Minnesota Medicaid: Your claims may be denied if you’re not enrolled before Oct. 1

Last modified: Oct. 25, 2024
Update: Clarification on state requirements for currently enrolled health care providers.

Starting Oct. 1, 2024, the Minnesota Health Care Programs (MHCP) mandated the following: All managed care organizations (MCOs) must reject claims from health care providers who are not enrolled in the Medicaid program but are contracted with the MCO or have recently billed as an MCO network health care provider.

We will reject claims with a service date of Oct. 1 from health care providers who are not enrolled with the state based on their National Provider Identifier (NPI) number.

Health care providers already enrolled with the state can disregard this notice.

How to enroll

To ensure compliance with the federal mandate, you must submit your enrollment application as soon as possible. If you’re contracted with multiple MCO plans, you only need to submit a single MHCP enrollment request.

All Medicaid health care providers must enroll through the Minnesota Department of Human Services (DHS). The enrollment process includes health care providers who render, order, refer and prescribe services to managed care members, depending on their specialty.

Enrolling with MHCP does not mean you are required to deliver services to fee-for-service members.

For information on the certification and licensure requirements and the enrollment process, go to the Enrollment with Minnesota Health Care Programs (MHCP) page on the Minnesota DHS site.