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Effective: December 1, 2006 |
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13.25.15ar1 - County Residence Disputes (Archive) |
Archived: August 1, 2008 |
DHS will determine financial responsibility for MA and GAMC when counties do not agree.
This could apply to three situations:
l A client files a new application or reapplication.
l Client with active MA or GAMC moves to another county.
l Counties do not agree on the effective date of the change of financial responsibility.
Note: Counties may submit HealthQuest questions about financial responsibility. HealthQuest will give policy guidance, but will not resolve disputes between counties.
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, refer the case to the county you believe to be responsible.
3. The county you believe to be responsible has 30 days to accept or reject financial responsibility. Failure to respond within 30 days makes the receiving county financially responsible.
4. If the receiving county rejects responsibility and the sending county disagrees, the receiving county must give DHS evidence clearly showing why it rejects financial responsibility.
If an active client has moved from one county to another, either county may request a determination from DHS. The current county of financial responsibility must keep the case open and service it pending resolution.
Evidence may be a letter describing the facts and the reasons the other county is financially responsible.
Send copies to the other county.
Send evidence to:
Appeals and Regulations Division
Department of Human Services
444 Lafayette Road
St. Paul, Minnesota 55155-3813
5. The servicing county has 15 days from the date it gets the evidence disputing financial responsibility to send its position and supporting evidence to DHS. If the servicing county does not submit its position, DHS will issue a binding opinion based on the evidence submitted by the county claimed to be responsible.
Within 60 days after receiving the evidence, DHS will issue an order to the county it finds financially responsible.
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 DHS's order 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.