Opioid prescribing reports
Minnesota law requires the Department of Human Services to provide individualized opioid prescribing reports to all health care providers who prescribed opioids for pain management and treat people enrolled in MinnesotaCare or Medicaid, also called Medical Assistance in Minnesota. This includes health care providers who only care for Medicaid and MinnesotaCare members enrolled in a managed care organization.
The opioid prescribing reports compare prescribers' opioid prescribing rates to the average rates of their peers in their specialty. The reports do not identify any individuals or groups. The data provided in the reports is from Medicaid and MinnesotaCare administrative claims data — the reports do not use data from the Prescription Drug Monitoring Program. The goal of sharing this data with providers is to support quality improvement.
Access your report
Providers who prescribed at least one opioid analgesic in an outpatient setting to a Medicaid or MinnesotaCare member in the measurement year will receive a report. Specific opioid formulation exclusions apply.
DHS will send the first individual prescribing reports in summer 2019 to your MN—ITS mailbox. To access your report, you must register for a MN—ITS mailbox. MN—ITS is the free, web-based HIPPA-compliant system DHS uses for electronic billing and communication with providers. This is not the same system that individuals use to purchase health insurance in the MNsure marketplace.
Enrolled providers receive a customized MN—ITS registration letter with an initial user ID and password. DHS will send MN—ITS registration letters to all opioid-prescribing providers who do not currently have a MN—ITS account via U.S. Postal Service in May and June 2019. DHS will send the opioid prescribing reports to providers who register their MN—ITS mailboxes. There will be two phases of report dissemination and updates will be provided through the Provider News website and on this website.
Providers who serve only Medicaid and MinnesotaCare members enrolled in managed care will not receive MN—ITS registration letters. Your reports will be sent via the U.S. Postal Service for year one. Providers who do not register for a MN—ITS mailbox will also receive their reports via the U.S. Postal Service.
Contact the MHCP Provider Call Center at 651-431-2700 or 800-366-5411 for questions about your MN—ITS mailbox or if you do not receive your MN—ITS registration letter.
Training on how to access the MN—ITS mailbox is available. Contact the MHCP Provider Call Center with specific questions about how to access your report at 651-431-2700 or 800-366-5411. The specific steps for accessing your report:
- Receive MN—ITS Registration Welcome Letter from DHS via U.S. Postal Service (sent to credentialing address on file)
- Enter username and temporary password from welcome letter on the MN—ITS Home page.
- Enter your contact information and register your MN—ITS account (new user)
- Read and agree to EDI Trading Partner Addendum
- Print or save a copy of your registration summary
- Use permanent username and password to login to mailbox
- Under your username is a link to your mailbox (upper left side of screen)
- Click “Miscellaneous Received” folder
- Opioid Prescribing Reports will be in the PRVLTR File Type
- The File Type area is blank until the Opioid Prescribing Reports are loaded
- Search start and end date are modifiable to look for documents loaded more than 30 days ago
- Opioid Prescribing Reports file name is: Your NPI Number_PvrLtr_Date_OpioidReport
- “Your NPI Number” is your National Provider Identified (NPI) Number
- “Date” is the date that DHS ran the opioid prescribing report
- Click “File” and “Open”
- Download file to your computer
The first set of reports use 2018 prescribing data. The data in each report is from Medicaid and MinnesotaCare administrative claims data. This means that only data on your Medicaid and MinnesotaCare patients will be included in the reports.
Patients included in the reports
The opioid prescribing reports exclude individuals who received a cancer diagnosis or treatment in the measurement year and individuals receiving hospice or palliative services. Patients receiving medication-assisted treatment for Opioid Use Disorder are also excluded from the prescribing reports.
All other Medicaid and MinnesotaCare members are included, including children, individuals with both Medicaid and Medicare coverage, and members for whom DHS receives a pharmacy claim.
The reports compare providers’ metrics to the average rates within their specialty group. DHS used the National Plan and Provider Enumeration System (NPPES) database to locate providers’ National Provider Identifier (NPI) primary taxonomy code. Providers are included in one of 30 specialty groups based on their NPI primary taxonomy code. DHS also reviewed provider enrollment data when a primary taxonomy code was missing.
Access the NPPES website to verify that your primary taxonomy code accurately reflects your current practice. Providers who disagree with their specialty group assignment are encouraged to change the primary taxonomy code associated with their NPI number. Alternatively, providers can update their enrollment information with DHS to change or add a specialty code associated with their provider type. DHS is also exploring options for physician assistants and advanced practice registered nurses to correctly identify their specialty practice.
DHS will not share the 2019 opioid prescribing reports with a prescriber’s practice, licensure boards or the public. In the future, DHS and the Opioid Prescribing Work Group will set parameters for disclosures to affiliated practices in accordance with Minn. Stat. 256B.0638. The statute permits the agency to notify a provider’s affiliated practice when the provider is required to participate in the quality improvement program. Public disclosure is only permitted at such time a provider is disenrolled from serving Medicaid and MinnesotaCare members.
The reports do not include any identifiable patient data or information about a specific prescription.
Quality improvement program participation
There are quality improvement thresholds for five of the seven opioid prescribing sentinel measures. Providers whose prescribing rate is above the threshold for any of the five measures will be required to participate in the quality improvement program if they also prescribed above a certain volume of opioid analgesic prescriptions to Minnesota Medicaid and MinnesotaCare enrollees in the measurement year. The reports present the comparative rates in bar graphs, and the quality improvement threshold is clearly marked in each graph. Prescribers will receive additional information about participating in the quality improvement review.
Participation in the quality improvement program is based on the follow-up set of reports, which will be released in 2020. The follow-up set of reports will provide updated data and prescribing rates reflecting the time after receipt of this first report.
Expectations of providers who must participate in the quality improvement program
DHS, the Opioid Prescribing Work Group and partners in the medical community are currently developing the quality improvement program and will identify a set of required activities — based on pain phase — that a provider would need to incorporate into their quality improvement plan. The activities will take into account different measures that are over set thresholds, provider practice types, system capacity, and existing quality improvement efforts within clinics or systems. Providers will submit their plan to DHS for review by an external body.
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