Certain services require prior authorization for Hennepin Health members. The prior authorization document (PDF) outlines which services require prior authorization or notification to Hennepin Health. Providers are responsible for verifying eligibility and benefits before providing services to members.
Hennepin Health follows the legislative standards outlined in Minnesota statute 62J.536. Per this statute, all claims submitted to Hennepin Health must be submitted electronically following the American National Standards Institute guidelines, Accredited Standards Committee X12 standard transactions or National Council for Prescription Drug Program (NCPDP) standards. Paper claim submissions will not be accepted. For additional information about Hennepin Health's electronic transaction guidelines, click here.
Five health plans – Blue Plus, HealthPartners, Medica, Hennepin Health and UCare – launched the Antidepressant Medication Management project in the spring of 2015. Interventions include working with providers and partners to support efforts to improve adherence to antidepressant medication with a particular focus on reducing ethnic and racial disparities. In 2016, the health plans combined the antidepressant medication management initiative with a depression-related initiative that focused on diagnosis and treatment of depression within the senior/Medicare population.
Provider Toolkit – Resources for providers and care coordinators working with culturally diverse and senior/Medicare patients experiencing depression include best practices for depression care, mental health resources for providers and patients, cultural competency and shared decision making.
Seven Minnesota health plans – Blue Plus, HealthPartners, Hennepin Health, Medica, PrimeWest Health System, South Country Health Alliance and UCare – are collaborating on a project to reduce the rate of chronic opioid use among the State Public Programs population in Minnesota. Minnesota Department of Human Services (DHS) has identified 45 days of opioid use as a critical timeline for patients prescribed opioids, as continued use beyond 45 days can result in long-term/chronic use or addiction. The goal of this project, which began in 2018, is to decrease the number of PMAP, SNBC, MSHO, and MSC+ members who reach that 45-day threshold by providing clinician, member, and community education and resources to understand best practices in opioid prescribing, potential alternative therapies and safe disposal options.
Provider Toolkit – Resources include patient education on pain and opioid prescriptions, addressing opioid prescription practices, identifying safe and effective pain management protocols, and nonpharmacologic and non-opioid pharmacotherapy alternatives.