2006 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    Subd. 5.[Repealed, 2001 c 161 s 58; 2001 c 203 s 19]
History: 1996 c 451 art 2 s 22; 1997 c 195 s 2-4; 2001 c 203 s 10