Hi all,

We just finished out meeting with the VA. Here are the things I can share right now, with some thoughts on next steps:

Background/more information on the issue

-This is a National issue, not just a MN issue. MN VA staff were unaware of any of this until 2 weeks ago.

-In 2020, agencies had started to merge over to Optum from VCA. The issue is with payments from VCA, NOT Optum. If you went to Optum right away when the transition started, you will be better off (less take back window) than those that waited to do so.

-VCA has stated that in contracts to providers, there is the below statement- stating that if your total visit service fee is not greater than your Medicare HIPPS code value, you will be paid on the FFS side, not the PDGM side. They clearly did not follow their own contract and paid folks out at the PDGM rate and are now asking for the money back (which we argued is not providers problem that they paid things out incorrectly). Please let me know if this does not make sense and I will send an example. My ask of your agency if you have this issue- can you please have someone review your contract from 2020 to see if you have this language in there? I have a feeling providers do not have this language in the contract.

A screenshot of a medical insurance policy

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-The MN VA staff is 1000% behind providers on this. They don’t feel this is right and are willing to assist in this as much as they can. Not only to help agencies but also to ensure access to care for veterans going forward.

Next steps- MN VA

-The MN VA staff will be contacted MN agencies to discuss your personal situation if you gave me permission to share your contact information. Again, these folks aren’t the ones doing the actual take backs, but they are here to help however they can and are extremely sympathetic to the situation and agree it’s a little crazy. If you did not give me permission to share your agency information but would like this done, please let me know and I will help facilitate this.

-They will be reaching out to National contacts to find out who providers can contact to get actual answers/information about their claims. They will let MHCA know, and I will pass this off to you ASAP.

Next steps- Agency action

-We asked the MN VA staff what providers should do right now- they stated that the national group/the ones doing the take backs advice was providers should pay right away. We cannot advise you either way on what to do but have some things for you to consider while you make the best decision for your agency.

-MHCA has asked the MN VA staff to push for an extension on the timeline to pay back while things are getting sorted out. The MN VA staff has committed to doing this and will let us know what they find out. We have also asked them to push the point that their overpayment 4 years ago is not the agencies fault- it is on them to pay correctly. We will see how far that gets. 😊

-We ask that your agency reach out to Congressional delegation regarding this matter. Please do so ASAP!! Please be professional but very firm in your communication on why this is an issue and focus on the VA clients; not your agencies financial business. That is the key here. Please reach out to both Senators and your Representative (Federal). Contact information for all can be found on the bottom of this page.

Next Steps- MHCA

-We have been meeting with Congressional Delegation over the last few weeks. Next week, we have two meetings with Senator Craig and Representative Finstad that we will elevate this issue. We will also elevate it in upcoming meetings and reach back out to those that we have recently meet with.

-We have an email out to NAHC to see what is being done on the federal level and how we can be of assistance.

-We will continue to work with the MN VA to keep the communication lines open for providers and assist however we can.

-We are considering additional advocacy efforts at this time.

If you have made it this far in my email, thank you for taking the time to read all of this! Sorry for this length of email on a Friday afternoon!
Please reach out to me directly if you have any additional questions that I can assist with.

More to come on this issue.

Have a great weekend everyone!

Brianna Lindell

Regulatory Affairs & Advocacy Manager

Minnesota Home Care Association

1265 Grey Fox Road, Suite 2 | Arden Hills, MN 55112-6929

Direct: 651.240.3380 | Main: 651.635.0607