HMO Annual Reporting
Beginning April 2014, Provider Network data must be submitted to the Central Data Repository hosted by the Minnesota Department of Human Services using a fixed length text file format as specified in the Provider Network File Layout. This provider network data file will satisfy the annual report requirements under Minnesota Rules 4685.2100 (D) and provider termination reporting requirements under Minnesota Statutes 62D.08, subd. 5. The fixed length provider network data file format and the Provider Network File Layout instructions replace the "Participating Provider Network Listing 4a" and the "Data Dictionary Participating Network Provider Listing 4b." Please see the "State of Minnesota - Provider Network File Layout" document and Administrative Bulletin #2014-1 listed below.
Pursuant to MS §62D.08 and §62D.115, MDH solicited input via an RFI from all interested stakeholders in May and again in July to insure a broad base of responses. HMOs will begin collecting data for complaint category reporting to MDH in January 2018 for reporting to be included in the HMO annual reports due in April 2019.
- Complaint Category Reporting (Excel)
- Enrollment (Excel)
- Statement of Revenue, Expenses and Net Income (Excel)
- Reallocation of Expenses and Investment Income (Excel)
The Minnesota Legislature repealed the following forms: #2 Summary of Complaints and Grievances; #3 Summary of Chemical Dependency Claims; #5 Medical Necessity Report.
Please send an email to email@example.com if you have any questions regarding HMO annual reports, provider termination reporting, or the submission of HMO and provider network data and information.