September 1, 2022
HealthChoices Expansion Update
HPP is excited to expand our award-winning Medical Assistance program into your communities effective September 1, 2022. Partnering with our provider network is an important part of our success and furthers our mission to build healthier lives and stronger communities.
As you are aware, the new health plan assignments take effect on September 1, 2022. Providers should use eCIS as our source of truth to determine a patient’s eligibility as well as their assigned health plan. By accessing eCIS, you can see the timeline of the member’s journey during this transition. Please ensure all your staff are aware of these updates.
We look forward to working collaboratively with you and the other providers in our network to meet our members’ needs and assure they receive the highest quality of care. We appreciate your support and are here to assist in answering any questions you may have regarding this procurement process. Please feel free to contact our Provider Services Helpline at 1-888-991-9023 (Monday – Friday, 9 a.m. – 5:30 p.m.)
Continuity of Care FAQs
My patient needed to choose a new physical health (PH) plan because the PH plan they have will not be available in the Medical Assistance (Medicaid) Program after September 1. What does this mean for me?
As a provider in the HealthChoices program, please remember Medicaid members will not lose eligibility in this transition. This change affects Medicaid only – NOT CHIP. Please do not deny care. Health Partners will work out any billing issues with you and other MCOs. Please ensure all your staff are aware of these updates and check the DHS eCIS eligibility system for eligibility and plan assignment.
Where can I go to confirm a member’s eligibility or to verify their health plan?
Providers should use eCIS as our source of truth to determine a patient’s eligibility as well as their assigned health plan. By accessing eCIS, you can see the timeline of the member’s journey during this transition.
Can my patient keep me as their current doctor if they chose a different PH plan?
The Department of Human Services is committed to ensuring members continue seeing their doctors and other providers. If a member is currently getting treatment, their new PH plan will make sure they continue to get the care they need. Members can keep their current doctor for as long as 60 days.
Who do I contact if I have questions?
We appreciate your support and are here to assist in answering any questions you may have. Please feel free to contact our Provider Services Helpline at 1-888-991-9023 (Monday – Friday, 9 a.m. – 5:30 p.m.)
What will happen to the member’s service that require prior authorization, such as shift nursing?
If you have a prior authorization for shift nursing or other services requiring prior authorization, there are continuity of care rules that help prevent a loss of break in services. If the services are for a child under the age of 21, the new plan will continue to honor the existing prior authorizations for the rest of the time remaining on the prior authorization period give by your previous plan. If the services are for an adult 21 years of age or older, the prior authorized services will continue at the same level with the previous plan for up to 60 days. When the authorization time period passes, your doctors will work with your new plan to renew the prior authorization for any services you continue to need.
Will my providers be paid for services I had before August 31 by the physical health plans leaving the program or zone(s) on September 1?
Yes. Physical health plans leaving the program or zones will continue to pay provider claims after September 1 for eligible services they provided up to August 31.