We have heard from our members that navigating today’s complex regulatory environment can be difficult and time-consuming for home care agencies. To support members in meeting compliance requirements and improving quality outcomes, MHCA is announcing a new Regulatory Consulting Program designed to provide members with customized, corrective support to strengthen compliance and survey readiness.

This program offers targeted consulting services in three key areas: chart audit review, QAPI audit review, and mock surveys for Medicare and comprehensively licensed agencies. See the chart on our website for further details on each option and to register.

The Minnesota Home Care Foundation is excited to offer a new scholarship program to support home care professionals in direct care, clinical, and administrative roles through continuing education and certification.

Eligible applicants must work for an MHCA-member agency and be in a role that is in the line of nursing, physical therapy, occupational therapy, speech therapy, social work, and/or administration. The scholarship provides up to $200 per course, with a maximum of three awards per agency each year.

Applications are accepted on a rolling basis and reviewed during the second week of:

• March (due March 1)

• June (due June 1)

• September (due September 1)

• December (due December 1)

Applicants will be notified of approval, and payments will be mailed by the 20th of the review month, with funds awarded to employers upon course completion.

For more information and to apply, click here.

Having trouble finding and keeping caregivers? Supply and demand are age-old issues in any industry, but one of the most significant issues in home care right now. Break free from siloed approaches and look at the caregiver lifecycle holistically to find and retain caregivers.

Register here.

On January 15 attendees will learn how to:

• Explore how emerging AI technologies are transforming leadership, operations, and workforce dynamics.

• Identify practical approaches to harness AI for innovation, efficiency, and organizational performance.

• Gain insights into the latest compliance and workforce regulations affecting the home-based care industry, including legal guidance on the use of AI tools in clinical environments, HIPAA obligations, PHI protection, and limitations on what staff may input into  ChatGPT.

• Develop leadership practices that balance technological advancement with ethical, legal, and human considerations.

Register here.

On January 22 attendees will learn how to:

1. Identify all elements that are used to calculate the PDGM HIPPS codes for payment.

2. Detail the elements that are used in the HHVBP Total Performance Score (TPS) and how the Linear Exchange Function (LEF) is used to calculate the impact on future Medicare payments.

3. Review the measures in the HHCAHPS model that impact the HHCAHPS Star Ratings and impact the calculation of HHVBP and therefore impact payment.

4. Outline the requirements of the HHQRP and how noncompliance will create a 2% decrease in future payments.

Register here.

Introducing our new Resource of the Month highlight that will be a new addition to the Informer in 2026 to help remind providers of the resources you receive with membership. This month we have our listservs!

MHCA’s listservs are a valuable resource for home care agencies, providing a trusted space to ask questions, share experiences, and learn from peers facing similar challenges. Our six listservs offer timely insights on regulatory changes and best practices by other home care professionals. MHCA prioritizes connection and collaboration, and we want our listservs to help agencies reduce isolation, stay informed, and make more confident decisions in an ever-changing home care environment.

Click here to access our listservs!

We are aware there are significant concerns regarding the prepayment reviews, which started recently. When DHS indicated that they didn’t expect much of an impact, we understood that agencies would see minimal delays from what they experience today. What we have discovered is that they were referencing the legal requirement to process clean claims within 30 days and complex claims within 90 days. They did not take into consideration what their actual practice has been; therefore, providers are experiencing unexpected and significant delays in payments.

MHCA appreciates members stepping up to join our advocacy efforts, as we sought relief for providers and continued services for clients. The urgency of the situation was heard! DHS is under significant pressure from the federal government who continues to threaten holding funds for the 14 targeted programs and they are navigating a difficult path that avoids federal intervention and discontinued funding while trying to ensure services are provided.

MHCA and a few stakeholders met with DHS leaders this morning. We were informed that a memo would be released today regarding a payment schedule, that has been accelerated in response to our petitions. It is our understanding that providers will receive 2 payments in January and following payments will return to a bi-weekly rhythm. Watch your in-boxes for that DHS memo!

It’s important to note that some flagged claims will be withheld going forward. These potential red flags don't necessarily mean there’s anything wrong, but it means that the state will need to request addition information. DHS is looking at concerning trends, like a spike in service that doesn’t make sense, an escalation in billing, and missing elements in the claim. DHS indicated that they will share further information on their analytics, noting that it varies by program.

In the meantime, MHCA recommends that providers proceed with extreme caution and attention to detail with claims, in an effort to minimize red flags. If there are service gap concerns in the meantime, please work with the lead agencies and MCO’s, as appropriate. DHS stated this morning that they are working with those entities.

The stakeholders and DHS have agreed to partner and improve communication going forward, for which we are grateful.

MHCA is also aware that providers have many questions and are anxious about if, and when, they’ll receive payment from  UCare for 2025 services and for the few UCare  programs that still exist in 2026. MHCA is in communication with the company tasked with managing the  UCare assets and administering them. We are awaiting further information on the reimbursement timing and process for the 2025 claims and will update members when we have more information.

DHS has confirmed that the 2026 claims will be processed through UCare Community Health Plan, which was acquired by Medica. These claims should be processed as normal and will not be impacted by the receivership. It’s possible that Medica will change the name going forward.

MHCA will continue to advocate for funds to be made available to home care agencies, to ensure client services continue. In the meantime, it would help MHCA’s advocacy efforts to know if you are awaiting claims payments from  UCare and for what year, the percent of your agency’s revenue that was from  UCare  in 2025, and when you expect to further action, such as staff layoffs, client discharges will be required. MHCA will aggregate this information to ensure confidentiality. Please send that to pduncan@mnhomecare.org.

Click here to read more information on this issue.

During the 2025 Minnesota Legislative Session, the Minnesota Legislature enacted a provision requiring MHCP providers that use electronic medical records to grant SMRT access to those records to help streamline disability determinations. Key details and next steps regarding this change are linked here, in a newsletter from DHS.

New tiered minimum wages are planned for 2026 for Personal Care Assistance (PCA) Choice and Community First Services and Supports (CFSS) budget model workers. 

Minnesota has not yet received federal approval; therefore, PCA Choice agencies and financial management services (FMS) providers are not required to implement the tiered schedule 2 wages until federal approval is granted.

MHCA will keep members updated if this change is approved.

Medica AccessAbility  Solution® Enhanced,  Medica’s integrated Medicare and Medicaid plan, will no longer be available as a health plan option for Special Needs  BasicCare (SNBC) members in any county beginning January 1, 2026.

For further details, click here.

The Minnesota Department of Health (MDH) will receive more than $193 million to support rural health care across the state.

The funding will be used for strategic investments in new technology tools that bring care closer to home for rural residents; improve outcomes for Minnesotans with or at risk of developing cardiovascular disease, diabetes, and chronic kidney disease; and expand the rural health care workforce through education and training pathways. The funding will also enhance technology-enabled care delivery, including mobile and community-based services, strengthen provider partnerships, and improve the financial stability of rural providers through targeted investments in technology and data infrastructure.

Additional details are available on MDH’s Rural Health Transformation Program website. MHCA will continue to engage with the state and keep you informed on how home care services can benefit from this funding.