Changes in Pre-Admission Screening Delayed; MnCHOICES Time Study to Proceed October 1
September 26, 2013
This is an update about implementing Legislative changes to the Pre-Admission
Screening (PAS) process and ending the Long Term Care Consultation allocation.
Through training sessions and business process meetings held around the state, many
know that during the 2013 legislative session, changes were made to the Long Term
Care Consultation statute (Minnesota Statute, Section 256B.0911) and the Minnesota
Board on Aging statute (Minnesota Statute, Section 256.975). These changes
redesigned and refinanced the federally mandated Pre-Admission Screening (PAS) process
and ended the Long Term Care Consultation allocation.
These statutory changes were passed under a contingency that requires approval of
federal funding from the Centers for Medicare and Medicaid Services (CMS) and the
Minnesota Management and Budget department prior to implementation. As of this announcement,
positive negotiations continue with CMS but the process is not yet finalized.
Therefore, changes to Pre-Admission Screening and the Long Term Care Consultation
allocation will not go into effect October 1, 2013 as stated in statute. Work continues
to receive approval from CMS so that 2013 legislative changes can be implemented.
More information will be provided as it is available.
How the implementation will proceed:
- The Pre-Admission Screening changes included shifting the role from the counties
to the Senior LinkAge Line® as well as removing an exemption for individuals
admitted to a nursing facility for less than 30 days. The changes also included
moving this telephone and fax-based process to an online referral page which will
be located at www.mnaging.org.
Please continue with current policies for requesting and
conducting Pre-Admission Screening (see Minnesota Statute, Section 256B.0911.) until
- The changes made to the statute also included a method to refinance the way in which
Pre-Admission Screening and Long Term Care Consultation (now referred to as MnCHOICES)
is reimbursed. Here is the way in which those payments will be impacted during
this transition period: The current method - where nursing facilities pay the counties
and the Department of Human Services (DHS) includes an adjustment in the Nursing
Facility (NF) payment rates - remains in place. Rate notices have been issued
- After CMS approval and implementation there will be a new method for reimbursement.
The NF allocation (current method) will end. In its place, DHS will pay the
counties for assessment on a quarterly basis using the existing federally-approved
- While changes to the way Long-Term Care Consultation (LTCC) is paid is postponed,
DHS will implement the time study October 1, 2013.
Therefore it is important for counties to be aware that the time study that was
scheduled to begin October 1, 2013 will proceed as planned.
- However, since the current method is still in place, private-pay residents will
need to be billed according to the rate notices that includes LTCC and facilities
must make payment to the counties for LTCC services until the contingent items are
approved. Counties must also continue payments on a monthly basis to the area
agencies on aging.
Once negotiations are finalized, the NF rate changes will be made but will be retroactive
to October 1. For example, if the approval comes after facilities have billed and
been paid for October services,
DHS will recover the LTCC portion of the payments through an adjustment to Remittance
Advices. Private-paying residents must be given refunds. If the resident is still
at the facility, it can be done as a credit to the next charge for monthly services.
If the person is no longer a resident, a reasonable effort must be made to send
the person a refund. The counties will be instructed to give refunds to NFs
for any amounts collected that represent payments due for months beginning October
1 and later. The Area Agencies on Aging will be instructed to provide a refund
to the counties for payments made for months beginning October 1 and later.
For information regarding Pre-Admission Screening changes, please continue to check www.mnaging.org
as up to date information will be posted.