Entering Recoveries in MMIS
Greg Lulic I County Liaison
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Why is this important?
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What has changed?
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What do you want counties to actually do?
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Selecting the Correct Obligation Type
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Type of recovery | Obligation type |
Any recovery made outside of the probate process, such as through: • Transfer-on-death deed (TODD) • Written agreement with parties | EA: Estate Affidavit |
Any recovery made through the probate process, such as: • Formal or informal probate | EP: Estate Probate |
There are two obligation types under which you must enter estate recoveries in MMIS for Medical Assistance (MA), Alternative Care (AC), or General Assistance Medical Care (GAMC) funds. The two obligation types are Estate Affidavit (EA) and Estate Probate (EP).
EA: Use obligation type EA whenever your recovery was made outside of a probate process.
EP: Use obligation type EP whenever your recovery was made through a probate process, such as formal probate, informal probate, special administration, or determination of descent.
Entering a Recovery: Steps
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1. In the mainframe, choose MMIS. Use the customary mainframe access method for your local agency.
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Entering a Recovery: Steps
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2. Enter your mainframe ID and password. Press Enter.
2. Enter your mainframe ID and password. Press Enter.
Entering a Recovery: Steps
3. In the upper-left corner of the screen, enter the system ID: MW00. Be sure to enter the digits “00” and not the letters “OO.” Press Enter.
4. On the MMIS main menu screen, select the recipient (member) subsystem (RECIPIENT FILE APPLICATION) by entering an “X” to the left of that choice. Press Enter.
Note: The applications you see listed on the main menu screen depend on your level of access to MMIS information and may not match those shown in the following screen shot.
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Entering a Recovery: Steps
5. On the RKEY screen, use action code I to make an inquiry, and enter the recipient (member) ID, name, and SSN or other ID.
In the upper-left corner of the RKEY screen, enter “RELG” after “NEXT:” and press Enter to navigate to the RELG screen.
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Entering a Recovery: Steps
6. The following screenshot of an example RELG screen shows three eligibility spans to choose from.
Keep track of the eligibility span begin and end date(s) for each service you recovered funds for in your estate claim. You will need these dates in step 9 of this procedure.
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Entering a Recovery: Note
The claims payment history provides a claim total for MA services, and if the MA member received MA under a specialized eligibility type, the report provides subtotals for MA services by eligibility type. The specialized eligibility types that appear on the report are as follows:
• MA-BC
• MA-NA
These eligibility types receive specialized federal funding and require separate obligation entry into MMIS if you recovered enough funds to attribute recoverable dollars to services received under these eligibility types. Consequently, you must track the begin and end dates found in MMIS for each of these eligibility types that appear in the claims payment history. The eligibility type is found in the “ELIG TY:” field.
For example, an MA-AX eligibility span would look similar to this:
01 PRG: MA MEDICAID ELIG TY: AX ADULTS WITHO
ELIG BEGIN: 03/01/14 ELIG END: 12/31/15 C
STATUS DATE: 12/26/15 DATE ADDED: 05/12/14
If an MA-AX subtotal appeared on your claims payment history, and you recovered enough funds to attribute recovery to services received under MA-AX eligibility, then you would record the eligibility begin and end date for MA-AX for obligation entry in step 9C.
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Entering a Recovery: Steps
7. Press F6 until you are back at the main menu. Select FINANCIAL CONTROL by entering an “X” to the left of that choice. Then press Enter.
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Entering a Recovery: OKEY
8. On the OKEY screen, use action code A (used to add a new recovery for a recipient [member]). Select your obligation type. Then press Enter to go to the next screen.
Screen shot of OKEY screen:
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Entering a Recovery: Order of Obligation Entry
9. On the next screen, the OBLG screen, enter the recovery amount for each service you recovered funds for. Do this by isolating the claim amount and your recovery amount for each service. If you have recovered on more than one service, repeat steps 7–10 for each recovery entry.
Prioritize attribution of recovery dollars to each service in the following order:
• AC services received before November 1, 2013
• AC services received on or after November 1, 2013
• GAMC services
• MA services received before January 1, 2020
• MA services received between January 1, 2020 and the end of the Public Health Emergency (PHE)
• MA-BC
• MA-NA
• MA-AX
Use the guidance on the next slides to enter recoveries for these services in the order presented.
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Important!
When the county is entering the eligibility span in Financial Control Obligation in MMIS, the worker cannot designate an end date on the first screen.
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This is what happens when you let the system default:
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You need to use the 2nd screen
The county worker should be entering the end date (2019 or earlier) on the second screen in obligation, OACT. This will result in the correct funding code assignment with the higher retained county recovery.
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This gets you to the correct obligation and the correct incentive
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Entering a Recovery: AC before 11/1/2013
9A. Entering a recovery for AC services
If the person received AC services, attribute recovery funds first to AC up to the total amount paid for AC services. If the person did not receive AC services, skip to entering GAMC.
i. AC services received before November 1, 2013
a. Review the claims payment history for AC claims paid before November 1, 2013, and total those claim amounts together.
b. On the OBLG screen, enter the following items to select the service for which you are entering a recovery:
• BEG DATE: AC eligibility begin date
• RECIP ID: Recipient (member) ID (eight digits) this will take you to the OBLIGATION MAX line.
c. Enter the amount of the AC claim total for services received before November 1, 2013, in the OBLIGATION MAX line on the OBGL screen. Hit “Enter” and it will take you to the OACT screen.
d. On the OACT screen enter:
• BEG DATE: AC eligibility begin date
• END DT: AC eligibility end date or 10/31/13, whichever date is earlier.
• Enter your recovery amount for those services
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Entering a Recovery: AC after 11/1/2013
ii. AC services received on or after November 1, 2013
a. Review the claims payment history for AC claims paid before November 1, 2013, and total those claim amounts together.
b. On the OBLG screen, enter the following items to select the service for which you are entering a recovery:
• BEG DATE: AC eligibility begin date or November 1, 2013– whichever date is later
• RECIP ID: Recipient (member) ID (eight digits) this will take you to the OBLIGATION MAX line.
c. Enter the amount of the AC claim total for services received on or after November 1, 2013, in the OBLIGATION MAX line on the OBGL screen. Hit “Enter” and it will take you to the OACT screen.
c. On the OACT/ 2nd screen, enter:
• BEG DATE: AC eligibility begin date or November 1, 2013– whichever date is later
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Entering a Recovery: GAMC
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If the person received GAMC services, then attribute recovery funds to GAMC up to the total amount paid for GAMC services. If the person did not receive GAMC services, skip this step.
i. Review the claims payment history for the subtotal of GAMC claims paid. Add up all GAMC claims
b. On the OBLG screen, enter the following items to select the service for which you are entering a recovery:
• BEG DATE: GAMC eligibility begin date
• RECIP ID: Recipient (member) ID (eight digits) this will take you to the OBLIGATION MAX line.
c. Enter the amount of the GAMC, in the OBLIGATION MAX line on the OBGL screen. Hit “Enter” and it will take you to the OACT screen.
d. On the OACT screen enter:
• BEG DATE: GAMC eligibility begin date
• END DT: GAMC eligibility end date
• Enter your recovery amount for those services
Entering a Recovery: Entering a Recovery for MA
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If the person received MA services, then attribute recovery funds to MA up to the total amount paid for MA services:
MA before 1/1/2020
a. Review the claims payment history for the subtotal of regular MA claims paid. Add up all MA claims from the earliest date of service through 12/31/2019.
b. On the OBLG screen, enter the following items to select the service for which you are entering a recovery:
• BEG DATE: MA eligibility begin date
• RECIP ID: Recipient (member) ID (eight digits) this will take you to the OBLIGATION MAX line.
c. Enter the amount of the MA received before 1/1/2020, in the OBLIGATION MAX line on the OBGL screen. Hit “Enter” and it will take you to the OACT screen.
d. On the OACT/ 2nd OBLG screen enter:
•BEG DATE: MA eligibility begin date
• END DT: MA eligibility end date or 12/31/2019, whichever date is earlier
• Enter your recovery amount for those services
MA During the PHE
MA between 1/1/2020 and the end of the Public Heath Emergency
a. Review the claims payment history for the subtotal of “plain” MA claims paid. Add up all MA claims from the 1/1/2020 through the end of the PHE.
b. On the OBLG screen, enter the following three items to select the service for which you are entering a recovery:
• BEG DATE: MA eligibly begin date OR 1/1/2020, whoever date is later
• RECIP ID: Recipient (member) ID (eight digits) this will take you to the OBLIGATION MAX line.
c. Enter the amount of the MA from 1/1/2020 through the end of the PHE, in the OBLIGATION MAX line on the OBGL screen. Hit “Enter” and it will take you to the OACT screen.
c. On the OACT/ 2nd OBLG screen enter:
•BEG DATE: MA eligibility begin date
• END DT: MA eligibility end date or the end of the PHE, whichever date is earlier
• Enter your recovery amount for those services
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Entering a Recovery: Entering a Recovery for MA
The PHE is not over yet, so this is just FYI:
MA after the end of the Public Heath Emergency
a. Review the claims payment history for the subtotal of “plain” MA claims paid. Add up all MA claims from the after the PHE.
b. On the OBLG screen, enter the following three items to select the service for which you are entering a recovery:
• BEG DATE: MA eligibly begin date or the end of the PHE, whoever date is later
• RECIP ID: Recipient (member) ID (eight digits) ) this will take you to the OBLIGATION MAX line.
c. Enter the amount of the MA received after the end of the PHE, in the OBLIGATION MAX line on the OBGL screen. Hit “Enter” and it will take you to the OACT screen.
c. On the OACT/ 2nd OBLG screen enter:
•BEG DATE: MA eligibility begin date or end of the PHE, whichever is later
• END DT: MA eligibility end date
• Enter your recovery amount for those services
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Entering a Recovery: Special MA types
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If the person received MA services, then attribute recovery funds to MA up to the total amount paid for MA services.
MA-NA
a. Review the claims payment history for the subtotal of MA-NA claims paid.
b. On the OBLG screen, enter the following three items to select the service for which you are entering a recovery:
• BEG DATE: MA-NA eligibility begin date
• RECIP ID: Recipient (member) ID (eight digits) ) this will take you to the OBLIGATION MAX line.
c. Enter the amount of the MA-NA , in the OBLIGATION MAX line on the OBGL screen. Hit “Enter” and it will take you to the OACT screen.
c. On the OACT/ 2nd OBLG screen enter:
•BEG DATE: MA-NA eligibility begin date
• END DT: MA-NA eligibility end date
• Enter your recovery amount for those services
MA-AX
a. Review the claims payment history for the subtotal of MA-AX claims paid.
b. On the OBLG screen, enter the following three items to select the service for which you are entering a recovery:
• BEG DATE: MA-AX eligibility begin date
• RECIP ID: Recipient (member) ID (eight digits) this will take you to the OBLIGATION MAX line.
c. Enter the amount of the MA-AX , in the OBLIGATION MAX line on the OBGL screen. Hit “Enter” and it will take you to the OACT screen.
c. On the OACT/ second OBLG screen, enter:
•BEG DATE: MA-AX eligibility begin date
• END DT: MA-AX eligibility end date
• Enter your recovery amount for those services
Entering a Recovery: Steps
10. On the OACT screen, you can do the following:
• Enter an activity begin date and an activity end date.
• Enter the amount paid or the amount of the obligation or recovery.
• Enter a note, such as a note of the receipt voucher number, number of the check received, and date of receipt.
Screen shot of OACT screen:
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Finding an Existing Recovery Using Action Code I
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To find an existing obligation, follow these steps:
1. Log in to MMIS. Select FINANCIAL CONTROL by entering an “X” to the left of that choice. At the OKEY screen, enter action code “I" and the obligation type or NPI name (your county name).
2. Review the results on the OSEL screen. To page forward, press F8. To page back, press F7.
3. Enter an “X” to left of the obligation that matches your criteria. Press Enter.
4. Review the results. To page forward to the OACT screen, press Enter again.
5. To exit inquiry at any point, press F6.
Key Points:
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Thank You!
Greg Lulic
Greg.Lulic@state.mn.us 651-431-3152
DHS Special Recovery Unit | mn.gov/dhs/ma-estate-recovery
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