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Service Verification Requirement for PCA Providers

New Service Verification Requirement for PCA Providers Effective August 1st

On August 1, a new requirement takes affect that mandates service verification of PCA services (256B.0705 Sec. 53 Subd 2). PCA providers are now required to make random, unscheduled telephone calls for the purpose of verifying that the individual PCA is present at the location where PCA services are being provided and is providing services. 

The new law states, agencies that submit claims for reimbursement for PCA services, must develop and implement administrative policies and procedures by which the agency verifies the services provided by a PCA. If more than one PCA provides services to a single service recipient, the agency must conduct a service verification for each PCA providing service.

 

What is Required?
For each service recipient, the agency must conduct at least one service verification every 90 days.
Service verifications must occur on an ongoing basis while the agency provides PCA services to the recipient.
During service verification, the agency must speak with both the PCA and the service recipient or recipient's authorized representative. 
An agency must fully document service verifications in a legible manner and must maintain the documentation on site for at least five years from the date of documentation.

 

For each service verification, documentation must include: 
The names and signatures (signatures are only required if the verification is done in person) of the service recipient or recipient's authorized representative, the PCA and any other agency staff present with the PCA during the service verification and the staff person conducting the service verification; the start and end time, day, month, and year of the service verification; and the corresponding PCA time sheet for the time period when the service verification was conducted.

 

The MN Office of the Inspector General may grant a variance to the service verification requirements if an agency uses an electronic monitoring system or other methods that verify a PCA is present at the location where services are provided and is providing services according to the prescribed schedule. 

 

An agency may substitute a visit by a qualified professional. Only qualified professional service verifications are eligible for reimbursement under section 256B.0659, Subd 14 or 19

MINNESOTA HOME CARE ASSOCIATION

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