Medical Assistance

2.1.1.2.2 Cooperation

Medical Assistance (MA) enrollees must comply with various eligibility requirements. Enrollees who fail to cooperate with requirements may have their MA coverage ended.

Cooperation is required for the following eligibility requirements:

1. MHCP Change in Circumstances

2. MHCP Fraud

3. MHCP Inconsistent Information

4. MA for Employed Persons with Disabilities (MA-EPD) Premiums and Cost Sharing

5. Medicaid Eligibility Quality Control (MEQC) and Payment Error Rate Measurement (PERM)

6. MA Mandatory Verifications

7. MA Referral for Other Benefits

8. MA Third Party Liability

Medicaid Eligibility Quality Control and Payment Error Rate Measurement Cooperation

DHS conducts Medicaid Eligibility Quality Control (MEQC) and Payment Error Rate Measurement (PERM) eligibility reviews for MA. Enrollees are encouraged to cooperate with these eligibility reviews, however, enrollees are not required to cooperate, as a condition of their eligibility for MA; the county, tribal or state servicing agency must:

• Verification is requested from the enrollee when MEQC or PERM eligibility reviews provide information that is inconsistent with information or documentation on file.

• Eligibility is redetermined when an MEQC or PERM review results in new information that affects eligibility.

Legal Citations

Minnesota Rules, part 9505.0080

Published:  June 1, 2016

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