medicare Cost County map and Cost Plan Transition attachments for more information.
Bulletins, Publications, or supporting materials to be included with this update: (Please attach to the email sent with this report.)