Minnesota Health Care Programs Fee for Service Outpatient Services Rates Study

The Minnesota Health Care Programs (MHCP) Outpatient Services Rates Study was approved by the Minnesota legislature in 2021 (Laws of MN, 2021, First Special Session, HF 33/Chapter 7, Article, Section 18) The Department of Human Services (DHS) contracted with an independent contractor, Burns & Associates division of Health Management Associates, Inc. (HMA Burns) to conduct a study of rate-setting for MHCP outpatient services. The intended contract began in August 2022 and will end in August 2024, or until all obligations set forth in the contract have been satisfactorily fulfilled, whichever occurs first.

News
Services
The following is a list of services included in the rate study:

Behavioral Health (BH) Outpatient Services
- Mental health services
  - Data collected services for future recommendation only: Psychiatric Residential Treatment Facility (PRTF)
- Residential and non-residential substance use disorder services
Disability Services
- Early intensive developmental and behavioral intervention benefits (EIDBI)
Health Care Administration Services
- Physical health services
Timeline
Contracted timeline for study:
- August 10, 2022 – Rates study began
- August 9, 2024 – Rates study end
We have completed the provider workgroup meetings and are now discussing internally on the fiscal impact and system implementation.

Behavioral Health Outpatient Services

Mental Health (MH)
- Dec. 19, 2023 – MH provider workgroup meeting #1
- Jan. 9, 2023 – MH provider workgroup meeting #2
- Jan. 18, 2023 – MH provider workgroup survey feedback deadline
- Jan. 30, 2023 – All MH provider survey webinar
  - Included MH provider workgroup meeting #3
- March 3, 2023 – All MH provider rate study survey submission deadline (IMPORTANT: DEADLINE EXTENDED to March 10, 2023)
- March 10, 2023 - All MH provider rate study survey submission deadline
- March 27, 2023 – MH provider workgroup meeting #4
- May 3, 2023 – MH provider workgroup meeting #5 (CANCELLED)
- June 7, 2023 – MH provider workgroup meeting # 5
- June 15, 2023 – MH provider workgroup meeting #6
- July 17, 2023 - MH provider workgroup meeting #7
- Aug. 30, 2023 - MN provider workgroup meeting #8
Substance Use Disorder (SUD)
- Dec. 19, 2023 – SUD provider workgroup meeting #1
- Jan. 9, 2023 – SUD provider workgroup meeting #2
- Jan. 18, 2023 – SUD provider workgroup survey feedback deadline
- Jan. 30, 2023 – All SUD provider survey webinar
  - Included SUD provider workgroup meeting #3
- March 3, 2023 – All SUD provider rate study survey submission deadline (IMPORTANT: DEADLINE EXTENDED to March 10, 2023)
- March 10, 2023 - All SUD provider rate study survey submission deadline
- March 27, 2023 – SUD provider workgroup meeting #4
- May 3, 2023 – SUD provider workgroup meeting #5 (CANCELLED)
- June 7, 2023 – SUD provider workgroup meeting #5
- June 15, 2023 – SUD provider workgroup meeting #6
- July 17, 2023 - SUD provider workgroup meeting #7
- Aug. 21, 2023 – SUD provider workgroup meeting #8
Psychiatric Residential Treatment Facility (PRTF)
- Jan. 27, 2023 – PRTF provider workgroup meeting #1
- Feb. 22, 2023 – Meeting with individual PRTF provider(s)
- Feb. 23, 2023 – Meeting with individual PRTF provider(s)
- May. 2, 2023 – PRTF provider workgroup meeting #2 (CANCELLED)
- June 9, 2023 – PRTF provider workgroup meeting #2
- July 6, 2023 – PRTF provider workgroup meeting #3 (CANCELLED)
- Aug. 15, 2023 – PRTF provider workgroup meeting #4
Behavioral Health Home (BHH)
- May 8, 2023 - BHH provider workgroup meeting #1
- June 13, 2023 – BHH provider workgroup meeting #2
- June 20, 2023 – BHH provider workgroup meeting #3
- July 7, 2023 – BHH provider workgroup meeting #4 (CANCELLED)
- Aug. 15, 2023 – All BHH providers meeting #4
- Sept. 7, 2023 – All BHH providers meeting #5
Disability Services

Early Intensive Developmental and Behavioral Intervention Benefits (EIDBI):
- Jan. 17, 2023 – EIDBI provider workgroup meeting #1
- Jan. 24, 2023 – EIDBI provider workgroup survey feedback deadline
- Jan. 31, 2023 – All EIDBI provider survey webinar
  - Included EIDBI provider workgroup meeting #2
- March 3, 2023 – All EIDBI provider rate study survey submission deadline (IMPORTANT: DEADLINE EXTENDED to March 10, 2023)
- March 7, 2023—EIDBI Technical assistance session offered at Department of Human Services 444 Lafayette building
- March 10, 2023 - All EIDBI provider rate study survey submission deadline
- March 28, 2023 – EIDBI provider workgroup meeting #3
- May 4, 2023 – EIDBI provider workgroup meeting #4 (CANCELLED)
- June 6, 2023 – EIDBI provider workgroup meeting #4
- July 11, 2023 – EIDBI provider workgroup meeting #5
Health Care Administration Services

Physical Health Services
- Aug. 15, 2023 – Physical Health provider workgroup meeting #1
- Aug. 31, 2023 – Physical Health provider workgroup meeting #2
FAQs
Here a few frequently asked questions and answers regarding the Behavioral Health Outpatient Services Rates Study:
1. Question: What services are included in the rate study?
  
  Answer: Behavioral health outpatient services, residential and non-residential substance use disorder services, early intensive developmental and behavioral intervention (EIDBI) services, and physical outpatient services.
2. Question: Why are Assertive Community Treatment (ACT), Intensive Residential Treatment Services (IRTS), Adult Residential Crisis Stabilization (RCS), and Psychiatric Residential Treatment Facilities (PRTF) included in the rate study?
  
  Answer: These services are included as a data collection for future rate reform recommendations only. No rate methodology will be provided at the end of the rate study survey contract.
  
  Update: Per DHS and stakeholder discussions, ACT, IRTS and RCS are no longer in part of the rates study. PRTF rate analysis is not a part of the rate study recommendations but is being done to help the providers and the State to explore viable options for further consideration.
3. Question: Why are Opioid Treatment Program (OTP) rates not in-scope of the rate study?
  
  Answer: DHS is proposing to update the rate methodology by creating a weekly drug bundle rate.
4. Question: Are Certified Community Behavioral Health Clinics (CCBHC) included in this rate study?
  
  Answer: No.
5. Question: Why was the Behavioral Health outpatient services, residential and non-residential SUD and EIDBI services survey deadline extended to March 10, 2023?
  
  Answer: DHS received provider inquiries requesting for an extension to allow them more time to review and complete their surveys and host an in-person technical assistance session for EIDBI providers to complete their surveys.
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