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Beginning on March 4, 2024, the Minnesota Department of Human Services will implement a process to incorporate 2021 legislation that requires outpatient 245G licensed programs to receive authorization when outpatient hours exceed six hours per day or 30 hours per week (254B.05 Subd. 5 (h)).
The Department of Human Services and Acentra (formerly named Kepro) currently have four trainings scheduled to explain the process. The elements include an overview of the registration process, a review of documentation required to show medical necessity and a demonstration of submitting a request.
Members who exceed six hours a day or 30 hours per week of outpatient hours at a 245G licensed facility with dates of service of March 4, 2024, and after, must obtain authorization from the medical review agent (Acentra) to receive payment for the additional hours of service. Acentra will be reviewing the cases to determine medical necessity for additional hours. This process is applicable for individuals whose care is funded by Medical Assistance or the Behavioral Health Fund.
If your program does not provide more than six hours a day or 30 hours per week to an individual client, you do not need to do anything further.
Action required by affected providers
If your program may provide, or is currently providing, more than six hours a day or 30 hours per week of treatment hours for an individual client, please follow the instructions below to register with Atrezzo Next Generation (ANG) and attend a training to become familiar with the process for requesting an authorization.
Registration with Atrezzo Next Generation (ANG)
· If you are not registered with Acentra, either review and follow the instructions in the ANG User Guide and/or attend one of the trainings listed below to learn how to register.
· If your organization is already using ANG as a part of the 1115 Demonstration, you do not need to register again. Additional locations/NPIs can be added to your user account by notifying Acentra at (866) 433-3658 or mh.sud.providerquestions@kepro.com.
To be paid for more than six hours a day or 30 hours per week of nonresidential SUD services, a provider will need to submit requested documentation and receive an authorization number to submit with their claim.
Authorizations are based on demonstrated medical necessity for more than six hours of treatment in a day or 30 hours of treatment per week. Authorizations will cover a 28-day span and a specified number of additional group and individual hours.
More materials with be posted in the Substance Use folder of Acentra’s website as soon as they become available.
Training dates
Trainings on the process will be held on the following dates:
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