This article is a section taken from Medical Assistance (MA), a part of the revisions and additions to the Minnesota Health Care Program Eligibility Policy Manual.
Medical Assistance (MA) Cooperation
Medical Assistance (MA) enrollees must comply with various eligibility requirements. Enrollees who fail to cooperate with requirements may have their MA coverage ended.
Cooperation is required for the following eligibility requirements:
MA-EPD Premiums and Cost Sharing
Medicaid Eligibility Quality Control (MEQC) and Payment Error Rate Measurement (PERM)
MA Referral for Other Benefits
Medicaid Eligibility Quality Control and Payment Error Rate Measurement Cooperation
DHS conducts Medicaid Eligibility Quality Control (MEQC) and Payment Error Rate Measurement (PERM) eligibility reviews for MA. Enrollees are encouraged to cooperate with these eligibility reviews, however, enrollees are not required to cooperate, as a condition of their eligibility for MA; the county, tribal or state servicing agency must:
-
Verification is requested from the enrollee when MEQC or PERM eligibility reviews provide information that is inconsistent with information or documentation on file.
-
Eligibility is redetermined when an MEQC or PERM review results in new information that affects eligibility.
Legal Citations
Minnesota Rules, part 9505.0080
CREDIT: The content of this post has been copied or adopted from the Minnesota Healthcare Programs Eligibility Policy Manual, originally published by the Minnesota Department of Human Services.
This is also part of a series of posts on Minnesota Healthcare Eligibility Policies.
