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Provider updates

Provider updates includes news, notifications and items of interest for Hennepin Health providers.

Drug formulary changes for 2021 Q1

Hennepin Health has made several changes to its drug formulary that impacts members of all plans. Read about which medications were added or removed.

  • 01/06/2021
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Flu shot season

All Hennepin Health members are encouraged to get a flu shot. We have developed a list of local pharmacies for where they can go. 
  • 11/25/2020
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Opioid webinar

An upcoming important educational webinar that may be of interest:

Meeting the Opioid Challenge: More Tools and Information for Care Coordinators
Tuesday, November 10, Noon - 1 pm

 
  • 10/13/2020
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Telehealth and COVID-19 update

Updated information on Hennepin Health’s current support of telehealth services and COVID-19 specific codes being used during the pandemic. This bulletin supplies summary information on how Hennepin Health has implemented CMS and DHS updates.
  • 08/24/2020
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Drug formulary changes for 2020 Q3

Hennepin Health has made several changes to its drug formulary that impacts members of all plans. An updated formulary has been posted online.

Read about which medications were added or removed.

  • 07/17/2020
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Hennepin County board declares racism a public health crisis

The Hennepin County board voted to declare racism a public health crisis in the county.
  • 07/06/2020
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Hennepin Health recognized with NACo award

Hennepin Health received a national award in the health category from the National Association of Counties (NACo). The award was for the program, Addressing Readmissions in County Health Plan Population Experiencing Homelessness. The award recognized work to integrate health care and social services by expanding access to housing navigation, and to reduce the readmission rate for Hennepin Health members who use Hennepin Healthcare’s flagship hospital, HCMC, for hospital services.

  • 06/30/2020
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Housing Stabilization Services

Housing Stabilization Services is a new state Medicaid benefit for people with disabilities and seniors launching July 2020. Hennepin Health will accept approved services from any MHCP-enrolled housing stabilization provider. Housing stabilization providers should get set up in the Hennepin Health claims system to coordinate reimbursement for services provided.

  • 06/19/2020
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Local pharmacy closures

Some local pharmacies in Minneapolis are currently closed. Please direct member prescriptions to open contracted pharmacies.

  • 06/19/2020
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Telehealth and COVID-19 updates

Updates from Hennepin Health on telehealth and COVID- 19 related services.
  • 05/20/2020
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Pain management and opioids guide for your patients

Helping your patients understand and successfully manage their pain is important and can be challenging. A new patient resource is now available.
  • 04/13/2020
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Provider bulletin: Coronavirus (COVID-19) update

Hennepin Health announces plan information associated with COVID-19. This applies to all members. Requirements and codes provided.

 

  • 03/11/2020
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Hennepin Health and Hennepin Healthcare get top prize in Healthcare Innovation awards program

Hennepin Health and Hennepin Healthcare earned first place in the 2020 Innovator Awards Program presented by Healthcare Innovation. The award recognized the team’s work to integrate health care and social services by expanding access to housing navigation, and to reduce the readmission rate for Hennepin Health members who use Hennepin Healthcare’s flagship hospital, HCMC, for hospital services.
  • 02/14/2020
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Provider Bulletin: 2020 Q1 Formulary Change Notification

Hennepin Health has made several changes to its drug formulary for 2020 Q1 that are applicable to Hennepin Health-PMAP, Hennepin Health-MNCare and Hennepin Health-SNBC members.

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  • 01/28/2020
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Get your flu shot!

Flu season is here! The Centers for Disease Control and Prevention (CDC) recommends everyone six months old and older get their annual flu vaccination.
  • 11/26/2019
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Improving Antibiotic Prescribing

Stratis Health is working with the AHRQ and other partners to support implementation of an evidence-based program focused on improving antibiotic prescribing in ambulatory clinics. The deadline to enroll is November 29, 2019.
  • 10/31/2019
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Provider Bulletin: 2019 Q3 Formulary Change Notification

Hennepin Health has made several changes to its drug formulary for 2019 Q3 that are applicable to Hennepin Health-PMAP, Hennepin Health-MNCare and Hennepin Health-SNBC members.
  • 10/01/2019
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Provider Bulletin: 2019 HCPCS Codes Changes

The Centers for Medicare & Medicaid Services (CMS) established a Medically Unlikely Edits (MUEs) of one unit per day for HCPCS codes H0031 and H0032 effective January 1, 2019. For claims with 2019 dates of service, Hennepin Health will reprocess claims billed with one unit without an UD modifier for reimbursement at the per session rate. 
  • 05/29/2019
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Provider Bulletin: 2019 Clinical Practice Guidelines

Hennepin Health’s Quality Management Committee formally adopted five medical, three behavioral health and two substance use clinical practice guidelines from nationally or locally recognized sources.

  • 05/20/2019
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Uniform Preferred Drug List FAQ

The MN Department of Human Services (DHS) has compiled a list of frequently asked questions for providers regarding the Uniform Preferred Drug List. 

 

  • 05/09/2019
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Provider Bulletin: 2019 Q1 Formulary Change Notification

Hennepin Health has made several changes to its drug formulary for 2019 Q1 that are applicable to Hennepin Health-PMAP, Hennepin Health-MNCare and Hennepin Health-SNBC members.
  • 01/08/2019
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Provider Bulletin: PCA and HCN Changes Effective January 1

Beginning January 1, 2019, all personal care assistance (PCA) and home care nursing (HCN) services for people under age 65 will be covered under fee-for-service (FFS), and will be paid by the Department of Human Services (DHS).

  • 01/04/2019
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Provider Bulletin: Subscriber Name Edit

Effective 1/04/2019, Hennepin Health will attempt to correct errors found in the subscriber name fields of incoming 837 claim transactions.

  • 01/03/2019
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Provider Bulletin: Updated Prior Authorization

Hennepin Health’s prior authorization document is ready and available for review.

  • 12/28/2018
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Provider Bulletin: SUD Reform

Hennepin Health will transition from the Rule 25 chemical dependency system to a direct access system, also referred to by its Minnesota Statute reference number Chapter 245G. This transition is taking place in a parallel process as Rule 25 and direct access treatment services are both covered until July 1, 2020 when Rule 25 will end.

  • 12/28/2018
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Provider Bulletin: HEDIS Rates

HennepIn Health has completed its annual 2018 HEDIS measure reporting.

  • 12/21/2018
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Provider Bulletin: Irbesartan Drug Recall

Hennepin Health was informed of a recall of the drug Irbesartan. The recall was made voluntarily by the drug manufacturer.
  • 11/20/2018
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Provider Bulletin: 2018 Q4 Formulary Change Notification

Hennepin Health has made several changes to its drug formulary for 2018 Q4 that are applicable to Hennepin Health-PMAP, Hennepin Health-MNCare and Hennepin Health-SNBC members.

  • 11/19/2018
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Upcoming November Webinar: Meeting the Challenges of Opioids and PAIN

The surge in opioid use and misuse in the U.S. is well known and highly publicized.This webinar will discuss the intersection of Substance Use Disorder (SUD) and mental health issues, along with the role that social determinants of health plays in both areas.
  • 10/18/2018
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Electronic Remittance Advice Issues October 5, 2018

It has come to the attention of Hennepin Health that there were issues during the processing of this week’s Electronic Remittance Advice (ERA) 835 file. The issues may have resulted in ERAs being rejected or incomplete ERAs being sent to clearinghouses. Hennepin Health is currently working on correcting the issues, and all ERAs for this week will be reissued. New or corrected ERA files will available by the end of the day on Monday, October 8, 2018.
  • 10/05/2018
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Provider Bulletin: Prescription Drug Recalls

Hennepin Health has been informed of three separate drug recalls. All three recalls were made voluntarily by the drug manufacturers.

  • 09/24/2018
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Provider Bulletin: SNIP Testing Levels 4 and 5

As of August 1, 2018, Hennepin Health began testing incoming transactions for compliance under SNIP Levels 4 and 5 requirements. This new implementation will allow for faster processing of clean claims and improved data quality with fewer data cycle errors. Beginning September 1, 2018, claims will reject if they do not pass SNIP Levels 4 and 5 testing.

  • 08/07/2018
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Hennepin Health Claims System Enhancement

On July 12, 2018, Hennepin Health’s claims system was enhanced to include the use of Optum Claim Edit System™ (CES) software. The enhancement is applicable for all new and adjusted professional (837P) and institutional (837I) claims for Hennepin Health-PMAP, Hennepin Health-MNCare and Hennepin Health-SNBC members.

  • 07/31/2018
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Child and Teen Checkup Fact Sheet Updates

The Minnesota Department of Health (MDH) has made several updates clarifying the requirements for Child & Teen Checkup (C&TC) screenings. These updates went into effect June 1, 2018 and have been incorporated into the C&TC fact sheets available on MDH’s website.

  • 07/19/2018
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Provider Bulletin: Formulary Changes

Hennepin Health has made several changes to its drug formulary that are applicable to Hennepin Health-PMAP, Hennepin Health-MNCare and Hennepin Health-SNBC members.

  • 07/17/2018
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Provider Bulletin: Rendering Provider Requirements

Hennepin Health is implementing a new custom edit that will be applied to all incoming 837 professional claim transactions. This new edit will reject claims submitted with certain procedure codes when a rendering provider is required, but not included.

  • 07/05/2018
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Provider Bulletin: Opioid Prescription Limitations

Hennepin County is currently experiencing an epidemic of opioid-related overdose deaths. To address this serious issue, Hennepin Health will be implementing two new limitations for opioid prescriptions effective August 1, 2018.

  • 07/03/2018
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Upcoming June Webinar: Meeting the Challenges of Opioids and PAIN

The surge in opioid use and misuse in the U.S. is well known and highly publicized.This webinar will introduce participants to two new resources to help address this issue in clinical practice.

  • 06/12/2018
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Taking Antidepressants

Learn more about Hennepin Health's role in a performance improvement project (PIP) for reducing disparity in antidepressant medication adherence.

  • 05/22/2018
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FAQ: Hennepin Health-PMAP and Hennepin Health-MNCare Out-of-Network Referrals vs. Authorizations

The referral requirements for accessing out-of-network providers differ between the ACO defined partnership network and in-network non-ACO partner providers. This FAQ provides tips and answers common questions.

  • 05/08/2018
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Provider Bulletin

Shannon Mayer, CEO of Hennepin Health since April 2014, is leaving Hennepin Health to take a new position with another Minnesota health plan. Her last day at Hennepin Health is Friday, April 20, 2018.

  • 04/18/2018
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Provider Bulletin

Effective March 15, 2018, Hennepin Health will be implementing a new timely filing rejection edit for all incoming Electronic Data Interchange (EDI) 837 Institutional (837I) and 837 Professional (837P) claims.
  • 02/20/2018
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Provider Bulletin

Hennepin Health identified a system mapping error that occurred on published Remittance Advice starting December 20, 2017. The claim adjustment reason code OA-209 was applied in error to paid service line items. This adjustment reason code should have reported as CO-45.
  • 02/07/2018
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Provider Bulletin

Effective January 1, 2018, Hennepin Health requires the appropriate number of subluxation diagnosis codes when billing CPT codes 98940, 98941, and 98942.
  • 01/31/2018
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Provider Bulletin

Hennepin Health is making several changes to its drug formulary in Q1 2018. These changes are applicable to Hennepin Health-PMAP, Hennepin Health-MNCare and Hennepin Health-SNBC members.

  • 01/18/2018
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Electronic transaction guidelines

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