Subpart
1.
Billing requirements.
The day service provider must comply with the requirements in
items A to E when submitting bills to the commissioner for reimbursement for
the provision of day training and habilitation services.
A. Bills must be submitted on forms supplied
by the commissioner, which identify for each client:
(1) the full-day or partial-day service rate
as provided by part
9525.1270, subpart
1, multiplied by the number
of days the client actually received day training and habilitation services
from the day service provider; and
(2) the transportation rate as approved under
part
9525.1270, subpart
1, multiplied by the number
of days the client was actually transported.
B. The day service provider must not bill for
days in which the client does not receive day training and habilitation or
transportation services.
C. The day
service provider must not bill for more than one service rate and one
transportation rate per client per day.
D. Day service providers whose rates have
been recommended under part
9525.1260, subpart
2 and approved under part
9525.1270, subpart
1, must submit bills to the
commissioner using a procedural code available from the Health Care Programs
Division.
E. Each bill from the day
service provider must be verified by the ICF/DD where the client resides before
the bill is submitted to the commissioner. A signature by authorized ICF/DD
personnel constitutes verification by the ICF/DD that the services were
provided on the days and for the charges specified.
Subp. 2.
Payment.
The commissioner shall pay the day service provider for bills
submitted under subpart
1 using the payment
procedures in Minnesota Statutes, sections
256B.041
and
256B.501,
subdivision 5, paragraph (f). No payment will be made by the commissioner for
day training and habilitation services not authorized under subpart
1, item E.
Subp. 3.
Errors and duplicate
payments.
If the day service provider becomes aware of a billing error
that results in an overpayment or an underpayment to the day service provider
or if the day service provider receives payment from another source for
services which were also paid for by the medical assistance program, the day
service provider shall promptly notify the commissioner and request an
adjustment request form. Within one year of receipt of a completed adjustment
request form, the commissioner shall:
A. in the case of an overpayment, require the
day service provider to repay an amount equal to the overpayment or adjust
future payments to correct the error or eliminate the overpayment; or
B. in the case of an underpayment, pay the
day service provider an amount equal to the underpayment or adjust future
payments to correct the error.
Notes
Minn. R. agency 196, ch. 9525, TRAINING AND HABILITATION REIMBURSEMENT PROCEDURES FOR ICF/DD'S, pt. 9525.1290
10 SR 68; 11 SR 1612;
L
2005 c 56
s
2
Statutory Authority: MS s
256B.501
