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Effective: December 1, 2006 |
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28.05.20ar1 - Out-of-State Services (Archive) |
Archived: June 1, 2009 |
Minnesota Health Care Programs will pay out-of-state medical providers for medical services rendered to Minnesota Health Care Program (MHCP) enrollees in the circumstances described below.
Enrollees who are temporarily absent from the state may receive:
l Services due to a medical emergency.
l Services that are needed and their health would be endangered if they traveled to Minnesota to receive services.
Some enrollees remain Minnesota's responsibility while living in another state. This includes:
l Non-IV-E foster children placed in other states under the Interstate Compact. For more information on the Interstate Compact, see http://www.dhs.state.mn.us/main/groups/children/documents/pub/DHS_id_000157.hcsp.
l State adoption assistance children who move to a state that does not exercise the federal option to accept responsibility for state adoption assistance children from other states.
l Residents of North Dakota nursing homes covered under the .
l Other enrollees placed in another state by agents of the state of Minnesota.
See State and County Residence for further information.
Instruct managed care enrollees who report temporary absences to contact their for information on receiving out-of-state services. The MCO may require prior authorization for non-emergency services and may have special provisions for payment of emergency services.
Providers who treat fee-for-service Minnesota Health Care Program enrollees must enroll as MHCP providers to receive payment. Potential providers may enroll retroactively to the date they provided services to an MHCP enrollee. To enroll as an MHCP provider, they may:
l Obtain provider enrollment forms at www.dhs.state.mn.us.
l Contact MHCP Provider Enrollment at 651-431-2700 or 1-800-366-5411, option 5.