*** The Health Care Programs Manual (HCPM) has been replaced by the Minnesota Health Care Programs Eligibility Policy Manual (EPM) as of June 1, 2016. Please refer to the EPM for current health care program policy information. ***
Effective: June 1, 2011 |
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13.25.15 - County Residence Disputes |
Archived: June 1, 2016 (Previous Versions) |
Refer to Bulletin #07-85-04, "Procedures for Deciding Financial Responsibility Disputes Between Counties."
DHS has the statutory authority to resolve disputes between county agencies regarding financial responsibility for human service programs ranging from medical assistance to commitment. DHS will determine financial responsibility for MA when counties do not agree.
County Procedures
Follow the dispute resolution procedures in this section if counties do not agree which county is financially responsible.
1. The servicing county must determine eligibility and approve coverage before requesting a determination of responsibility. The servicing county should continue providing benefits, payments, or services until DHS determines financial responsibility.
2. Within 60 days of the approval, notify the county you believe to be responsible and forward case information including the application, relevant documentation, and reasons for denying financial responsibility.
3. The county you believe to be responsible has 30 days to accept or reject financial responsibility. Failure to respond within 30 days constitutes acceptance of financial responsibility.
4. If the receiving county rejects responsibility and the sending county disagrees, either county may request a determination from DHS. Complete the Request for Department Resolution of Financial Responsibility (DHS-4457). Follow the instructions on the form. Submit the form along with all supporting materials concerning the dispute to DHS.
The county initiating department resolution should clearly state how the law supports their position and attach supporting documentation.
All material provided to DHS must be copied and sent to the other county involved.
The current county of financial responsibility must keep the case open and service it pending resolution.
5. DHS will send a letter to the other county (or counties) involved and invite them to submit evidence and arguments by the given deadline. The record closes on the deadline date and no further evidence or arguments are accepted after that date.
DHS will issue a written decision within 60 days from the date the record closes.
6. If either county disagrees with the order, it may appeal to the district court within 30 days of the issuance of the order. The county must follow the order from DHS pending the district court's decision.
7. When counties send disputes to DHS within the time frames outlined above, reimbursement from the financially responsible county starts with the date of application or the date of eligibility.
If counties send the dispute evidence later, reimbursement begins with the submission date.
If the non-responsible county has not received federal and state reimbursement, the financially responsible county must reimburse the non-responsible county for the total amount paid.
If the non-responsible county has received federal and state reimbursement, the financially responsible county must reimburse only the county share, if any.