News & Press

MDH Announces New Fines

Wed, 19 Jun 2019 19:33:11 GMT

A new temporary maltreatment compensation fund has been established as part of the Comprehensive Home Care Law, effective July 1, 2019. This special revenue account will expire July 31, 2021 when the Assisted Living Licensure becomes law.

MHCA has been in communication with the Department of Health with clarification questions and will share more information as it becomes available.

We can confirm the following fines:

1. New Fine: temporary licensees who fail to notify the commissioner within five days of beginning to serve clients will now be fined $1000. This fine was effective upon enactment of the Elder Care and Vulnerable Adult Protection Act of 2019 in May.

2. Increased Fines: fines for level 2 through 4 violations will increase, with immediate fine imposition for both surveys and investigations.

3. New Fines: a fine of $1,000 will be imposed for licensees found responsible for maltreatment. A fine of $5,000 may be imposed if the commissioner determines the licensee is responsible for maltreatment consisting of sexual assault, death, or abuse resulting in serious injury. When a fine is assessed for substantiated maltreatment, the commissioner shall not also impose an immediate fine for the same circumstance.

Fines collected for substantiated maltreatment violations will be deposited in a dedicated special revenue account and appropriated to the commissioner to provide compensation to clients subject to maltreatment. A client may choose to receive compensation from this fund, not to exceed $5,000 for each substantiated finding of maltreatment, or take civil action. Nothing in this new law affects the rights available to clients under current law or prevents a client from filing a maltreatment report in the future.

Wage Theft in Minnesota

Wed, 27 Mar 2019 18:28:11 GMT

Most Minnesota employers want to comply with the law and correctly pay their employees for the work they perform. When an employer fails to pay its workers all wages earned, their workers may report a wage-theft violation to the Department of Labor and Industry (DLI). The DLI is committed to assisting employers that want to pay their workers correctly. Below are some compliance tips to avoid committing wage theft.

Pay your employees the applicable state minimum wage. Minnesota's 2019 minimum-wage rates are $9.86 an hour for large employers and $8.04 an hour for small employers. For additional details about the state's
minimum-wage rates, visit www.dli.mn.gov/business/employment-practices/minimum-wage-minnesota. New rates take effect Jan. 1 each year. Employers operating in Minneapolis or St. Paul should understand the requirements of the minimum-wage ordinances in those cities.
Pay your employees for all hours worked. Employees must be paid for employer-required training and for time needed to prepare to perform work, such as restocking supplies and performing safety checks. If you require employees to meet at a centralized location before driving to a worksite, pay the employee for the drive-time from the location to the worksite. Employers cannot require employees to remain at work and "punch in" only when it gets busy, "punching out" when business gets slow.
Pay your hourly employees for overtime. Federal law requires most hourly employees to receive overtime after working 40 hours in a workweek. Some employees are exempt from this requirement, but still need to be paid overtime after 48 hours in a workweek under Minnesota law.
Pay your employees at least every 31 days, on a regularly scheduled payday that they are notified of in advance.
Do not misclassify employees as independent contractors. Such misclassification not only adversely impacts employees, it also creates a competitive disadvantage for employers that comply with state laws related to workers' compensation, unemployment insurance and tax withholding.
Do not take unlawful deductions from your employees' paychecks. Deductions that generally cannot be made include: property loss or damage; cash shortages; and tool or uniform expenses.

Resources

Visit DLI's Employment Practices webpage at ww w.dli.mn.gov/business/employment-practices for information about child labor, minimum wage, nursing mother accommodations, overtime, parental leave, payroll recordkeeping and tip regulations, plus other important labor standards issues.
Contact DLI if you have any questions. DLI's Labor Standards is available from 7:30 a.m. to 6 p.m., Monday through Friday, at 651-284-5075 and dli.laborstandards@state.mn.us.
Invite Labor Standards to meet with your company or business association. They meet with businesses, nonprofits and others to explain Minnesota labor standards law.

Families and Children Managed Care Contract Changes Jan 1st

Wed, 21 Nov 2018 11:29:00 GMT

Beginning Jan. 1, 2019, all personal care assistance (PCA) and home care nursing (HCN) services for people under age 65 will be covered under fee-for-service (FFS). Members will continue to be enrolled in the MCO they were enrolled in, but managed care organization (MCO) contracts for Minnesota Health Care Programs (MHCP) members under age 65 will no longer cover PCA and HCN. MHCP will cover the services on a FFS basis beginning Jan. 1, 2019.

Counties or tribes are responsible for annual assessments for service agreements that ended on Dec. 31, 2018, and after. Provider agencies should submit a Referral for Reassessment for PCA Services (DHS-3244P) to the member’s tribe or county of residence 60 days before the end date of a service agreement.

MCOs are responsible for annual assessments for existing service agreements with an end date on or before Dec. 30, 2018. Follow the usual procedures for annual assessment requests from MCOs for service agreements that end on or before Dec. 30, 2018. If the MCO approved a service agreement based on its last assessment with an end date that is on or after Jan. 1, 2019, it will be valid for the length of the agreement.

PCA service agreements
If a PCA provider does not receive a service agreement to continue services before Dec. 31, 2018, fax the PCA Technical Change Request (DHS-4074A) and a copy of the MCO service agreement to the Disability Services Division (DSD) Resource Center at 651-431-7447. State in the “Additional Information” section “for MCO transition.”

Home care nursing service agreements
Home care nursing (HCN) service agreements will transition to the usual FFS process through the medical review agent, KEPRO, as described in the Authorization section of the MHCP Provider Manual. HCN providers will continue to assess for HCN services. If an HCN provider does not receive a service agreement to continue services by Dec. 31, 2018, submit the Home Care Technical Change Request (DHS-4074) and a copy of the MCO service agreement through MN–ITS or the KEPRO portal. State in the “Additional Information/Treatment Plan” section “for MCO transition.”

Changes do not affect other health care services
Under this contract change, members will continue to be enrolled in the MCO they were enrolled in and the MCO will continue to pay for their other health care services.

The contract change does not apply to the two options for seniors (age 65 and over): Minnesota Senior Health Options (MSHO) or Minnesota Senior Care+ (MSC+). MSHO and MSC+ MCOs will continue to authorize and pay for PCA and HCN services. (pub. 11/16/18)

Click here for more information.

Electronic Visit Verification

Wed, 21 Mar 2018 04:03:27 GMT

Electronic Visit Verification

The federal government has required that every state have an Electronic Visit Verification (EVV) system in place by January 1, 2019 for personal care services and by January 1, 2023 of home health care services. The federal government will penalize each state that does not comply .25% on the federal match on Medical Assistance for these services increasing to 1% over time. This penalty is likely to be passed on to providers through rate reductions if imposed. The MHCA supported legislation during the 2017 legislative session to insure Minnesota’s compliance and to minimize the financial burden on providers and to prevent the disruption of care to clients. The expectation was that after gaining stakeholder input during 2017, that Governor Dayton would include in his 2018 supplemental budget an EVV proposal that would comply with the federal law, minimize provider costs, and prevent a disruption in client services. Unfortunately, the Governor did not include such a proposal in his budget. This is alarming because the primary option that the state now has to comply with federal law under existing appropriations is to mandate that providers use an EVV system that is not operated or funded by the state at the expense of the providers. The alternative is to not be compliant which would result in a penalty likely passed on in reduced provider rates. The MHCA is not supportive of the federal EVV mandate. However, given its reality and the potential negative impact that inaction on the state level will have on providers, the MHCA is actively engaging the legislature to address the EVV mandate in a way that will minimize the financial burden on providers and to prevent the disruption of care to clients.

Capitol Happenings

Wed, 21 Mar 2018 03:59:32 GMT

Capitol Happenings

All three MHCA priority issues have seen movement at the Capitol. The bill which would set a new Start of Care (SOC) reimbursement rate has been introduced and referred to the Senate Health and Human Services Finance and Policy Committee and the House Health and Human Services Reform Committee. The legislation which would require agencies to be notified if a client to be served is a registered predatory offender has been heard in the House Health and Human Services Reform Committee and is scheduled to be heard in the House Public Safety Committee. The “licensure” bill, which would update the complex state home health rules and regulations, has been heard in the Senate Human Services Reform committee and was laid over as we await a fiscal note, and has been heard in the House Health and Human Services Reform Committee and was passed on to the House Health and Human Services Finance Committee where it is scheduled to be heard Thursday.

Other issues we are tracking:
- Several bills related to elder abuse, that include modifications of regulations and Bill of Rights, the establishment working groups and allowance of electronic monitoring
- Creation of Complex PCA Category and Payment
- Raising of the Medical Assistance Spenddown Income and Asset Limits
- Nurse Licensure Compact, allowing nurses from other states and US Territories to work in MN. This is of particular importance in light of the workforce shortage challenges.
-Governor’s proposal to increase rates for personal care assistance and self-directed programs by 1.69% effective July 1, 2018

New Commissioner of Health Appointed

Tue, 6 Feb 2018 20:09:32 GMT

Governor Mark Dayton has appointed Jan Malcolm to lead the state Health Department. Malcolm previously led the department under Governor Jesse Ventura from 1999 to 2003 and succeeds Acting Commissioner Dan Pollock, who has served in the role since Dec. 19.

“Jan Malcolm brings exceptional experience in public and non-profit health management to the Minnesota Department of Health,” said Governor Dayton. “Her expertise will be invaluable as the Department works to protect and improve the health of all Minnesotans, especially our seniors. I thank her for her willingness to undertake this vitally important challenge.”

Malcolm is currently an adjunct faculty member at the University of Minnesota School of Public Health, where she co-directs a national research and leadership development program funded by the Robert Wood Johnson Foundation. Previously, Malcolm helped develop initiatives to strengthen the nation’s public health system as a senior program officer at the Robert Wood Johnson Foundation, served as CEO of the Courage Center and as President of the Courage Kenny Foundation following the merger of Courage Center and the Sister Kenny Rehabilitation Institute. She has also worked as Vice President of Public Affairs and Philanthropy at Allina Health.

Commissioner Ehlinger Resigns from MDH

Wed, 20 Dec 2017 16:17:24 GMT

Minnesota Department of Health Commissioner Edward Ehlinger, M.D. resigned Tuesday. The move comes after a five-part Star Tribune series reported that there was mishandling of elder abuse in senior care facilities.

Ehlinger came to the Health Department in 2011 as a respected advocate for public health after several years running the University of Minnesota student health service. In his six years as commissioner, the agency placed new emphasis on reducing racial and economic health disparities across Minnesota and rolled out innovative projects to improve public health through preventive care, diet, fitness and other wellness activities.

“Serving as Minnesota’s Health Commissioner has been a tremendous honor and the pinnacle of my public health career that has been devoted to helping improve the health and well-being of my community,” said Dr. Ehlinger. “I am thankful to Governor Dayton for this opportunity to serve, and grateful to the many tremendous public health professionals at the Department for the work they do every day to improve the lives of Minnesotans. I am proud of the work we have done to make our state healthier, for all of us.”

In a statement released on Tuesday, Governor Dayton said he was grateful to Commissioner Ehlinger for his many years of dedicated service.

Deputy Commissioner Dan Pollock will serve as acting Commissioner until a permanent replacement is appointed by Governor Dayton. Pollock expressed his strong commitment to immediately advancing MDH’s efforts to improve its management of maltreatment investigations.

Although these recent reports focused on residential care, MHCA will continue to work with MDH on home care licensing and regulatory issues, including quality of care.

Help Preserve the Promise of Medicaid

Wed, 20 Dec 2017 15:29:37 GMT

This Is Medicaid is a coalition of nonprofit organizations from across Minnesota working to protect Medicaid from harmful changes and funding cuts. The coalition is asking for your help to ensure Congress receives a strong message of how critical Medicaid is to clients.

Medicaid was established in 1965 along with Medicare as an entitlement (if you quality, you receive it). As a whole, Medicare pays for the care of 1 in 5 Minnesotans: Older Minnesotans, low income adults, people with disabilities, children and families?

In 2017, there has been talk of repealing Medicaid. The implications would end Minnesota’s Medicaid Expansion, impacting 200,000 Minnesotans. The state would then be forced to choose: provide fewer services, cover fewer people, reduce rates, draw funds from other state programs, or raise taxes.

The coalition has been cultivating new champions in Congress. They have built a strong rapid response system nationally and activists were quickly activated when the Graham-Cassidy bill started gaining steam.

This is Medicaid is asking for your support to help preserve the promise of Medicaid today! Make sure your U.S. Senators and U.S. Representatives keep hearing from you and consider volunteering on their phone banks to share the message of how critical Medicaid is to your clients. Ask that our congressional delegation oppose any legislation that would include block grants, cap or cut Medicaid or reduce it to pay for tax cuts.

Visit www.thisismedicaid.org to sign up for emails and take the ‘Pledge to Protect Medicaid.’

Follow them on twitter @ThisIsMedicaid and like them on Facebook.com/ThisIsMedicaid

Q&A With the Department of Human Services

Tue, 14 Nov 2017 19:01:41 GMT

Q: Should providers that provide services to MHCP members enroll all of their locations?

A: MDH started requiring enrollment for all locations when they implemented the screening requirements. At this point, new agencies coming in must enroll all locations. They would then provide and bill the services from those locations.

However, for the current existing providers, although they can move forward with submitting the requests for the new locations, DHS had suggested they hold off until it was announced to all. And if they did enroll those locations, they should continue submitting claims and obtaining the authorizations through the original agency, until future notice. The reason we had suggested they hold off is because we wanted to provide a tool that will make transitions service authorization easier and help to ensure all of the PCA applications are approved as appropriate.

Answer provided by Danielle Bean, Manager - Claims, Provider Enrollment & Operations Data Integrity, Member and Provider Services, DHS

Face to Face Encounter Requirements

Wed, 7 Jun 2017 04:08:28 GMT

Legislation passed as part of the Health and Human Services Omnibus Finance bill contains specific direction for the state in coming into compliance with this new federal mandate. The language states that a face-to-face encounter by a qualifying provider must be completed for all home health services regardless of the need for prior authorization, except when providing a one-time perinatal visit by skilled nursing. The face-to-face encounter may occur through telemedicine as defined in statute. The encounter must be related to the primary reason the recipient requires home health services and must occur within the 90 days before or the 30 days after the start of services. The face-to-face encounter may be conducted by one of the following practitioners, licensed in Minnesota: (1) a physician;(2) a nurse practitioner or clinical nurse specialist;(3) a certified nurse midwife; or(4) a physician assistant. The allowed nonphysician practitioner performing the face-to-face encounter must communicate the clinical findings of that face-to-face encounter to the ordering physician. Those clinical findings must be incorporated into a written or electronic document included in the recipient's medical record. To assure clinical correlation between the face-to-face encounter and the associated home health services, the physician responsible for ordering the services must:(1) document that the face-to-face encounter, which is related to the primary reason the recipient requires home health services, occurred within the required time period; and (2) indicate the practitioner who conducted the encounter and the date of the encounter. For home health services requiring authorization, including prior authorization, home health agencies must retain the qualifying documentation of a face-to-face encounter as part of the recipient health service record, and submit the qualifying documentation to the Commissioner or the Commissioner's designee upon request.

State Requires Additional Training

Tue, 16 May 2017 20:11:17 GMT

MHCA has been in dialogue with MDH for several months on the interpretation of the HWS statute 144.D effective January 2016 that requires additional dementia training. Existing dementia training requirements for all home care providers can be found at MN Statute 144A.4796 at the end of the document.

It has been MHCA’s understanding the provider that has been named as the ‘arranged’ home care provider of the registered HWS establishment is required to be in compliance with additional hours of dementia training for staff (and their supervisors) that have direct contact with the client. (Dementia training is also required for the HWS staff that have direct contact with the client including housekeeping, maintenance, and dietary staff).

It has come to our attention that MDH is interpreting the statute to include all licensed and certified home care agencies providing services within a registered HWS that markets or advertises themselves as offering ‘assisted living’ or ‘memory care’ to be included in the statutory requirements. This means agencies found not to be in compliance at the time of survey will be cited and a fine of $200 per employee reviewed if the required dementia training has not been completed. Prior to imposing the fine, the commissioner must allow two weeks for staff to complete the required training.

In short, MDH’s interpretation is that all new employees (including contracted staff) hired after January 1, 2016 must have a minimum of 4 or 8 hours of dementia training within either 120 or 160 days of work. Ongoing, each employee providing service to an individual in these settings must have 2 hours of annual training based on the employee’s date of hire. Employees that have been hired prior to January 1, 2016 must have 2 hours of dementia training on an annual basis.

Reference: MN Revisor

MHCA will continue active dialogue with MDH to discuss the intent and interpretation of the current statute.

MDH Announces Provider Teleconference

Mon, 17 Apr 2017 21:54:12 GMT

Join the Minnesota Department of Health (MDH) Home Care and Assisted Living Program staff for our first provider teleconference: Home Care Matters

Thursday, May 4, 2017
10:00 – 11:30 am

The purpose of the teleconference is to give providers across the state an
opportunity to:
• Hear from MDH about regulatory issues
• Ask questions of MDH representatives
• Have a discussion about issues affecting home care in Minnesota

Mark your calendars and watch for registration information in the near future.

For more information, contact MDH at health.homecare@state.mn.us or (651) 201-5273.

FREE Foundations in Privacy Toolkit Now Available

Fri, 31 Mar 2017 21:56:07 GMT

FREE Foundations in Privacy Toolkit now available

MN Dept. of Health (MDH) announced that Gray Plant Mooty (GPM), a MN law firm, has developed a “Foundations in Privacy Toolkit” to help address many of the common legal and operational challenges of exchanging patient health information amongst different providers in Minnesota. MDH funded GPM’s project to analyze legal barriers and develop the toolkit. The toolkit and other health information privacy resources are available here: http://www.health.state.mn.us/e-health/privacy/index.html.

The toolkit contains the following types of material, organized by subject area:

· Template policies and procedures

· Template agreements

· Flow charts

· Checklists

The policy and procedure documents are available in multiple formats that can be customized and implemented as part of an organization’s privacy compliance efforts. The flow charts and checklists can be used to analyze business relationships and unique disclosure situations, the template agreements can be used to guide negotiations and simplify execution, and all the documents can be used in workforce training.

Gray Plant Mooty also has the following webinar trainings available:

The Foundations in Privacy Toolkit (recorded February 17, 2017) (play webinar)

HIPAA Breach Analysis (recorded March 14, 2017) (play webinar)

Legislative Highlights

Tue, 7 Mar 2017 03:00:19 GMT

Raising the Medical Assistance Spenddown Income and Asset Limits *MHCA PRIORITY ISSUE*
Overview: This bill raises the asset limits for individuals and couples accessing Medical Assistance to $10,000 for an individual (current law is $3,000) and $18,000 for a couple (current law is $6,000). The bill was passed on to the House HHS Finance Committee and heard in the Senate Human Services Reform Committee and was laid on the table for further discussion once a fiscal note becomes available.

Best Life Alliance Bill to Raise Wages for Direct Support Professionals *MHCA PRIORITY ISSUE*
Overview: The bill requests a 4% rate increase effective July 1st, 2017 and a 4% rate increase effective July 1st 2018.
This bill has travelled through policy committee hearings in both bodies and is waiting to be heard in finance committees in both bodies. A fact sheet about the bill that can be shared with legislators and others can be found here.

Modifications to the Hospice Bill of Rights
Overview: This bill modifies the hospice bill of rights by requiring that hospice agencies provide patients with a 30 day notice when they are discharging patients. MHCA is working in collaboration with the MN Network of Hospice and Palliative Care to address concerns with this bill.

MA Face to Face Legislation
MHCA has included language around the requirements of this subdivision only apply to fee-for-service medical assistance. Managed care plans and county-based purchasing plans must not require face-to-face encounter requirements for home health services provided under medical assistance managed care.

Electronic Visit Verification
Overview: This is the bill that directs the state to move forward with developing an electronic visit verification system for PCA and CFSS to be in compliance with new federal regulations. The bill directs DHS to bring together a stakeholder group to help produce a report with recommendations for how to move forward by January of 2018. MHCA Executive Director Kathy Messerli will be testifying at a hearing in the House HHS Reform Committee today (3/7).

Hearing Loss Care Requirements
MHCA leadership and Kevin Goodno have been in communications with the proponents of this bill. Due to these communications, the bill was changed to make the training optional, although MHCA will still be communicating with the bill authors that we feel the language is not necessary due to training and resources already in place and noting our strong concern about the growing list of trainings on various disabilities or illnesses and the precedent this sets given that this list could grow endlessly.

Complex Pediatric Home Care Nursing Definition and Rate
This bill, which MHCA is supporting, was heard on 2/9 in the House HHS Policy Committee and was passed on to the House HHS Finance Committee, where it was heard on 3/1 and laid over for possible inclusion in the committee's omnibus bill.

Creation of Certified Paraprofessional
This bill has been “laid on the table” to allow time to see if a compromise can be found in the coming weeks. MHCA will continue to monitor this bill.

Have You Transitioned to NETStudy 2.0 Yet?

Mon, 6 Feb 2017 19:38:18 GMT

If Not, Take Action This Month!

Access to the Department of Human Services (DHS) original NETStudy portal will be transitioned to “view only” effective February 28, 2017. This means that all background study requests for affected providers must be submitted through NETStudy 2.0 beginning March 1, 2017 (unless noted below). The Department of Human Services has provided MHCA with the following update.

NOTE: This notice does not apply to entities that submit background studies required for adoptions, guardians, guardians ad litem, Tribal governments and authorities under contract with DHS, and for providers that received an exception in 2016 to delay their transition.

The transition to NETStudy 2.0 began in December 2015. Providers who are required to transition to NETStudy 2.0 have been contacted to set up accounts in the new system, except for a small group for whom DHS has incomplete or inaccurate email addresses, including tier one home and community-based service providers. Email addresses are needed for DHS to send the onboarding tool. A list of entities that have not completed onboarding is posted on the background study web page for you to check. The list specifies the action needed by the entity to complete the onboarding process. The list and instructions can be found on the background studies web page under the Entities that need to onboard – Act Now section.

If you are not currently using NETStudy 2.0 but have access to submit background study requests, please begin entering all background study requests in NETStudy 2.0 immediately. If you receive email notices of background study technical assistance calls, you have a NETStudy 2.0 account.

Daily technical assistance Web Ex calls will continue through February 2017. More information and training materials are available on the background study web page under the Implementation and training section, including an onboarding manual, a comprehensive NETStudy 2.0 user manual, a quick start guide, and a series of YouTube videos that demonstrate key parts of the NETStudy 2.0 system.