Managed Care Organizations (MCO) contract information, forms and resources

Contract resources

• Joint Administrative Bulletin 2022-1: Conversion Therapy 
• Children’s therapeutic services and supports (CTSS) materials
• Applicant Guidelines (DHS-3623) (PDF)
• Application (DHS-3610) (PDF)
• Certification Process (DHS-3622) (PDF)
• Integrated Enrollment Policies and Procedures (DHS-3953) (PDF)
• List of Covered Drugs Model Guidelines (DHS-7877) (PDF)
• Maps
• Materials Guide
• Materials Review Checklist (DHS-8111) (PDF)
• Member Handbook Guidelines
• Model contracts
• Provider Directory Guidelines (DHS-7402) (PDF)
• Transparency and Accountability Report Format Summary (PDF)

Forms and documents

• Managed care organization MHCP provider enrollment forms
• Other Health Insurance Reporting form (DHS-6340) (PDF)
• Third Party Administrator MCO Setup form (DHS-5858) (PDF)
• TPA Enrollment Application (DHS-5859) (PDF)

Enrollment figures

• Minnesota Health Care Programs managed care enrollment figures

Fraud and abuse requirements

• Deficit Reduction Act Assurance Statement (DHS-6372) (PDF)
• Minnesota Restricted Recipient Program (MRRP) brochure (DHS-4659) (PDF)
• Medical Referral for MRRP Enrollee form (DHS-2978) (PDF)
• MRRP Enrollment Reporting form (DHS-4656) (PDF)

MCO systems workgroup information

• Health plan systems workgroup information

Procurement

The Minnesota Department of Human Services (DHS) will issue a series of Request for Proposals (RFP) seeking qualified responders to provide health care services to eligible Minnesotans through the Medical Assistance and MinnesotaCare programs.  The schedule for the release of these RFPs is as follows:

• January 2021 – RFP for the seven county metro-Twin Cities area Families and Children contracts beginning January 1, 2022 (includes Anoka, Carver, Dakota, Hennepin, Ramsey, Scott and Washington)
• October 2021 – RFPs for statewide seniors and Special Needs BasicCare (SNBC) contracts beginning January 1, 2023
• January 2022 – RFP for greater Minnesota Families and Children contracts beginning January 1, 2023 (includes the 80 greater Minnesota counties exclusive of the 7 metro counties)

The notification of the RFP will appear in the Minnesota State Register and the RFP will be appear on the DHS public website.

Reporting specifications

• Provider Directory Change Report Template (XLSX)
• Incentive and withhold specifications and HEDIS Hybrid specifications
• Third party liability (TPL)

Screening tools

• Developmental and social-emotional screenings, MDH

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