MHCP provider news and updates

In a coordinated effort to reduce fraud, waste and abuse in Minnesota’s Medicaid program, Governor Tim Walz announced on Oct. 29 a new process for Minnesota Department of Human Services (DHS) to review claims for certain Medicaid benefits and services before they are paid. Read the news release on the governor’s office Press Releases webpage.

This new “pre-payment review” process will be overseen by a third-party vendor, Optum. For 14 specific services that have been identified as high risk, Optum will verify that billed services were necessary, correctly documented and provided before DHS makes payments.

Minnesota Health Care Programs has 30 days to pay or deny clean claims (without attachments), and 90 days to pay or deny complex claims (replacement claims, Medicare crossovers, third-party liability claims, claims with information in the notes or comment fields, or claims with attachments). The DHS Commissioner has the legislative authority to suspend and perform a deeper analysis on any claims which may be potentially suspect with regard to fraud, waste or abuse. There may be payment processing delays as we roll out this new pre-payment review process. We are working with Optum on a regular interval to review any suspended claims for these 14 Medicaid services and will continue to adjudicate claims timely and efficiently without compromising needed review. DHS is not holding all submitted claims for these 14 Medicaid services for 90 days. Some submitted claims could be suspended for up to 90 days and, of course, some of these claims may be denied.

DHS recognizes that payment delays have impacts on providers, and we are committed to processing claims as quickly as possible and within the mandated timelines. We appreciate your patience as we initiate and refine our new pre-payment review process. Please continue to provide services to MHCP members and submit your claims as you normally would. We are implementing this new process for fee-for-service claims only.

Pre-payment review will be an ongoing and permanent new business process for DHS as fee-for-service claims come in and before provider payments go out. Importantly, this new safeguard will be tied to services, not provider types. 

For reference, here are the 14 high-risk benefits and services with a link to their Provider Manual sections:

1. Adult Companion Services 
2. Adult Day Services
3. Adult Rehabilitative Mental Health Services 
4. Assertive Community Treatment 
5. Community First Services and Supports 
6. Early Intensive Developmental and Behavioral Intervention 
7. Housing Stabilization Services
8. Individualized Home Supports
9. Integrated Community Supports 
10. Intensive Residential Treatment Services
11. Night Supervision Services
12. Nonemergency Medical Transportation Services 
13. Recovery Peer Support 
14. Recuperative Care

Continue to submit claims for these services based on information outlined in our MHCP Provider Manual and Community-Based Services Manual. If you have questions, contact the Provider Resource Center. (pub. 10/29/25, rev. 10/31/25)

We recommend providers check their MN–ITS mailbox regularly for important correspondence from Minnesota Health Care Programs (MHCP). MHCP delivers the following provider information electronically to each provider’s MN–ITS mailbox account. 

• Provider news and updates
• Enrollment letters
• Medical, dental and service authorization letters
• Remittance advices

Providers are required to verify member eligibility. Use MN–ITS or call the automated Eligibility Verification System at 651-431-2700 or 800-366-5411 option 1. Review the Verifying MHCP Eligibility in MN–ITS and Understanding Eligibility Results in MN–ITS videos for more information.

The Minnesota Department of Human Services has created a frequently asked questions webpage about the new pre-payment review process that Governor Walz announced on Oct. 29, 2025. Please refer to the FAQ page for the most current information about pre-payment review, and submit additional questions through the email link at the bottom of the page. (pub. 11/6/25)

Minnesota Health Care Programs (MHCP) has rescheduled the November Recuperative Care Resources and MN–ITS Training for Nov. 18, 2025. We rescheduled the original Nov. 11, 2025, date because of the Veterans Day federal holiday. The Nov. 18, 2025, training will be from 9 a.m. to 4 p.m. and held through a webinar. Refer to the Recuperative Care Resources and MN–ITS Training webpage for all training dates and to register. 

Call the MHCP Provider Resource Center at 651-431-2700 or 800-366-5411 with questions about this message. (pub. 11/5/25)

Minnesota Health Care Programs limits physical therapy visits to 14 per year and occupational therapy visits to 24 per year effective Jan. 1, 2026, unless authorization is obtained. You may request authorization using the Atrezzo Provider Portal. Atrezzo is offering training sessions during December and January for providers to learn how to register and use the Aterzzo Provider Portal. Refer to the MN UM Atrezzo Implementation - Provider Portal Training Registration webpage for more information and to register for training sessions. (pub. 11/4/25)

Minnesota Department of Human Services (DHS) received approval from Centers for Medicare & Medicaid Services for a temporary moratorium on enrolling new EIDBI providers effective, Nov. 1, 2025. DHS will not enroll any new EIDBI provider agencies during this moratorium. Any new submissions received on or after Nov. 1, 2025, will be denied. EIDBI agencies enrolled before Nov. 1, 2025, may enroll new locations. The moratorium is set to end April 30, 2026, but may be extended in six-month increments if necessary. Refer to article 6 of the Minnesota Session Laws – Chapter 9 webpage for more information. 

Call the Minnesota Health Care Programs Provider Resource Center at 651-431-2700 or 800-366-5411 if you have questions about this message. (pub. 10/31/25)

The federal Centers for Medicare and Medicaid Services approved a State Plan Amendment that will terminate Minnesota’s HSS program. The program will end Oct. 31, 2025. Oct. 31, 2025, is the last day to provide HSS services. Refer to the DHS press release for more information and resources about the end of HSS. (pub. 10/31/25)

We recently placed a memo regarding MN–ITS email and phone number validation into providers’ MN–ITS PRVLTR folder. We are aware some providers have issues opening the memo. Refer to the MN–ITS email and phone number validation (PDF) to view the memo. (pub. 10/31/25)

In November, the Minnesota Department of Human Services (DHS) is hosting online Community First Services and Supports (CFSS) information sessions for Minnesota Health Care Programs members who receive CFSS services. There are multiple dates for the sessions and each session will cover:

• CFSS basic information
• CFSS service delivery plans

These information sessions are targeted to enrolled members, but CFSS lead agencies and providers are welcome to attend. DHS encourages lead agencies and providers to share this link for CFSS information sessions with members who receive CFSS services. (pub. 10/30/25)

Beginning Jan. 1, 2026, Recovery Community Organizations and Substance Use Disorder Treatment programs will have peer recovery services reviewed by Acentra, the Minnesota Department of Human Services medical review agent. Refer to the Reviews of peer recovery support documentation to begin Jan. 1, 2026, Behavioral Health e-Memo for more information. (pub. 10/27/25)

Undocumented adults will no longer be eligible for MinnesotaCare at the end of the day on Dec. 31, 2025. Kids under age 18 will remain eligible. Visit the What if I am undocumented? webpage to learn more. 

Providers should verify the member’s eligibility for Minnesota Health Care Programs using the secure, online MN–ITS eligibility verification transaction before providing a service (or at least once per month if billing monthly or for multiple services provided in one calendar month). (pub. 10/27/25)

The Minnesota Department of Human Services (DHS) requests public comments on disability waiver plan amendments proposed for fall of 2025 before we submit them to Centers for Medicare & Medicaid Services for approval.

Submit comments to DSD.PublicComments@state.mn.us by 4 p.m. Friday, Nov. 21, 2025. 

Review the DHS requests public comments on amendments to the disability waiver plans Disability Services Division eList announcement for more information. (pub. 10/24/2025)

We have revised this message to state Minnesota Health Care Programs (MHCP) began covering emergency medicine service, procedure code G2213, effective Oct. 1, 2025. Procedure code G2213 is an add-on code billed with an evaluation and management visit to report resource costs for initiating medications for opioid use disorder in the hospital emergency department setting. 

Contact the MHCP Provider Resource Center at 651-431-2700 or 800-366-5411 if you have questions about this message. (pub. 10/23/25, rev. 10/24/25)

On July 4, 2025, President Trump signed the Federal Reconciliation Bill (H.R.1) into law. This new law brings changes to Medicaid, a federal health insurance program called Medical Assistance in Minnesota. All states must implement the changes in the law, which include additional requirements for eligibility. 

Nothing has changed yet. The first changes won’t take effect until fall 2026. This gives Minnesota Department of Human Services time to review the details, get more information from the federal government, and communicate the changes clearly to Minnesotans. 

We recently published our What the new federal budget law means for Medicaid webpage with resources and information: a timeline, details about the coming changes and how they may affect the people you serve, and a partner toolkit to help communicate clearly and accurately to impacted Medical Assistance enrollees. 

We will add more content as we get more guidance from the federal government, so check the webpage often. (pub. 10/21/25) 

Minnesota Health Care Programs (MHCP) will soon require the NPI of the ordering and prescribing pharmacist to be listed on lab, vaccine and pharmacy claims when ordered or prescribed by individual pharmacists. Individual pharmacists are required to enroll with MHCP to prevent potential billing disruptions. Refer to Pharmacy and Pharmacist Enrollment Criteria and Forms in the MHCP Provider Manual for enrollment information.

Additionally, the NPI will also be required for medications ordered or prescribed by individual pharmacists using Minnesota Board of Pharmacy approved protocols, including for HIV prophylaxis and hormonal contraceptives and prescriptions for covered over-the-counter medications.

Call the MHCP Provider Resource Center at 651-431-2700 or 800-366-5411 with questions about this message. (pub. 10/21/25)

Minnesota Department of Human Services (DHS) created a letter, text message and new webpage with information for enrollees who will lose MinnesotaCare coverage effective the end of the day, Dec. 31, 2025. These enrollees will lose coverage because they haven’t shown an immigration status. The coverage closure applies only to adults. Kids under 18 will remain eligible. Note the following timeline and link for each communication:

• Letter – We began mailing letters to affected enrollees Oct. 21, 2025.
• Text message – We will send the following message the week of Oct. 20, 2025: 
• MN Dept of Human Services: MinnesotaCare eligibility for some adults ends Dec. 31, 2025. Kids under age 18 remain eligible. Visit mn.gov/dhs/minnesotacare to learn more.
• Webpage – We published a new What if I am undocumented? webpage Oct. 21, 2025, with resources and information. 

These enrollees will also receive a system-generated Closing Notice in mid-November. (pub. 10/21/25)

The Minnesota Paid Leave program will offer payments and job protections so people can take time off work to care for themselves or their loved ones beginning Jan. 1, 2026. Refer to the Minnesota Paid Leave overview (PDF) (Hmoob | Español | Af-Soomaali) and the Employer resource toolkit webpage to learn about the program.

Employers play an important role in Paid Leave. You will help your employees access and use the program. You can start preparing now. Refer to the Employers: Prepare for Paid Leave today webpage to get your organization ready. (pub. 10/21/25)

The Minnesota Department of Human Services (DHS) offers weekly questions and answer sessions for using the Minnesota Provider Screening and Enrollment (MPSE) portal. 

The MPSE portal Q & A sessions will switch to daily MPSE technical assistance sessions, held from 1-1:30 p.m. starting November 3. The daily sessions will focus on MPSE navigation and general technical questions. The last weekly session will be held October 29, 2025.

The MPSE portal is our web-based system providers use to submit and manage their enrollment records for Minnesota Health Care Programs. 

Click the button on the MPSE portal training webpage to join the sessions. (pub. 10/20/25)

The Minnesota Legislature authorized several rates and monthly budget increases effective Jan. 1, 2026, for Alternative Care, Essential Community Supports, Elderly Waiver, disability waivers, home health services, personal care assistance, and Community First Services and Supports. Find information about the service rates and budget changes, including links to resources, rate methodologies, instructions and contacts on the Long-term services and supports rates changes webpage. (pub. 10/17/25)

HHAeXchange is hosting two training sessions to help providers meet the new electronic visit verification (EVV) compliance thresholds effective Jan. 1, 2026. These sessions are open to all providers, regardless of the EVV system they use.

Session 1: Getting Caught Up with EVV 
Reviews EVV basics and provides guidance for providers who have not started using EVV yet. The training will cover getting started with EVV, tracking the onboarding process, understanding provider identifiers and steps to integrate third-party vendors with HHAeXchange.

• Date: Oct. 23, 2025
• Time: 2:30 p.m. CST
• Registration: Link to register

Session 2: Boost Your EVV Compliance 
Offers practical tips and strategies for providers to improve EVV compliance. This training will cover compliance reporting, preparing caregivers for compliance and the Self-Service Resource review for providers who have already begun using EVV.

• Date: Nov. 5, 2025
• Time: 2 p.m. CST
• Registration: Link to register

Use the Client Support Portal to contact HHAeXchange if you have questions about these trainings. Use the DSD Contact Form to submit questions you have about this message. (pub. 10/16/25)

Effective July 1, 2025, the Minnesota Department of Human Services (DHS) must complete a pre-enrollment risk assessment of any facility or provider seeking to enroll as a recuperative care services provider (Minnesota Session Laws – 2025, 1st Special Session, Chapter 9, Article 7, Section 19).

Refer to Recuperative Care Enrollment Criteria and Forms in the Minnesota Health Care Programs (MHCP) Provider Manual for more information. 

For providers that have submitted an enrollment application, refer to the following for next steps:

• Received on or after July 1, 2025: All submitted enrollment applications
  Providers need to complete and comply with the new requirements including submitting the Recuperative Care Provider Pre-Enrollment Risk Assessment (DHS-8747) (PDF). 
• Received before July 1, 2025: Approved or completed enrollment applications (current recuperative care providers)
  Current providers will be notified when they need to submit the Recuperative Care Provider Pre-Enrollment Risk Assessment (DHS-8747). Do not submit the PERA before we notify you. 
• Received before July 1, 2025: Incomplete enrollment applications
  Providers need to complete and comply with the new requirements including submitting the Recuperative Care Provider Pre-Enrollment Risk Assessment (DHS-8747) (PDF). 

About the PERA review process:

• Allow 30 days from date of completed submission for processing your PERA.
• We may deem the potential facility or organization ineligible and deny or rescind enrollment at any time during the PERA review process. 
• We will email providers (at the email address that providers include on the PERA) a letter with the approval or denial decision. You can only start the recuperative care enrollment process after you receive the PERA approval letter.
• You can appeal in writing an ineligibility decision within 30 business days of being notified of the decision. You can find more information about this process in the emailed letter that informs you of your denied PERA. 

 Call the MHCP Provider Resource Center at 651-431-2700 or 800-366-5411 with questions about this message. (pub. 10/15/25) 

Governor Walz recently issued executive order Empowering State Agencies to Continue Combatting Fraud (PDF). It gives Minnesota Department of Human Services (DHS) authority to immediately disenroll MHCP providers who have not billed in the past 12 months. On Oct. 15, 2025, DHS will begin deactivating enrollment records with no claims activity in the past 12 months. We will notify providers of their disenrollment via U.S. mail starting Oct. 15. Providers who are disenrolled for this reason will need to reenroll if they begin providing services to a MHCP member.

Contact the MHCP Provider Resource Center at 651-431-2700 or 800-366-5411 if you have questions about this message. (pub. 10/13/25)

The Minnesota Department of Human Services (DHS) requests public comments on proposed policy changes for the Brain Injury Waiver application (PDF) before submitting the amendments to the Centers for Medicare & Medicaid Services for approval. Submit comments to DSD.PublicComments@state.mn.us by 4 p.m. Friday, Nov. 7, 2025. 

Review the DHS requests public comments on BI Waiver application Disability Services Division eList announcement for more information. (pub. 10/9/25)

The Minnesota Department of Human Services (DHS) has sent providers who attended the entire Community First Services and Supports (CFSS) Steps for Success workshop on September 17-19, 2025, their certificates of completion. 

DHS sent the certificates to the email address used to register for the September CFSS Steps for Success workshop. Providers who completed the entire training should have received their certificate by the end of the business day Oct. 9, 2025. 

Call the Minnesota Health Care Programs Provider Resource Center at 651-431-2700 or 800-366-5411 with questions about this message. (pub. 10/9/25)

Minnesota Department of Human Services announced the Housing Stabilization Services (HSS) program will end Oct. 31, 2025. Refer to the Housing Stabilization Services program to end Oct. 31 GovDelivery message we sent to the public Oct. 2, 2025, for more information.

DHS will notify members receiving HSS of this service end date via the U.S. Postal Service and text message. DHS will notify providers who only provide HSS that they are being terminated as enrolled Minnesota Health Care Programs providers via their MN–ITS mailbox or the U.S. Postal Service. (pub. 10/8/25)

Minnesota Health Care Programs (MHCP) implemented criteria for billing modifiers A1 to A5 for surgical dressings. Claims submitted with modifiers A1 to A5 will pay up to the “per wound” amount based on the modifier and limit listed on the Medical Supply Coverage Guide. 

Due to system limits of MMIS, providers must call the MHCP Provider Resource Center at 651-431-2700 or 800-366-5411 for claims submitted with modifiers A6 to A9. These modifiers require a work order via the MHCP Provider Resource Center. MHCP Provider Resource Center representatives will send claims submitted with A6 to A9 for reprocessing. 

Review the Surgical Dressings section of the MHCP Provider Manual for information on billing surgical dressings and these modifiers. Review the Medical Supply Coverage Guide for information on MHCP quantity limits. Contact the MHCP Provider Resource Center at 651-431-2700 or 800-366-5411 if you have questions about this message. (10/7/25)

DHS announces youth behavioral health webinar series for hospital support staff

The Minnesota Department of Human Services (DHS) is excited to announce the posting of our webinar-based trainings for support staff working in hospital settings, about effective care for youth experiencing a behavioral health crisis. DHS partnered with the Training Institute at People Incorporated to provide webinars that address youth behavioral health and managing challenging behaviors throughout 2024 and 2025. Recordings of those trainings are now available on the DHS YouTube channel using the following links. 

• Managing Challenging Behaviors
• Comprehensive Care Plannings
• Crisis De-escalation
• Culture and Equity Considerations
• General Pediatric Mental and Behavioral Health Conditions and Presentations
• Patient Engagement
• Building Resiliency and Self-Care
• Suicide Risk Assessment 
• Supporting Coworkers and Team
• Trauma Informed Care

(pub. 10/6/25)

The Minnesota Department of Human Services (DHS) is excited to announce the posting of our webinar-based trainings for professionals who provide mental health and substance use disorder services in school settings on topics related to effective care for youth experiencing a behavioral health crisis. DHS partnered with the Training Institute at People Incorporated to provide webinars that address youth behavioral health and managing challenging behaviors throughout 2024 and 2025. Recordings of those trainings are now available on the DHS YouTube channel using the following links. 

• Best Practices for Providing Mental Health and Addiction Services in Schools
• Professional Boundaries and Ethics
• Creating Diagnostic Formulations in IEP Assessments 
• Crisis De-escalation
• Culture and Equity Considerations
• General Pediatric Mental and Behavioral Health Conditions and Presentations
• Professional Boundaries and Ethics
• Recommendations for Managing Complex Behaviors in School Settings
• Conducting Reimbursable Behavioral Health Services
• Building Resiliency and Self-Care

(pub. 10/6/25)

Minnesota Health Care Programs (MHCP) providers who are licensed to provide substance use disorder (SUD) treatment and withdrawal management (WDM) services are required to attest to and certify each ASAM level of care they provide.

Certification is required for providers to remain eligible for payment under MHCP. It also ensures that clients have access to the full continuum of care, now including ASAM Level 2.5 (Partial Hospitalization).

What’s changing and why
We’ve streamlined and expanded the process:

• Three forms have been combined into one: Substance Use Disorder (SUD) Services and Level of Care Assurance Statement (DHS-6381) (PDF).
• Providers now only need to complete one form for both service assurance and ASAM attestation, reducing paperwork and saving time.
• ASAM Level 2.5 (Partial Hospitalization) is now required to complete the same certification process as all other ASAM levels of care.

What you need to do

• If you are a current provider already certified in your ASAM levels of care, no action is required.
• If you are a new provider or a current provider adding an ASAM level of care (including Level 2.5 Partial Hospitalization):
  • Follow certification instructions on the ASAM resources for Minnesota SUD treatment providers webpage
  • Complete the enrollment steps outlined in the SUD Services Enrollment Criteria and Forms section of the MHCP Provider Manual after Minnesota Department of Human Services approves your ASAM certification.

Email asam.dhs@state.mn.us if you have questions about this message. Refer to the Substance Use Disorder (SUD) Services Enrollment Criteria and Forms section of the MHCP Provider Manual. (pub. 10/2/25)

Minnesota Department of Human Services (DHS) will allow billing through the HHAeXchange EVV system for unit-based, fee-for-service programs effective September 2025. With HHAeXchange billing, a provider’s claim for in-scope EVV services will be automatically submitted to DHS on the provider’s behalf when all criteria are met on the visit. 

HHAeXchange billing is currently optional and providers are not required to set up billing through HHAeXchange now. Providers may continue billing through their existing processes if they choose not to use HHAeXchange’s billing system. 

Who can use billing through HHAeXchange?

• HHAeXchange Enterprise users - HHAeXchange billing is available beginning Sept. 30, 2025, for providers paying for enterprise enhancements beyond the state-sponsored EVV system.
• HHAeXchange State EVV System users - HHAeXchange billing will be available beginning December 2025 for providers using only the DHS-sponsored EVV system (without enhancements or third-party imports).

You will be required to complete billing system training from HHAeXchange before billing using the system. HHAeXchange will send registration details by email later this fall.

HHAeXchange will email providers information about the billing system in the coming weeks to the email address used to complete the HHAeXchange enrollment form. 

Use the Client Support Portal to contact HHAeXchange if you have questions about billing. Use the DSD Contact Form to submit questions you have about this message. (pub. 10/2/25)

The Minnesota Department of Human Services (DHS) is offering free and low-cost online DirectCourse classes to help Home and Community-Based Services (HCBS) licensed providers, personal care assistance and Community First Services and Supports direct support workers meet training requirements and sharpen their skills to deliver high-quality, person-centered support.

The University of Minnesota Institute on Community Integration designed a Minnesota DirectCourse Crosswalk (a series of charts that connect training requirements to training courses) to support providers in Minnesota. If a provider needs to meet a certain rule or regulation, the crosswalk will identify courses that meet the requirements. To explore how DirectCourse aligns with these training needs, review the Minnesota DirectCourse Crosswalk.

DirectCourse classes cover competency-based training for licensed providers that include:

• Training that overlaps with Minnesota DHS competencies, Centers for Medicaid & Medicare Services core competencies for the direct support workforce and 15 core competencies approved by the National Alliance of Direct Support Professionals.
• Meeting certain 245D license training requirements.
• Education on the Positive Support Rule.
• Association of Community Rehabilitation Educators and Credentialed Employment Support Professional certification. Visit the College of Employment Services page for more information on certification requirements. 

DirectCourse featured classes include:

• College of Direct Support trains direct support workers to prioritize life in the community for the people they support.
• College of Frontline Supervision, Management and Leadership trains supervisors, managers and leaders to apply best practices to support Minnesota Health Care Programs members across disability, aging, mental health and other long-term services.
• College of Employment Services trains employment professionals to support people with disabilities in achieving fulfilling, competitive and integrated employment.
• Person-Centered Counseling covers information and skills for HCBS service providers to implement person-centered planning principles and practices.

To sign up for DirectCourse classes, submit a Request for learner account form. After you submit the form, you will receive enrollment instructions via email in two to three business days.

The following organizations may set up their own account for free classes:

• Organizations that serve nine or fewer people with disabilities.
• State, county and Tribal nation employees.

Organizations that serve 10 or more people with disabilities may set up learner and administrator accounts for a fee based on the number of participants they have. For more information about prices, review the “Free and low-cost options” tab on DirectCourse online classes.

For more information, email Minnesota’s DirectCourse learning administrator. (pub. 9/30/25)

Minnesota Health Care Programs (MHCP) revised authorization requirements and coverage criteria for custom orthotics and recreational devices. 

Under the Orthoses heading of the Orthotics and Prosthetics section of the MHCP Provider Manual, we added descriptions for prefabricated, custom fitted, and custom fabricated orthoses. MHCP covers one unit of prefabricated orthotics for the spine and the hip and two units of prefabricated orthotics for lower and upper limb per each impacted extremity for purposes of everyday use and one unit for purposes of bathing per calendar year without authorization. MHCP pays for two prefabricated units per type of orthosis for extremities. For custom fitted and custom fabricated orthotics, MHCP covers one unit for the spine and hip and one unit for lower and upper limbs per each impacted extremity for purposes of everyday use and bathing without authorization. Authorization is required for recreational orthotics, excess quantities of prefabricated orthotics, and subsequent new custom orthotics if the member’s current device is less than three years old. 

Under the Repairs and Replacements heading, MHCP defined the reasonable useful lifetime (RUL) for custom orthotics or prosthetics. The usual RUL of five years for durable medical equipment does not apply to these devices. Custom fitted and custom fabricated devices are considered custom orthotics. MHCP pays for custom orthotic and initial prosthetic devices for purposes of everyday use and bathing without authorization. 

Repairs to a device now require authorization if the combined submitted charge is $1,000 or more. This change is effective Oct. 1, 2025. 

Review the Orthotics and Prosthetics section of the MHCP Provider Manual and the Medical Supply Coverage Guide for information on MHCP authorization requirements and quantity limits by HCPCS code. Contact the MHCP Provider Resource Center at 651-431-2700 or 800-366-5411 if you have questions about this message. (9/30/25)

The 2024 Legislature amended Minnesota Statutes, 245D.10, subdivision 1 to include the requirement:

A license holder must use forms provided by the commissioner to report service suspensions and service terminations under subdivisions 3 and 3a.

The Minnesota Department of Human Services (DHS) has developed standardized forms for reporting service terminations and temporary service suspensions to meet requirements in 2024 legislation. Effective immediately, Home and Community-Based Services licensed 245D providers must use the following forms to report service terminations and suspensions:

• Notice of Temporary Service Suspension (DHS-2828C) (PDF) 
• Notice of Service Termination (DHS-2828D) (PDF)

Each form includes instructions for how and when providers are required to notify DHS. 

Note: Providers must download and open the forms in Adobe Reader or Adobe Acrobat for full functionality. For more information, refer to Frequently asked questions for eDocs. 

Contact the Disability Services Division at positivesupports@state.mn.us or the 245D Licensing Help Desk at 651-431-6624. (pub. 9/26/25)

We have revised this message to clarify an individual provider must complete a new background study in NETStudy 2.0 whenever the individual provider becomes affiliated with an EIDBI agency. The Minnesota Department of Human Services (DHS) is implementing new requirements for EIDBI individual providers. 

Effective Aug. 5, 2025, EIDBI providers must have a complete DHS background study with an “eligible” or “set-aside” result before they provide services.

What providers must do

• An EIDBI individual provider must complete a new background study any time the individual provider becomes affiliated with an EIDBI agency. Any EIDBI agency enrolling, reenrolling or revalidating individual providers must include the individual’s Background Study ID or Application ID from the NETStudy 2.0 system. Submit using the Minnesota Provider Screening and Enrollment (MPSE) portal or by fax.
• If submitting in MPSE, include the Background Study ID or Application ID from the NETStudy 2.0 system in the Notes section of an Enrollment Record Request. Upload a Fee-for Service (FFS) only or FFS and Managed Care Organization In-Network Provider Agreement (DHS-4138) (PDF) and the following applicable forms:
  • Early Intensive Developmental and Behavioral Intervention (EIDBI) Qualified Supervising Professionals (QSP) Assurance Statement (DHS-7120C) (PDF)
  • Early Intensive Developmental and Behavioral Intervention (EIDBI) Level I Provider Assurance Statement (DHS-7120D) (PDF)
  • Early Intensive Developmental and Behavioral Intervention (EIDBI) Level II Provider Assurance Statement (DHS-7120E) (PDF)
  • Early Intensive Developmental and Behavioral Intervention (EIDBI) Level III Provider Assurance Statement (DHS-7120F) (PDF)
• If submitting by fax, you must enter the NETStudy 2.0 Background Study ID or Application ID in the Individual Provider Personal Profile section of the Individual Provider Enrollment Application (DHS-4016) (PDF), complete and submit the Fee-for Service (FFS) only or FFS and Managed Care Organization In-Network Provider Agreement (DHS-4138) (PDF) and the following applicable forms:
  • Early Intensive Developmental and Behavioral Intervention (EIDBI) Qualified Supervising Professionals (QSP) Assurance Statement (DHS-7120C) (PDF)
  • Early Intensive Developmental and Behavioral Intervention (EIDBI) Level I Provider Assurance Statement (DHS-7120D) (PDF)
  • Early Intensive Developmental and Behavioral Intervention (EIDBI) Level II Provider Assurance Statement (DHS-7120E) (PDF)
  • Early Intensive Developmental and Behavioral Intervention (EIDBI) Level III Provider Assurance Statement (DHS-7120F) (PDF)

Form changes

• The MHCP Individual Provider Profile Change (DHS-3535) (PDF) is no longer accepted to add EIDBI affiliations.
• Starting Aug. 5, 2025, the MHCP Individual Provider Profile Change (DHS-3535) (PDF) may only be used to:
  • End an affiliation
  • Submit a name change
  • Add a National Provider Identifier (if the provider previously had a Unique Minnesota Provider Identifier (UMPI)

Call the Minnesota Health Care Programs Provider Resource Center at 651-431-2700 or 800-366-5411 if you have questions about this message. (pub. 8/7/25, rev. 9/4/25, 9/26/25)

In January 2026, the Minnesota Department of Human Services (DHS) will review provider electronic visit verification (EVV) data to ensure EVV complies with federal and state requirements. Providers required to use EVV by the 21st Century Cures Act (PDF) must enroll with HHAeXchange regardless of their chosen EVV system or payer. Providers are required to submit all their EVV visit data through HHAeXchange, including visits that are not fully compliant. 

EVV compliance timeline

• Providers must meet at least 50 percent EVV compliance for all visits billed after Jan. 1, 2026.
• Providers must meet at least 80 percent of EVV compliance for all visits billed after July 1, 2026.

Provider responsibilities
HHAeXchange emails providers a monthly compliance report via the email HHAeXchange has on file for providers around the 25th of each month with performance data for the previous month. Providers are responsible for monitoring their EVV compliance performance for all tax IDs, national provider identifiers (NPIs) and unique Minnesota provider identifiers (UMPIs) associated with their agencies that are required to submit EVV data. 

DHS receives the same report and uses it to assess overall compliance. Providers must take action to comply with the requirements immediately. Providers who do not meet compliance thresholds will receive a notice about required corrective actions in the PRVLTR folder in their MN–ITS mailbox.

Corrective actions
A notice of corrective action may include the following: 

• an increase in the rate of compliance by a specified deadline, 
• the requirement for the provider to submit a written plan to DHS outlining how compliance will be improved, or 
• the requirement for the provider to meet with DHS to review performance and discuss next steps. 

If a provider does not respond to the notice of corrective action, or fails to make the required improvements, DHS may take additional enforcement action. This could include recovering payments that have already been issued or withholding future payments until the provider demonstrates compliance.

Providers required to use EVV can review the AASD and DSD eList announcement - EVV compliance requirements for more information on compliance, provider responsibilities and potential corrective actions. 

Provider support 
DHS is committed to helping providers prepare for and meet EVV compliance requirements. DHS will share additional resources when they are available, including the following:

• Update to the EVV Policy Manual
• Office hour sessions that allow providers to learn more about compliance and ask questions 
• HHAeXchange training opportunities and events
• Resources to help providers monitor and improve compliance 

Visit the Electronic visit verification webpage for more information about EVV. Refer to HHAeXchange’s Minnesota Provider Information Center webpage for more information about HHAeXchange in Minnesota.

Call the MHCP Provider Resource Center with any questions about this message at 651-431-2700 or 800-366-5411. (pub. 9/25/25)

On Friday, Aug. 1, the Minnesota Department of Human Services (DHS), on the guidance of its own DHS Office of Inspector General, moved to terminate the Housing Stabilization Services program due to large-scale fraud found by OIG's data analysis and investigatory work.

We know this news brings up many questions for HSS providers and clients, especially about the timeline for termination and whether providers can continue providing services for the time being. DHS has compiled an Housing Stabilization Services program termination FAQ webpage for HSS providers and clients that contains all of the information available at this time.

Terminating the entire HSS program is a complex action involving numerous parties, and it cannot be immediately enacted. Until then, eligible HSS providers can continue to deliver services to enrolled individuals and individuals may continue applying to the program at this time.

This is a developing situation and DHS will update the FAQs and communicate with providers as more information is received.

We are hearing that there is confusion between Housing Support and Housing Stabilization Services. It might be helpful to clarify whenever possible that these are two separate programs:

• Housing Stabilization Services helps a person find and keep housing.
• Housing Support (formerly known as Group Residential Housing or GRH) is a resource for adults with low incomes who have a disability or are 65 or older that helps eligible recipients pay for their housing costs. Counties and some tribes administer the Housing Support program for the state and are responsible for determining eligibility.

(pub. 8/12/25)

Due to new legislative updates and revalidations, the MHCP Provider Resource Center is experiencing high call volume. You may experience a longer wait time or you will have to call back at a different time. 

You may also refer to the following webpages:

• MHCP billing resources webpage for billing resources 
• MHCP provider training webpage for free training sessions for specific provider types and services

We will offer free question and answer sessions for the MPSE Portal beginning Feb. 7, 2024. Refer to the Minnesota Provider Screening and Enrollment (MPSE) portal training webpage for more information about the sessions. (pub. 1/29/24)

The Minnesota Department of Human Services will be offering weekly questions and answers sessions for the MPSE Portal. Questions and answers sessions take place every Wednesday from 1 to 2 p.m. starting on Feb. 7, 2024. These sessions are free and no registration is required.

MPSE questions and answers sessions will be held virtually using the Microsoft Teams platform, but attendees do not need to have Microsoft Teams installed. Participants can use the browser version. Find the link to join the questions and answers session on the MPSE portal training webpage.

Who should attend?

• Owners of MHCP-enrolled organizations.
• Individual providers who maintain their own MHCP enrollment records.
• Employees of MHCP-enrolled organizations who maintain provider enrollment records. 
• Employees of MHCP-enrolled organizations who process affiliations or do credentialing.
• Employees of MHCP-enrolled organizations responsible for MHCP compliance. 
• Individuals or organizations interested in becoming an MHCP provider for the first time.
• Anyone interested in learning more about the MPSE portal.

(pub. 3/18/24)

MHCP offers training for providers who provide services for members enrolled in MHCP. We have updated on-demand and online training opportunities on the MHCP provider training webpage.

On-demand videos
On-demand videos are arranged by category, including Minnesota Provider Screening and Enrollment Portal (MPSE), MN–ITS and Billing. Each video can be viewed in 10 minutes or less and provides instructions on a concept or technique.

Online training
Online training is arranged by content for all providers or specific providers. Training is led by an instructor who will help attendees navigate the Minnesota Department of Human Services website and locate and use MHCP provider information and other related webpages or internet-based applications such as MN–ITS. All instructor-led training is online only. (pub. 11/22/22)

Minnesota Health Care Programs (MHCP) offers free online training for MHCP-enrolled providers. Go to the MHCP provider training webpage to review the list of available training. (rev. 3/3/25)

Minnesota Health Care Programs (MHCP) is offering free online Provider Basics Resources and MN–ITS training to all enrolled MHCP providers who bill fee-for-services claims. This training is being offered monthly beginning Mar. 10, 2021.

You will learn how to navigate the MHCP provider webpages and the MHCP provider manual, and how to use MN–ITS administration, mailbox and eligibility requests (270/271) features. Go to the Provider Basics webpage to register for this training.

Claim training is not provided in this training. Refer to the MHCP provider training webpage to register for provider-specific claim training. (pub. 2/11/21)

Minnesota Health Care Programs (MHCP) offers free on-demand training videos arranged by category on the MHCP provider training webpage. Each video can be viewed in about 10 minutes and provides instructions on a concept or technique. (pub. 6/3/25)