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Minnesota AUC Newsletter

October 2019

Looking for AUC TAG co-chairs

The primary work of the AUC is conducted in Technical Advisory Groups (TAGs) where co-chairs play a key role in helping set agendas and priorities and in working with the Minnesota Department of Health (MDH) to complete reviews and updates to Minnesota Uniform Companion Guides, best practices, and other resources. We are always looking for someone interested in helping co-chair the TAGs, whether you are new or experienced. Interested and want to find out more? Please contact David.Haugen@state.mn.us.

National News

HHS adopts rule rescinding Health Plan ID (HPID) and Other Entity Identifier (OEID)

The federal department of Health and Human Services (HHS) today issued a final rule rescinding a previous rule that had required the use of Health Plan Identifiers (HPID) and “Other Entity” Identifiers (OEID) in HIPPA transactions. This final rule also removes the definitions for the “Controlling health plan" (CHP) and "Subhealth plan" (SHP). The rescinding rule becomes effective December 27, 2019.

Background:

The Accountable Care Act of 2010 required that the Secretary of HHS adopt a standard unique health plan identifier (HPID). A final rule for the HPID was published September 5, 2012, and included an “other entity identifier” (the OEID) for an entity that is not a health plan, individual, or health care provider, but that needs to be identified in a HIPAA transaction.

Soon after publication of the September 2012 final rule, industry stakeholders, in particular, health plans, identified a number of implementation challenges with the policy. Stakeholders informed HHS that the HPID was not needed for routing HIPAA transactions nor did it provide information about health plan products and benefits. Further, they stated it would not reduce the cost of managing financial and administrative information, and that if they were to implement the HPID, it would impose significant costs instead of decreasing them. Stakeholders also indicated that the OEID had minimal value and stated they were confused about the enumeration, purpose, and use of the OEID.

Based on industry’s concerns about the September 2012 final rule, HHS issued a statement of enforcement discretion in October 2014, which delayed enforcement of the requirements pertaining to HPID enumeration and use of the HPID in the HIPAA transactions. Between 2014 and 2018, HHS continued to receive input from stakeholders and from the National Committee on Vital and Health Statistics (NCVHS), requesting that the regulatory mandate for the HPID be removed. On December 19, 2018 HHS published a proposed rule to rescind the adoption of the standard unique HPID and OEID, as well as the definitions of CHP and SHP as those terms are integrally related to the HPID requirements.

HHS reviewed comments it received for the 2018 proposed rule and conducted other analyses resulting in the final rule published in today’s Federal Register rescinding the 2012 HPID/OEID.


Reminder re. New Medicare Card: Claim Reject Codes After January 1

The federal Centers for Medicare & Medicaid Services (CMS) recently issued the following reminder:

Starting January 1, 2020, you must use Medicare Beneficiary Identifiers (MBIs) when billing Medicare regardless of the date of service:

  • We will reject claims submitted with Health Insurance Claim Numbers (HICNs) with a few exceptions
  • We will reject all eligibility transactions submitted with HICNs

If you do not use MBIs on claims after January 1, you will get:

  • Electronic claims reject codes: Claims Status Category Code of A7 (acknowledgment rejected for invalid information), a Claims Status Code of 164 (entity’s contract/member number), and an Entity Code of IL (subscriber)
  • Paper claims notices: Claim Adjustment Reason Code (CARC) 16 “Claim/service lacks information or has submission/billing error(s)” and Remittance Advice Remark Code (RARC) N382 “Missing/incomplete/invalid patient identifier”

Do not wait. Protect your patients’ identities by using MBIs now for all Medicare transactions. Need an MBI?

  • Ask your patients for their cards. If they did not get a new card, give them the Get Your New Medicare Card flyer in English or Spanish.
  • Use your Medicare Administrative Contractor’s look-up tool. Sign up for the Portal to use the tool.
  • Check the remittance advice. We return the MBI on the remittance advice for every claim with a valid and active HICN.

For more information, see the MLN Matters Article.


ICD-10 Vaping Coding Guidance

Vaping-associated lung injuries are increasingly in the news. The Minnesota Department of Health (MDH) is working with local public health and health care providers to investigate reports of severe lung injury potentially related to vaping and e-cigarette use among teens and adults. With similar reports coming from other states, MDH is partnering with the U.S. Centers for Disease Control and Prevention (CDC) to determine a cause for the vaping-related injuries and illness and what steps may be taken to prevent additional illness.

A supplement to the ICD-10-CM Official Coding Guidelines is available for encounters related to e-cigarette, or vaping, product use. Visit the 2020 ICD-10-CM webpage for more information.

 

Other News

Minnesota Department of Health (MDH) seeking community partners to help develop statewide child and family health strategic plan

(Please share the information below with others that may be interested.)

The Child and Family Health (CFH) Division at the Minnesota Department of Health (MDH) is seeking community members to participate on Strategy Teams to help develop a strategic plan to guide future work in child and family health. The planning process follows a comprehensive assessment of the health and well-being of Minnesota’s maternal and child health populations– including mothers, fathers, children (including those with special health needs), families, and communities.

The Strategy Teams will work together to develop strategies to address the priority needs identified by the assessment and evaluate progress on the strategies. A committee with representatives from the MDH CFH Division, the University of Minnesota School of Public Health’s Maternal and Child Health Program, and local public health agencies, as well as family advisors will lead the planning process.

The CFH Division is looking for a variety of perspectives and experience to develop the strategies. If interested and to learn how you can become involved in this important work to “move the needle” in improving health outcomes for maternal and child health populations, please visit the Child & Family Health Strategy Teams webpage.

Note: The recruitment of Strategy Team members ends Monday, November 11, 2019.

DHS Provider News

The Minnesota Department of Human Services (DHS) administers several publicly funded health programs [“Minnesota Health Care Programs (MHCP)]” including Medical Assistance, Minnesota’s name for Medicaid. DHS is a “group purchaser” (payer) subject to Minnesota Statutes, section 62J.536 requirements for the standard, electronic exchange of certain health care administrative transactions.

DHS is also an active member and participant on the AUC, and publishes a regular electronic newsletter with news and resources for providers enrolled to serve MHCP members. Given that the DHS “MHCP provider news and updates” newsletter may be of interest to AUC members as well, all issues of this newsletter will also include a “reminder” link to the DHS newsletter webpage for easy reference. Providers may also sign up to receive the DHS newsletter directly through DHS’s free provider email lists.

 
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