2002 Minnesota Statutes

     256B.071 Medicare maximization program. 

    Subdivision 1.    Definition.  (a) "Dual entitlees" 
 means recipients eligible for either the medical assistance 
 program or the alternative care program who are also eligible 
 for the federal Medicare program.  

    (b) For purposes of this section, "home care services" 
 means home health agency services, private duty nursing 
 services, personal care assistant services, waivered services, 
 alternative care program services, hospice services, 
 rehabilitation therapy services, and suppliers of medical 
 supplies and equipment. 

    Subd. 2.    Technical assistance to providers.  (a) The 
 commissioner shall establish a technical assistance program to 
 require providers of services and equipment under this section 
 to maximize collections from the federal Medicare program.  The 
 technical assistance may include the provision of materials to 
 help providers determine those services and equipment likely to 
 be reimbursed by Medicare.  

    (b) Any provider of home care services enrolled in the 
 medical assistance program, or county public health nursing 
 agency responsible for personal care assessments, or county case 
 managers for alternative care or medical assistance waiver 
 programs, is required to use the method developed and supplied 
 by the department of human services for determining Medicare 
 coverage for home care equipment and services provided to dual 
 entitlees to ensure appropriate billing of Medicare.  

    Subd. 3.    Referrals to Medicare providers required.  
 Non-Medicare certified home care providers and medical suppliers 
 that do not participate or accept Medicare assignment must refer 
 and document the referral of dual eligible recipients to 
 Medicare providers when Medicare is determined to be the 
 appropriate payer for services and supplies and equipment.  
 Providers will be terminated from participation in the medical 
 assistance program for failure to make such referrals. 

    Subd. 4.    Medicare certification requirement.  
 Medicare certification is required of all medical assistance 
 enrolled home care service providers as required under Title XIX 
 of the Social Security Act.  

    Subd. 5. Repealed, 2001 c 161 s 58; 2001 c 203 s 19 

    HIST: 1996 c 451 art 2 s 22; 1997 c 195 s 2-4; 2001 c 203 s 10