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... Worker (CDCS, CSG, PCA, CFSS) Provider Agreement (DHS-4611) Individual Non-Pay-To Provider Agreement (DHS-4611A) ... Worker (CDCS, CSG, PCA, CFSS) Provider Agreement (DHS-4611) Individual Non-Pay-To Provider Agreement (DHS-4611A) ...
Description: This page lists all Provider Eligibility and Compliance (PEC) enrollment forms that accept electronic signatures
Date:
August
12, 2025
... ANOKA
4298
49015
9
15
2015
BECKER
913
4611
20
15
2015
BELTRAMI
915
5523
17
15
... KANABEC
649
1961
33
22
2030
KANDIYOHI
1558
4611
34
22
2030
KITTSON
241
424
57
22
...
Date:
February
14, 2017
... 4469B) (PDF) Individual Support Worker Provider Agreement (DHS-4611) (PDF) Electronic Visit Verification Electronic Visit Verification (EVV) ( ...
Description: Steps for Success is a three-day workshop offered to CFSS agency staff to meet the PCA/CFSS provider agency training requirements when enrolling or maintaining enrollment with Minnesota Health Care Programs (MHCP). MHCP provides these training sessions to agency staff via webinar.
Date:
April
17, 2026
... Pediatric (age 17 or under)
9.67
4.4611
N/A
1.15
1.15
1.00
...
Date:
November
27, 2017
... Pediatric (age 17 or under)
9.67
4.4611
1.00
1.15
1.15
1.00
...
Date:
September
22, 2017
23-19 IHP State Plan Amendment
STATE: MINNESOTA
ATTACHMENT 3.1-A
Effective: January 1, 2024
TN: 23-19
Approved:
Page 79b
Supersedes: 17-25 (15-15, 13-01, ...
Description: 23-19 IHP State Plan Amendment
Date:
November
29, 2023
... 697
1840
9214
9,075
0
95,575
4611
3210
23,078
45,743
5183
181
Total
...
Date:
May
26, 2022
... 83
Watonwan
24,190
2,826
1,854
4611
33,481
83
Watonwan
90
480
12
83
...
Date:
May
26, 2022
... the Consultant Services Help Line at 651-366-4611, Monday – Friday, 9:00am – 4:00pm.
Minnesota Zoo
...
Date:
June
01, 2018
... the Consultant Services Help Line at 651-366-4611, Monday – Friday, 9:00am – 4:00pm.
Board of ...
Date:
November
17, 2023