Study group would waylay governor’s proposal for unit-based billing

It’s a delicate balance trying to address fraud while also ensuring continuity of care. This continuing throughline was once again discussed in the House Human Services Finance and Policy Committee Wednesday, this time regarding the Integrated Community Support programs.

Many ICS providers have decried the Department of Human Services’ budget proposal from Gov. Tim Walz to switch from daily rate billing to unit-based billing. Many are concerned that this change could devastate programs, punish good actors and leave vulnerable adults without needed services.

ICS services, which provide home care to people with disabilities in provider-controlled, multi-family housing, have been flagged as one of the state’s 14 Medicaid high-risk programs vulnerable to fraud with news outlets reporting cases of overbilling. The governor’s proposed change to billing aims to standardize expectations for typical support needs and prevent over-authorization.

As an alternative, Rep. Brion Curran (DFL-White Bear Lake), sponsors HF1767 that, as amended, would establish a legislative study group and prohibit the Department of Human Services from implementing changes to ICS until the group has submitted a transition plan to the Legislature. The bill comes in the wake of DHS’ termination of the housing stabilization program, which was done without legislative approval.

No action was taken on the bill.

The work group would be “focused on what ICS should and could look like so that it’s not vulnerable to fraud and it’s meeting the needs of people who are supporting our neighbors,” Curran said. 

Curran and Josh Berg, director of services and strategic growth at Accessible Space Inc., emphasized that the bill would not prevent the department from investigating fraud. It simply would not allow the department to end or make changes to the program until the work group completed its recommendations to the Legislature.

“This bill slows the dangerous part without stopping progress,” Berg said.

The ICS program was first created five years ago and Zahnia Harut, CEO at Affinity Care MN, said providers have navigated a lack of clarity and multiple policy changes since. She supports the bill’s effort to develop a better understanding of how these programs can be run. “All ICS providers are currently uncomfortable with the status quo.”