- Advocate legislatively
WHEREAS the Minnesota Restricted Recipient Program (MRRP) was developed to improve safety and quality of care and to reduce costs for Minnesota Health Care Program (MHCP) recipients who have misused or abused MHCP services;
WHEREAS MRRP identifies MHCP members (any major program code) who have used services at a frequency or amount that is not medically necessary or who have used health services that resulted in unnecessary costs to MHCP (once identified, these people are placed under the care of a designated primary care physician or other providers who coordinate their care for a 24-month period);
WHEREAS emergency health care services, in response to a condition that, if not immediately diagnosed and treated, could cause a person serious physical or mental disability, continuation of severe pain or death, may be provided to an MRRP recipient without the authorization or referral of the primary care physician—however, this has not been followed and pharmacies has been denying prescriptions if not prescribed by PCP;
WHEREAS the primary care provider must fax a Medical Referral for MRRP Enrollee (DHS-2978) to the MRRP office no later than 90 days after the date of service of the referred-to provider service, increasing burdens on the PCP and creating more work for the primary care team;
WHEREAS the primary care provider has been contacted by other providers to send prescriptions in times that the primary care provider might not be available—despite good intention of reducing misuse or system abuse, this program has caused dangerous situations for patients by not receiving their life saving medications on time and causing delay of care;
WHEREAS, if a patient moves to a new location and has a new address, they will be automatically assigned a new local provider even if they have not established care with them;
BE IT RESOLVED that the MAFP partner with other stakeholders to advocate for Minnesota Department of Human Services to re-evaluate parameters of the Minnesota Restricted Recipient Program to limit burden on primary care physicians and other providers and undue harm on patient care.
Originally submitted resolution
BE IT RESOLVED that the MAFP engage primary care providers and lawmakers to re-evaluate parameters of the program to limit burden on primary care providers and undue harm on patient care.
Supporting information
This policy, while made from good intentions, has inadvertently put patients at risk of harm. Having only a single provider be able to order medications is dangerous, especially when the patient is medically complex and requires care from numerous specialists. What if the one provider is unreachable in an emergency? Why are PCPs being assigned who have never seen the patient and now are responsible for prescribing medications for a patient they don’t evaluate? Having only one prescribing provider can delay necessary care.
Comments in support (9)
Macaran Baird – The current rule is putting patients at risk who need emergency care.
Nancy Baker – I think the authors of the resolution have made a good case for adopting this resolution.
Andrew Slattengren – It is time to change how patients are assigned. The current process puts patients and physicians at risk.
Erin Westfall – Patients need fewer barriers to access care if we are to ever achieve equity in our healthcare system.
Robert Koshnick – This resolution is not against the basic concept but simply suggests that it needs to be improved.
Chris Reif – I agree this needs to be completely reworked to address “Maximizing medication management for complex patient care”.
Keith Johnson – Restricting care to primary care providers leads to delays in care. Restriction should be loosened to show for urgent and emergency services. This would decrease administrative burden on PCPs.
Glenn Nemec – While a bit vague, I think this resolution points us in a more useful direction than the previous one.
Margaret Kirkegaard – Re-evaluation of the program intent and outcomes is reasonable.
Comments against (1)
Thomas Seaworth – No one should have to be “assigned” patients they have not seen nor have a relationship with if that includes any responsibility for the care of the patient until that relationship is established.
