KodaComplyHome care rules, state by state, in plain EnglishDocuments collected September 22, 2026

Minnesota home care rules

Minnesota licenses home care providers through the Department of Health (MDH) at two levels, basic and comprehensive, while Medicaid personal care agencies (PCA, now being replaced by Community First Services and Supports, CFSS) enroll with the Department of Human Services (DHS) instead. For seniors on Medical Assistance (Minnesota's Medicaid), seven health plans offer Minnesota Senior Health Options (MSHO) and Minnesota Senior Care Plus (MSC+) in 2026. What is changing now: DHS began enforcing electronic visit verification (EVV) compliance thresholds on Jan. 1, 2026, rising to 80% from July 1, 2026, and fee-for-service claims for high-risk services such as CFSS and adult companion services can be held for pre-payment review.

78 official documents·collected September 22, 2026·checked against them September 22, 2026
License for non-medical home care?YesBasic home care license from MDH for help with dressing, bathing, toileting and similar tasks. Housekeeping, meal preparation and shopping only: a $20 or $50 registration instead. Medicaid PCA agencies are exempt from the MDH license.
License for home health?YesComprehensive home care license from MDH (nursing, therapy, delegated tasks, medication management). For Medicaid, a home health agency is a Medicare-certified home care provider.
EVV80% from July 1Required for PCA, CFSS and home health. DHS began enforcing compliance thresholds on Jan. 1, 2026: at least 50%, then at least 80% from July 1, 2026 (DHS notice, March 2026).
Medicaid health plans7 plans for seniorsMSHO and MSC+ in 2026: Blue Plus (every county), HealthPartners, Itasca Medical Care, Medica, PrimeWest Health, South Country Health Alliance, UCare

What changed, and what to do about it

Red means act now, amber means read it this month, grey is for the record.

Act nowEnforced since Jan. 1, 2026 · 80% from July 1, 2026

EVV: DHS's compliance threshold is 80% from July 1, 2026

DHS began enforcing EVV compliance thresholds on Jan. 1, 2026: at least 50% from Jan. 1 and 80% from July 1. HHAeXchange sends DHS and providers a compliance report around the 25th of each month. Providers that miss the threshold get corrective action notices in the PRVLTR folder of their MN–ITS mailbox. You must track compliance for every tax ID and provider number that has to send EVV data.

What to do: Read each monthly compliance report and fix missed or edited visits before the next one. Check your MN–ITS mailbox for notices.
Read this monthAnnounced Oct. 29, 2025 · records-request notice March 31, 2026

Claims for CFSS and companion services may be held for review

Fee-for-service claims for 14 high-risk services, including CFSS, adult companion, individualized home supports, integrated community supports and night supervision, go through pre-payment review by Optum. Claims may be held for up to 90 days. Separately, DHS and CMS may ask for records on flagged claims after payment, and you have 15 days from the notice to send them.

What to do: Check the PREPAYDOCREQUEST folder in your MN–ITS mailbox often, keep shift records ready, and answer requests on time.
Read this monthEffective Jan. 1, 2026 · system updated Feb. 13, 2026

New tiered PCA and CFSS rates, with a 72.5% wage rule

PCA and CFSS agency rates now depend on each worker's tier (Base, then Levels 1 to 4 by hours of experience). DHS said it would reprocess claims for Jan. 1 to Feb. 12, 2026 that include a Level 1 to 4 worker, with reprocessed claims appearing from March 24 through April 2026. Agencies must document that at least 72.5% of PCA and CFSS revenue goes to worker wages and benefits.

What to do: Make sure each worker's tier is on your claims, and keep records that show how you meet the 72.5% rule.
For the record245D moratorium from Jan. 1, 2026 · enrollment freeze from Jan. 27, 2026

245D licensing paused; high-risk enrollment freeze

DHS stopped accepting new 245D license applications and new service lines from Jan. 1, 2026, and canceled pending applications; the moratorium is expected to last until Dec. 31, 2027. Separately, from Jan. 27, 2026, DHS froze new Medicaid enrollments in 13 service categories it identified as high risk for fraud; DHS's January list of 13 high-risk services includes CFSS and PCA agencies and companion care. The freeze was initially slated to last six months, with exceptions where more capacity is needed, and the documents we hold don't say whether it was extended. Current providers can keep serving their clients.

What to do: If you planned to add a waiver service or open a CFSS agency, ask DHS about the current status before you apply.
For the recordMarch 31, 2026

PCA ended for Alternative Care members

Alternative Care (AC) members can no longer get PCA after 11:59 p.m. on March 31, 2026. They must move to CFSS, another AC service or informal supports.

What to do: If you still have AC members with PCA authorizations past March 31, call their case managers.

Deadlines coming up

Dates taken from the rules and notices as we read them.

70days
December 2, 2026

CFSS Steps for Success workshop (Dec. 2–4, 2026)

Three-day online workshop from MHCP. Registration closes seven business days before it starts, or earlier if the session fills.

464days
December 31, 2027

245D licensing moratorium expected to end

DHS said the moratorium, which started Jan. 1, 2026, was expected to last 24 months.