Wednesday, June 4, 2025

 Official Publication of Minnesota Home Care Association

  Inside the Informer

  Member News

Customer Service Training for Front-Line Staff – One Low Price for Your Agency!

FAQs

1. How long will these recordings be available? For 90 days starting on June 24 and ending on September 24.

2. Can anyone at our branch office watch them? Yes! The registration is per agency location.

3. Can multiple people watch at the same time? Yes, and they can watch on any device that connects to the internet. The videos will not be available for download.

Available on-demand starting June 24.

 MHCA In Action

MHCA Meets with DHS to Address Concerns with CFSS

MHCA Executive Director Kathy Messerli, MHCA Regulatory Affairs Manager Paulette Duncan, and board members Jammie Kummer and Rochelle Wodarz met with the Minnesota Department of Human Services (DHS) Director of Disability Heidi Hamilton regarding ongoing issues and concerns with CFSS.

Hamilton stated that if a provider is having specific questions on authorizations or other concerns, the provider should email details of the situation to DHS at dhs.cfss@state.mn.us so their issues are addressed individually. If you email them at that address and you do not get a timely response, let Paulette know at pduncan@mnhomecare.org and she will escalate questions to DHS for members.

Training was specifically discussed, as it appears the case managers aren’t fully aware of the protocols and there has been a gap in knowledge between county workers and contract workers. Hamilton said that DHS is working on consistent training for county workers and contract workers when it comes to approving service plans. MHCA proactively advocated with DHS to share the training materials with providers, encouraging them to refer case managers to the materials as needed. We will have a link to these materials.

DHS is also aware that the SEIU Union has reached out to PCAs regarding how the transition will impact workers and their wages, suggesting they talk with their clients. They will be following up with the union representative. We encourage you to maintain regular communication with your workers, who may be hearing from various parties about this transition to CFSS.

  STATE NEWS

Minnesota Legislative Session Ends Without an Approved Budget

We continue to wait for a Special Session to be called, approving the state’s budget bills. It is our understanding that there is verbal agreement on the Senate Health and Human Services budget, and we remain hopeful this will be resolved soon. In the meantime, layoff notices are being sent to state employees due to a potential government shutdown on July 1st if a state budget is not passed by June 1st. These notices are precautionary, indicating a potential layoff if a budget is not approved.

While bill language has not been shared, the spreadsheet indicates that the following provisions of interest to MHCA are in the final agreement:

• Funding the SEIU Collective Bargaining Agreement for PCA/CFSS
• Permit the provision of CFSS during acute care hospital stay
• Future DWRS inflationary adjustments are tied to CPI-U and cap at up to 4% annually.
• Unknown changes to the Waiver Reimagine Task Force and the Waiver Reimagine interaction with Home Care Nursing

Medical Assistance and MinnesotaCare Fee-For-Service Member Handbook Published

Minnesota Health Care Programs published a handbook for members with coverage through Medical Assistance fee-for-service or MinnesotaCare fee-for-service. This handbook gives members information about who to call with questions, details on covered services, member rights and responsibilities, and more.

Individual Direct Support Worker (DSW) Records Marked as Inactive

Active DSW enrollment records were changed to inactive the week of May 19, 2025. The Minnesota Department of Human Services is aware of this, and they are working to change the impacted records to active.

DSW enrollment records will be changed to active by end of day June 4, 2025. If your Personal Care Assistance and Community First Services and Supports claims were denied with MN–ITS claim status code 132 and remark code N290 on your June 3 or June 17 remittance advice, you will need to resubmit claims after we have changed the enrollment records to active.

Please do not call the Minnesota Health Care Programs (MHCP) Provider Resource Center to start a case, as they will correct all impacted DSWs as a batch. If you have questions about this message, call the MHCP Provider Resource Center at 651-431-2700 or 800-366-5411.

  federal news

Qualifications for Speech-Language Pathologists Providing Outpatient Speech-Language Pathology Services

The Centers for Medicare & Medicaid Services (CMS) revised the regulation to require speech-language pathologists (SLPs) to meet requirements as a condition for outpatient SLP service payment and coverage. Since 2005, CMS’s outpatient therapy regulations for all therapists—PTs, OTs, their supervised assistants, and SLPs—have matched personnel requirements for therapists working in HHAs.

Learn more.

CMS Rolls Out Aggressive Strategy to Enhance and Accelerate Medicare Advantage Audits

On May 21, 2025, the Centers for Medicare & Medicaid Services (CMS) announced a significant expansion of its auditing efforts for Medicare Advantage (MA) plans. Beginning immediately, CMS will audit all eligible MA contracts for each payment year in all newly initiated audits and invest additional resources to expedite the completion of audits for payment years 2018 through 2024.

Currently, CMS is several years behind in completing these audits. The last significant recovery of MA overpayments occurred following the audit of payment year (PY) 2007, despite federal estimates suggesting MA plans may overbill the government by approximately $17 billion annually. The Medicare Payment Advisory Commission (MedPAC) estimates this figure could be as high as $43 billion per year. CMS’s completed audits for PYs 2011–2013 found between 5% and 8% in overpayments.

To address this backlog, the Trump Administration has introduced a plan to complete all remaining RADV audits for PY 2018 to PY 2024 by early 2026. Key elements of the plan include:

• Enhanced Technology: CMS will deploy advanced systems to efficiently review medical records and flag unsupported diagnoses.
• Workforce Expansion: CMS will increase its team of medical coders from 40 to approximately 2,000 by September 1, 2025. These coders will manually verify flagged diagnoses to ensure accuracy.
• Increased Audit Volume: By leveraging technology, CMS will be able to increase its audits from ~60 MA plans a year to all eligible MA plans each year in all newly initiated audits (approximately 550 MA plans). CMS will also be able to increase from auditing 35 records per health plan per year to between 35 and 200 records per health plan per year in all newly initiated audits based on the size of the health plan.  This will help ensure CMS’s audit findings are more reliable and can be appropriately extrapolated as allowed under the RADV final rule. 

In addition to these efforts, CMS will collaborate with the Department of Health and Human Services Office of Inspector General (HHS-OIG) to recover uncollected overpayments identified in past audits. CMS reaffirms its commitment to ensuring all Medicare Advantage plans comply with federal requirements and accurately report patient diagnoses used for payment.

 2025 Electronic Visit Verification (EVV) Summit in Chicago

The National Alliance for Care at Home and the National EVV Association are hosting the first ever joint EVV summit. This event will occur as a pre-event workshop in conjunction with the 2025 National Alliance for Care at Home Financial Summit on Sunday, July 27, 2025, and will represent the first time that Alliance Provider Members, State Government Agencies, and EVV Vendors can jointly discuss program, policy, and operational improvements.

During the pre-event workshop, attendees will have the opportunity to hear updates about the current state of EVV in states across the country, learn about the latest CMS actions and priorities regarding EVV, identify promising practices and areas of concern, and discuss opportunities for collaborative problem-solving to improve state policy, provider experience, and service-delivery.

Learn more and register.

  Educational Opportunities

Upcoming MHCA Events - Register Today!

On-Demand Opportunities

Click on the logos below for a list of courses offered!

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Minnesota Home Care Association
P: 651.635.0607  |  F: 651.635.0043  |  www.mnhomecare.org  |  membership@mnhomecare.org

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Mission: MHCA represents and supports Minnesota home care providers committed to high quality home care services.
Vision: MHCA will shape the home care landscape to improve and sustain quality home care services.