Medicaid Member Engagement Committee (MMEC)

Agenda

Welcome & Icebreaker

• Welcome
• Meet & Greet
• Icebreaker
• Conflict of Interest

Guest Speaker

• Dental Services and Provider Shortages: Rachael Buchwitz and Sara Regner
  • Q&A

Discussion

• Annual Goals Tracking
  • Provide education
    • Member handbook work has been slowed due to other duties with deadlines.
  • Improving the Customer Support Center (CSC) experience
    • Task force formed between North Dakota Health and Human Services and human service zone staff.
      • As of June 1, eligibility team members are required to work eight additional hours each week.
        • In the first two weeks, more than 4,282 extra hours were worked. 
  • Improving the website
    • Our website continues to undergo significant long-term work. Right now, we are beginning to meet with Medical Services staff to explore each webpage, its compliance to accessibly requirements, need for each webpage and navigation to each webpage.
  • Sharing access to resources
    • E-News is sharing resources around dental services, the enrollment of community health workers, new school-based services and more.
• Current Event Tracking
  • Rural Health Transformation Program
    • Rural Health Care Suicide Prevention initiative to improve health care for people at risk of suicide.
    • $40 million to the Rural Hospital Clinical Equipment funding opportunity to upgrade equipment and strengthen emergency and specialty healthcare.
    • $1.5 million to support a mobile mammography unit for rural communities in the western part of North Dakota. 
    • Learn more about these and other RHTP opportunities.
  • Behavioral Health Rehabilitative Services
    • No updates.
  • Community Health Worker and Community Paramedicine Services
    • No updates.
  • Traditional Healing Services: Monique Runnels
    • State Plan Amendment (SPA) denial and next steps
    • Section 1115 waiver overview
    • Tribal workgroup development
    • Waiver planning and application components
• Status Updates on Prior Discussion
  • Customer Support Center updates
    • Is the CSC tracking reasons for calls yet to find whether they result from fixable issues such as better training or program updates to avoid confusing or inaccurate member notices?
      • Not at this time, but it is a proposed change, pending approval.
• A public message around MMEC membership 
  • Create a message describing the MMEC membership experience to be added to our MMEC webpage. What do we want others to know? How can we make the MMEC more inviting and appealing?
    • As a member, you will be introduced to committee work and current members. Some members have never been part of committee work before and others have more experience. 
      Before we meet, our agenda is sent out so we can prepare our thoughts and ideas for the topics we will discuss. We get to decide what we talk about and what we aim to impact. Our committee meets online for 1.5 hours every other month. We talk about North Dakota Medicaid changes, challenges and positive impacts. We look at what can be improved and our part in that process. The MMEC is made up of people who want to impact healthcare and healthcare coverage for members in our state. Our members come from all walks of life, bringing unique experiences and points of view. Please consider being our next valued member!
• Meeting survey
  • We didn’t get any feedback on our last meeting. Was there a barrier to filling out the form?
• Working/Not Working 
  • What has been going well or needs improvement with your Medicaid coverage since we last met?
• Q&A
  • Time for questions about any topic of choice. 
• Related News
  • Medicaid Opportunities to Strengthen Oral Health Access in Rural Communities.

Next Steps

• MMAC Meeting Prep
  • What topics would you like to see discussed at future MMAC meetings?
• MMEC Satisfaction Survey
  • Last meeting’s satisfaction survey held no results.
  • MMEC members to take satisfaction survey for this meeting
• Stipends Reminder
  • Return needed documents for timely stipend processing.
• Reminder for Next Meeting
  • Reschedule for Sept. 8, 2026 meeting
    • Sept. 1 at 9:30 a.m. - 11:30 a.m. CT
    • Sept. 10 at 9:30 a.m.- 11:30 a.m. CT
• Upcoming Meetings
  • Nov. 10, 2026
• Meeting Adjourned:

Minutes

Welcome & Icebreaker

Welcome

• Come to order: 9:30 a.m.
• Welcome
• Roll Call
  • Members present
    • Allison Wanner
    • Ashley Roulette
    • Ashley Steele
    • Candace Swenning
    • Eldor Scheid
    • Kara Hanson
    • Neha Patel
  • Members absent
    • Jacqueline Frost-Hodny
    • Emily Gilpin
    • Heather Skadsem
  • Also present
    • Janice Tweet, Coverage Policy Director
    • Jen Sheppard, Member Liaison
    • Monique Runnels, Tribal Liaison
    • Rachel Buckwitz, Utilization Review Administrator
    • Sara Regner, Utilization Review Coding Specialist
    • Wendy Schmidt, Policy Analyst

• Icebreaker

  • Did you celebrate Independence Day? If you did, what did you do? If not, what is a summer holiday that you love to celebrate, and what did you do last time you celebrated it?

• Conflicts of Interest

  • Opportunity to disclose a potential conflict of interest.
    • No conflicts were shared.
  • Committee decision to accept or refuse conflict of interest.
    • N/A.

Guest Speaker

• Dental Services and Provider Shortages: Rachael Buchwitz and Sara Regner
• We discussed dental services covered by North Dakota (ND) Medicaid and which services are covered under dental versus medical. We discovered the process for deciding which dental services ND Medicaid will cover. 
• We explored the dental provider shortage and identified that ND Medicaid reimbursement rates are on-par or above other states in our region. We acknowledged demographic impacts on professional workforce shortages, overwhelmed dental practices and prohibitive costs of schooling for dental providers.
• Presenters explained how Insure Kids Now data helps them understand provider shortages. ND Medicaid is using targeted outreach and policy changes to reduce administrative burden and increase dental provider enrollment. Presenters offered help finding dental providers and shared that travel is often involved for those in rural areas.
• Bismarck State College (BSC) is starting a dental hygiene program. They will offer student loan repayment options to train more dental providers to work in our state. 
• Questions and Answers (Q&A). 
  • Q: One member shared that their dentist reported being reimbursed at 50% for provided services. What percentage of dental billing charges does Medicaid pay?
    • A: ND Medicaid reimburses a flat rate for each service. Providers set their own rates, so the percentage that ND Medicaid covers differs by provider. There are a great number of services covered.
  • Q: 265 dentists are currently enrolled with ND Medicaid. What is the total number of dentists in ND?
    • A: About 385 providers are affiliated with the Dental Association but not all may be actively practicing. This number was much lower than the MMEC anticipated.
  • Q: How many students will BSC be able to accommodate?
    • A: 14 students.
  • Q: Do any enrolled dentists offer emergency care services?
    • A: Most dentists will only provide emergency services to established patients due to needing the patient’s health history.
  • Q: What causes claims denials?
    • A: Claims can be denied for many reasons. If a dentist provides a service that needs to be pre-authorized, that claim may be denied until the provider obtains a prior authorization. A denial can also occur if benefits are not coordinated correctly between more than one source of health care coverage. 
  • Q: When does ND Medicaid cover services?
    • A: There are times that Medicaid cannot pay certain claims. They can pay for claims that become the patient responsibility.
  • Q: Does BCBS Medicaid Expansion cover dental? If not, this should be changed.
    • A: No. This was reviewed during the last legislative session but did not pass. The next step is to speak to your area representative and/or a legislator to help represent this need during next legislative session.
  • Q: What dental information would be recommended to share with members?
    • A: Remind members to call and cancel versus not show up to a scheduled appointment and to use non-emergency medical transportation to get to and from appointments.

Discussion

• Annual Goals Tracking
  • What do we want to achieve within each of our 2026 goals?
    • Provide education
      • Member handbook work has been slowed due to other duties with deadlines.
    • Improving the Customer Support Center (CSC) experience
      • Task force formed between North Dakota Health and Human Services and human service zone staff.
        • As of June 1, eligibility team members are required to work eight additional hours each week.
        • In the first two weeks, more than 4,282 extra hours were worked. 
    • Improving the website
      • Our website continues to undergo significant long-term work. Right now, we are beginning to meet with Medical Services staff to explore each webpage, its compliance to accessibly requirements, need for each webpage, and navigation to each webpage.
    • Sharing access to resources
      • E-News is sharing resources around dental services, the enrollment of Community Health Workers, new school-based services and more.
• Current Event Tracking
  • Rural Health Transformation Program
    • Rural Health Care Suicide Prevention initiative to improve healthcare for people at risk of suicide.
    • $40 million to the Rural Hospital Clinical Equipment funding opportunity to upgrade equipment and strengthen emergency and specialty healthcare.
    • $1.5 million to support a mobile mammography unit for rural communities in the western part of ND. 
    • Learn more about these and other RHTP opportunities.
  • Behavioral Health Rehabilitative Services
    • No updates.
  • Community Health Worker and Community Paramedicine Services
    • No updates.
  • Traditional Healing Services
    • State Plan Amendment (SPA) denial and next steps
      • We pursued a SPA. Centers for Medicare and Medicaid Services (CMS) did not approve, but recommended a demonstration waiver instead. 
    • Section 1115 waiver overview
      • What a demonstration waiver is compared to a SPA. What information and actions are needed to develop a demonstration waiver. 
    • Tribal workgroup development
      • This group will review traditional services to cover, provider qualifications, how to implement services, prioritize community needs and more. 
    • Waiver planning and application components
      • How to apply and plan for a demonstration waiver through CMS.
• Status Updates on Prior Discussion
  • Customer Support Center updates
    • Is the CSC tracking reasons for calls yet to find whether they result from fixable issues such as better training or program updates to avoid confusing or inaccurate member notices?
      • Not at this time, but it is a proposed change, pending approval.
• A Public Message Around MMEC Membership 
  • Create a message describing the MMEC membership experience to be added to our MMEC webpage. What do we want others to know? How can we make the MMEC more inviting and appealing?
    • As a member, you will be introduced to committee work and current members. Some members have never been part of committee work before and others have more experience. 
      Before we meet, our agenda is sent out so we can prepare our thoughts and ideas for the topics we will discuss. We get to decide what we talk about and what we aim to impact. Our committee meets online for 1.5 hours every other month. We talk about ND Medicaid changes, challenges and positive impacts. We look at what can be improved and our part in that process. The MMEC is made up of people who want to impact healthcare and healthcare coverage for members in our state. Our members come from all walks of life, bringing unique experiences and points of view. Please consider being our next valued member!
      Member suggested adding a sentence about Medicaid needing feedback from members to elevate concerns to leadership. Members suggested adding a relevant example.
• Attending Other States’ BAC Meetings
  • Members were presented with the potential opportunity to attend other states’ BAC meetings to observe their meeting practices. Several members were interested in this opportunity. 
• Meeting Survey
  • We didn’t get any feedback on our last meeting. Was there a barrier to filling out the form?
    • Two members stated that they had submitted their surveys and perhaps there was an error in receiving them. 
    • It was determined that accessing and remembering to take the survey would be easiest if the link were shared in the chat at the end of the meeting.
• Working/Not Working 
  • What has been going well or needs improvement with your Medicaid coverage since we last met?
    • One member shared their concern for lengthy wait times to specialists and how many aren’t enrolled in ND Medicaid making it harder to see a specialist in a reasonable amount of time. 
    • Another member mentioned the lack of staffing for home healthcare services due to challenges in competitive pay.
• Questions and Answers (Q&A)
  • Q: Is there a solution to waiting an hour on hold when calling to use non-emergency medical transportation? This is a great barrier to using this service.
    • A: Member liaison to follow up and deliver feedback.
• Related News
  • Medicaid Opportunities to Strengthen Oral Health Access in Rural Communities.

Next Steps

• MMAC Meeting Prep
  • What topics would you like to see discussed at the next MMEC meeting
    • Continuation of current topic discussions
    • Mental Health/SUD services
    • Elder health/assisted living
    • How to request non-covered services
• MMEC Satisfaction Survey
  • Last meeting’s satisfaction survey results showed the following ratings:
    • We didn’t get any feedback on our last meeting. Was there a barrier to filling out the form?
      • The MMEC members expressed that the form was not allowing submissions to some, others had submitted and most agreed that it was easiest if the link is shared during the meeting.
• Stipend Reminder
  • Return needed documents for timely stipend processing.
• Reminder for Next Meeting
  • Reschedule for Sept. 8, 2026 meeting due to scheduling conflict.  
    • Sept. 1 at 9:30 a.m. - 11:30 a.m. CT
      • Vote showed favor for this option.
    • Sept. 10 at 9:30 a.m.- 11:30 a.m. CT
• Upcoming Meetings
  • Nov. 10, 2026
• Meeting Adjourned: 11:30 a.m. CT

MMEC Meeting Minutes 7/2026 PDF

Agenda

Welcome & Icebreaker

• Welcome
• Meet & Greet
• Icebreaker
• Conflict of Interest

Guest Speaker

• 1915(i) Behavioral Health and Substance Use Disorder (SUD) Services: Cody Stanley
  • Q&A

Discussion

• Annual Goals Tracking
  • What do we want to achieve within each of our 2026 goals?
    • Provide education
      • We have finalized our April issue of E-News to include Rural Health Transformation Program updates, new services, how to connect with the Customer Support Center, connecting with our Quality Outreach team, and more.
    • Improving the Customer Support Center (CSC) experience
      • As we strive for further impact, we are sharing information to members on ways to most effectively connect with the CSC.
    • Improving the website
      • Our website is undergoing significant work to improve digital accessibility according to the Department of Justice’s revision to the Americans with Disabilities Act (ADA). 
    • Sharing access to resources
      • April’s E-News is sharing how to most effectively connect with the CSC, best times to call, other ways to connect, and how to help us improve the CSC.
• Current Event Tracking
  • Rural Health Transformation Program
    • On March 18, 2026, the first funding opportunity became available. Nearly $10 million will support 37 critical access hospitals in their retention of health care professionals. These funds will be used for retention bonuses, tuition reimbursement, training, childcare, and more. Applications are being accepted through 5 p.m. on April 30, 2026. More information can be found on our News and Events webpage.
    • On April 22, three new grant opportunities were announced. This includes a Zero Hour Physical Education initiative that will provide rural middle and high school students with physical activity opportunities at the beginning of their school day. Another of these is the Community Gardens Project that will support rural community garden development. Lastly, the Community-Based Walking Programs will offer leadership, activities, achievement recognition, and recruiting of participants. 
  • Behavioral Health Rehabilitative Services
    • No updates at this time.
  • Community Health Worker and Community Paramedicine Services
    • We do not have any community paramedicine providers enrolled yet.
    • We do have 12 community health workers enrolled throughout the state. These workers are in Fargo, Grand Forks, Wahpeton, and Beulah. 
    • Questions/Concerns:
      • How does someone become enrolled as a CHW?
        • The certification and ND Medicaid enrollment processes were reviewed.
  • Traditional Healing Services
    • No updates at this time.
• Status Updates on Prior Discussion
  • Promote the applyforhelp@nd.gov email for non-urgent needs. 
  • Share best practices for getting through to the Customer Support Center and other resources.
    • We are publishing an article in this month’s issue of E-News that will share alternative ways to connect with the Customer Support Center and how to get the most out of your time when calling.
  • Dental, vision, and hearing information were requested multiple times at our last meeting.
    • What information do you want to know on these topics?
    • What information do you want to share on these topics?
    • What action do we want to take in these coverage areas?
  • Sharing member stories
    • Would anyone be interested in attending Medical Services’ annual staff meeting in October to present on what Medicaid means for you? 
  • Website improvements
    • We are currently doing major work to our website to comply with DOJ standards for digital access. Our website had over 300 webpages and more than 1100 documents just for Medicaid. We currently have broken links and are temporarily taking down several pages and adjusting documents as we work toward ADA compliance and overall clean up.
      • What message should we post to share with our virtual visitors that our website is under construction and where should we place this message?
• Working/Not Working 
  • What has been going well or needs improvement with your Medicaid coverage since we last met?
• Q&A
  • Time for questions about any topic of choice. 

Next Steps

• MMAC Meeting Prep
  • Suggested discussion topics for future MMAC meetings are listed below. What specifically do we want to discuss about each of these topics?
    • Concerns around accessing disability services.
    • Coverage concerns for vision services.
    • Coverage concerns for hearing services.
    • Dental concerns for shortage in providers.
      • How can we remedy the provider shortage?
• MMEC Satisfaction Survey
• Stipend Reminder
  • Return needed documents for timely stipend processing.
• Reminder for Next Meeting
  • July 7, 2026 @ 9:30 a.m.
• Upcoming Meetings
  • September 8, 2026
  • November 10, 2026
• Meeting Adjourned: 11:20 a.m.

Minutes

Welcome & Icebreaker

• Come to order: 9:30 a.m.
• Welcome
• Roll Call
  • Members present
    • Allison Wanner
    • Ashley Roulette
    • Candace Swenning
    • Eldor Scheid
    • Jacqueline Frost-Hodny
    • Kara Hanson
    • Neha Patel
  • Members absent
    • Ashley Steele
    • Emily Gilpin
    • Heather Skadsem
  • Also present
    • Janice Tweet, Coverage Policy Director
    • Jen Sheppard, Member Liaison
    • Monique Runnels, Tribal Liaison
    • Wendy Schmidt, Policy Analyst
    • Cody Stanley, 1915(i) Administrator
• Icebreaker
• Conflicts of Interest
  • Opportunity to disclose a potential conflict of interest.
    • No concerns were expressed.

Guest Speaker

• 1915(i) Behavioral Health and Substance Use Disorder Services: Cody Stanley
  • Toured program webpages and content, explored eligibility, and reviewed how to apply. We reviewed how to find a provider and different service types such as peer support, housing support, and transportation. Instructions were provided on how to obtain certification to administer the WHODAS.
• Questions/Concerns:
  • What is 1915(i)?
    • The care coordinator is a critical 1915(i) service. Once someone signs up, they are connected with a care coordinator. The care coordinator makes sure the member gets services and help. The care coordinator helps members understand which community-based services they need and connects them to those services.
  • Can anyone administer the WHODAS assessment?
    • There are training requirements for those wanting to administer the WHODAS. 
  • Is there a lack of providers for these services? A concern about the lack of providers and services was expressed. 
    • Yes, in some areas of North Dakota, there may be a lack of providers or providers may not be able to serve more members. We are always looking for new providers. 

Discussion

• Annual Goals Tracking
  • What do we want to achieve within each of our 2026 goals?
    • Provide education
      • We have finalized our April issue of E-News to include Rural Health Transformation Program updates, new services, how to connect with the Customer Support Center, connecting with our Quality Outreach team, and more.
    • Improving the Customer Support Center (CSC) experience
      • As we strive for further impact, we are sharing information to members on ways to most effectively connect with the CSC.
    • Improving the website
      • Our website is undergoing significant work to improve digital accessibility according to the Department of Justice’s revision to the Americans with Disabilities Act (ADA). 
    • Sharing access to resources
      • April’s E-News is sharing how to most effectively connect with the CSC, best times to call, other ways to connect, and how to help us improve the CSC.
• Current Event Tracking
  • Rural Health Transformation Program
    • On March 18, 2026, the first funding opportunity became available. Nearly $10 million will support 37 critical access hospitals in their retention of health care professionals. These funds will be used for retention bonuses, tuition reimbursement, training, childcare, and more. Applications are being accepted through 5 p.m. on April 30, 2026. More information can be found on our News and Events webpage.
    • On April 22, three new grant opportunities were announced. This includes a Zero Hour Physical Education initiative that will provide rural middle and high school students with physical activity opportunities at the beginning of their school day. Another of these is the Community Gardens Project that will support rural community garden development. Lastly, the Community-Based Walking Programs will offer leadership, activities, achievement recognition, and recruiting of participants. 
  • Behavioral Health Rehabilitative Services
    • No updates at this time.
  • Community Health Worker and Community Paramedicine Services
    • We do not have any community paramedicine providers enrolled yet.
    • We do have 12 community health workers enrolled throughout the state. These workers are in Fargo, Grand Forks, Wahpeton, and Beulah. 
    • Questions/Concerns:
      • How does someone become enrolled as a CHW?
        • The certification and ND Medicaid enrollment processes were reviewed.
  • Traditional Healing Services
    • No updates at this time.
• Status Updates on Prior Discussion
  • As requested, we have promoted how to connect to the Customer Support Center (CSC), preparing for your call, best times to call, and alternatives to calling the CSC. 
  • Dental, vision, and hearing information were requested multiple times at our last meeting. What information do we want to know or share on these topics? What actions do we wish to take?
    • Why do we have dental provider shortages, and what we can do to increase dental provider enrollment in ND Medicaid?
    • Consider how the Rural Health Transformation Program (RHTP) could help remedy some concerns in these areas such as expanded training for existing providers and support rural dentistry growth. 
    • Explore which covered oral health services are billable under dental vs. medical coverage.
    • Understand what data/tracking is done to understand how many members are needing dental services but unable to get them due to provider shortages. 
  • We are currently doing major work on our website to comply with Department of Justice standards for digital access. Our website has over 300 webpages and more than 1100 documents just for Medicaid. We currently have broken links and are temporarily taking down several pages and adjusting documents as we work toward ADA compliance and overall clean up.
  • Questions/Concerns:
    • Concerns were expressed about the need to have adequate dentistry services throughout the state. Members are starting to see situations where other members are needing major surgeries but cannot get them due to untreated dental health issues. 
    • Request to revisit dental service concerns in a future MMEC meeting.
    • One member shared that the State Council on Developmental Disabilities is also exploring the dental services concern. 
    • A member expressed concern that they are struggling to find covered dental services even in urban areas of the state. 
    • Does the website have a chat with an agent feature?
      • We do not have that capability yet.
    • Concerns were shared for members losing coverage due to CSC staffing shortages resulting in untimely renewals for coverage.
    • One member experiences about a 20–30-minute wait when calling recently. 
    • Another member shared that during recent calls to the CSC, there were between 40-70 callers ahead of them and they usually don’t have the ability to wait this long. 
    • Is the CSC tracking call reasons and whether they are due to fixable issues that could significantly reduce concerns such as calls for lost coverage due to staff not keeping up with eligibility redeterminations and the automatically produced warning letters?
    • Members were asked about interest in attending a Medical Services all-staff meeting to present on how ND Medicaid has impacted their lives. Volunteers were noted.
• Working/Not Working 
  • What has been going well or needs improvement with your Medicaid coverage since we last met?
    • No further concerns were shared.
• Q&A
  • Time for questions about any topic of choice. 

Next Steps

• Stipend Reminder
  • Return needed documents for timely stipend processing.
• MMAC Meeting Prep
  • What topics would you like to see discussed at the next MMEC meeting
    • No further recommendations were made.
• Reminder for Next Meeting
  • July 7, 2026 @ 9:30 a.m.
• Upcoming Meetings
  • September 8, 2026
  • November 10, 2026
• MMEC Satisfaction Survey
• Meeting Adjourned: 11:30 a.m.

MMEC Meeting Minutes 5/12/25 PDF coming soon.

Agenda

Welcome & Icebreaker

• Welcome
• Meet & Greet
• Icebreaker
• Conflict of Interest

Guest Speaker

• Provider billing: Alyssa Neis Claims Administrator
  • Q&A
• Provider reimbursement: LeeAnn Thiel, Reimbursement Director
  • Q&A

Discussion

• Annual Goals Tracking
  • What do we want to achieve within each of our 2026 goals?
    • Providing education
    • Improving the Customer Support Center experience
    • Improving the Self-Service Portal
• Current Event Tracking
  • Rural Health Transformation Program
    • On January 21st, 2026, a special Legislative session was held to start appropriating funds for rural health transformation. This means that the Legislature made the decision to discuss how funds will be spent. The Department of Health and Human Services will administer the funding and open grant opportunities in February. These funds must be obligated by Oct. 1, 2026, and spent by September 2027. 
    • CMS is reviewing a revised budget. Once this budget is approved, the first grant opportunity is expected to be released.
  • Behavioral Health Rehabilitative Services
    • Held documentation trainings to ensure providers have the information needed to be successful in submitting service authorizations to exceed the soft limits.
  • Community Health Worker and Community Paramedicine Services
    • No community health workers have enrolled in Medicaid.
  • Traditional Healing Services
    • Resilient Pathways event held to consider options for pursuing reimbursement for Traditional Healing Services.
    • Met with CMS to learn more about 1115 Demonstration Waiver option.
• Status Updates on Prior Discussion
  • Direct mailer for MMEC open seats ad
    • We have selected 100 members to get a printed flyer advertising our open MMEC seats!
• Identifying Impactful Areas of Change for Members
  • These three pillars guide us as we consider the holistic experience of Medicaid members and identify where to focus our improvement efforts. We should consider standards of quality, professionalism, effectiveness, and accuracy in all areas of service. 
  • Review the three pillars of member satisfaction and what services, tools, and methods are represented by each. 
  • How well does this breakdown capture aspects of the member experience?
  • What should we add, remove, or change to best capture aspects of the member experience?
    • Tools and Methods (Support for member independence in their health care coverage management)
      • Customer Support Center (CSC)
      • Website
      • Self-Service Portal (SSP)
      • Specialists/Worker Education
      • Applications
      • Other
    • Education (Information and information-delivery systems or methods)
      • Handbook
      • Newsletters
      • Staff-led Educational Opportunities
      • Member Letters
      • Posters/Flyers
      • Other
    • Services (Covered services, non-covered services, limitations, policy, and methods for use of services)
      • Service Delivery Methods
      • Covered Services
      • Limits
      • Other
• E-News Topics Exploration
  • Suggestions:
    • New and changing benefits
    • Insurance guidance
    • Drug formulations
    • How to get and use benefits
    • Substance use disorder information
    • How to select a provider
    • Transportation
    • Promote under-utilized services
    • Covered Services
  • What do we want to know about the suggested topics?
    • Define suggested topics
    • List what information we should share
    • Include related resources
    • Include relative contact information
• Working/Not Working 
  • What has been going well or needs improvement with your Medicaid coverage since we last met?
• Q&A
  • Time for questions about any topic of choice. 
• How do we feel about the new agenda?

Next Steps

• Stipend Reminder
  • Return needed documents for timely stipend processing.
• MMAC Meeting Prep
  • What topics would you like to see discussed at the next MMAC meeting?
• Reminder for Next Meeting
  • May 12, 2026 @ 9:30 a.m.
• Upcoming Meetings
  • July 7, 2026
  • September 8, 2026
  • November 10, 2026
• MMEC Satisfaction Survey
• Last meeting’s Satisfaction Survey results showed the following ratings:
  • MMEC impact on Medicaid: 5/5
  • Feeling heard while sharing: 5/5
  • Overall satisfaction: 5/5
• Suggestions for meeting facilitation improvements include:
  • Gain feedback and increase interaction with new members
  • Fill the MMEC
  • Continue sharing information
  • Suggested areas of focus were:
    • Track legislative activity and new bills
    • Further discussion of vision, dental, and hearing services
    • Adding services via the SFN-905
• Positive feedback included: 
  • Overall communication around traditional healing
  • Great information was shared
  • MMEC members to take Satisfaction Survey for this meeting
• Meeting Adjourned: 11:20 a.m.

Minutes

Welcome & Icebreaker

• Come to order: 8:27 a.m.
• Welcome
• Roll Call
  • Members present
    • Allison Wanner
    • Ashley Roulette
    • Ashley Steele
    • Candace Swenning
    • Eldor Scheid
    • Heather Skadsem
    • Jacqueline Frost-Hodny
    • Kara Hanson
    • Neha Patel
  • Members absent
    • Emily Gilpin
  • Also present
    • Janice Tweet, Coverage Policy Director
    • Jen Sheppard, Member Liaison
    • Monique Runnels, Tribal Liaison
    • Wendy Schmidt, Policy Analyst
    • Alyssa Nies, Claims Administrator
    • LeeAnn Thiel, Reimbursement Director
• Conflicts of Interest
  • Opportunity to disclose a potential conflict of interest.
    • No concerns were expressed.

Guest Speaker

• Provider Billing: Alyssa Neis
• Covered claims statistics, process, delays, and provider support.
• Provider Rates: LeeAnn Thiel
• Covered the provider rates setting process and examples of provider rates.
• Q&A
• Do providers get reimbursed at the same rate whether they are rural or urban?
  Yes. 
• How are provider rates set?
• Rates are set based on a formula that geographically adjusts the national rates.
• How are Medicaid service rates set?
• Some service rates are set based on provider costs such as nursing facilities or basic care. Some rates are specific to ND such as ambulance, dental, non-emergency medical transportation.
• Costs are updated annually for inflation. 
• Each facility has its own costs and reimbursement rates.
• Working with legislators is one way to address rates.
• Are there dentists that will provide services at current rates? 
• Rates are reset to make them current. Then, these are inflated forward. Legislature decides when to reset base rates.
• Current dentists share that they can only provide services for so many ND Medicaid patients due to current reimbursement being 50% of costs. 
• We are aware and trying to advocate for this concern. 
• Suggestion was made to set higher rates for preventive dental services. 
• Do dental rates follow Medicare rates?
• Rates are specific to ND.
• Who initiates rate reviews?
• This can happen within Health and Human Services or involve outside stakeholders, the Dental
• Association, or legislature. The MMEC can bring this forward for 2027-2029 budget work. 
• How do our rates compare to surrounding states?
• We think we are comparable to neighboring states but have not checked recently. 

Discussion

• The new agenda format was introduced as a Word document instead of a PowerPoint to better align with accessibility and to offer a more concise layout.
• Annual Goals Tracking
  • What do we want to achieve within each of our 2026 goals?
    • Provide education
      • Continue to produce E-news.
      • How to log into the Self-Service Portal.
      • Have members share real stories in advocacy.
    • Improving the Customer Support Center experience
      • Decrease wait time.
      • Add a call-back option.
      • Add a ticket number to reference when issues are not resolved and assign them to an assigned worker. 
      • Better equip call center staff to answer questions and provide more support in the moment.
      • Shorten the application process. Vulnerable people can’t afford to wait up to three months for approval/denial.
    • Improving the website
      • Reduce changes because they disorient and confuse members. 
    • Sharing access to resources
      • Promote the applyforhelp@nd.gov email for non-urgent needs.
      • Share best practices for getting through to the Customer Support Center and other resources.
• Current Event Tracking
  • Rural Health Transformation Program
    • On January 21st, 2026, a special Legislative session was held to start appropriating funds for rural health transformation. This means that the Legislature made the decision to discuss how funds will be spent. The Department of Health and Human Services will administer the funding and open grant opportunities in February. These funds must be obligated by Oct. 1, 2026, and spent by September 2027. 
    • CMS is reviewing a revised budget. Once this budget is approved, the first grant opportunity is expected to be released.
  • Behavioral Health Rehabilitative Services
    • Held documentation training to ensure providers have the information needed to be successful in submitting service authorizations to exceed the soft limits.
  • Community Health Worker and Community Paramedicine Services
    • No community health workers have enrolled in Medicaid.
      • One member shared that she is aware of a facility getting ready to enroll staff as community health workers. 
  • Traditional Healing Services
    • Resilient Pathways event was held to consider options for pursuing reimbursement for Traditional Healing Services.
    • Met with CMS to learn more about 1115 Demonstration Waiver option.
• Status Updates on Prior Discussion
  • Direct mailer for open MMEC seats
  • 100 flyers were mailed. 12 flyers were returned because of bad addresses. Two people applied. One was eligible. One interview was set up but did not take place.
  • MMEC reviewed a proposal of three pillars of the holistic member experience. Pillars will bring focus to tools and methods to support member independence, education, and covered services.
    • What should we add, remove, or improve to capture a balanced focus for our holistic member experience?
      • Add posters/flyers for CBOs and waiting rooms beneath the education pillar.
      • Keep putting updates in E-News for the One Big Beautiful Bill Act impacts.
      • Educate members on:
        • The difference between Medicaid and Medicaid Expansion
        • Waivers
        • Medication coverage
        • Behavioral health referrals and services
        • Out-of-state services
        • Non-emergency medical transportation
        • Getting efficient and effective member support
• Working/Not Working
  • What has been going well or needs improvement with your Medicaid coverage since we last met?
• Annual MMEC Evaluation
  • Identify main goals for the MMEC to achieve through the upcoming year. 
• Q&A
  • Will MMEC member receive tax documents for stipends?
    • Tax documents are sent out in January to those who earned $600 or more during the previous year.

Next Steps

• Stipends Reminder
  • Return needed documents for timely stipend processing.
• MMAC Meeting Prep.
  • What topics would you like to see discussed at the next MMEC meeting?
    • Dental concerns for shortage in providers and what can remedy this.
    • Concerns around accessing disability services.
    • Coverage concerns for vision services.
    • Coverage concerns for hearing services.
• Reminder for Next Meeting
  • May 12, 2026 @ 9:30 a.m.
• Upcoming Meetings
  • July 7, 2026
  • September 8, 2026
  • November 10, 2026
• MMEC Satisfaction Survey
  • Last meeting’s satisfaction survey results were reviewed and members were asked to take the satisfaction survey for this meeting.
• Meeting Adjourned: 11:20 a.m. 

MMEC Meeting Minutes 11/4/25

Agenda

Welcome & Icebreaker

• Roll call
• Meet & Greet
• Icebreaker
• Conflict of Interest
• Compensation reminder

Guest Speaker

• Public comment and the policy change process: Wendy Schmidt
• MMAC overview: Janice Tweet

Discussion

• Past topic follow-ups
• Last meeting's survey results
• 11/4/25 Meeting Interactive Questions
• RHTP Tracking
• Annual MMEC Satisfaction Poll Results
• Official Vote
• Working/Not Working
• Q&A

Next Steps

• MMAC Meeting Prep
• Annual schedule

Minutes

Welcome & Icebreaker

• Meeting called to order at: 9:30 a.m.
• Meeting adjourned: 11:15 a.m.
• Roll Call
  • Members present
    • Allison Wanner
    • Ashley Roulette  
    • Ashley Steele
    • Candace Swenning
    • Eldor Scheid
    • Emily Gilpin 
    • Jacqueline Frost-Hodny
    • Kara Hanson
    • Neha Patel
  • Members absent
    • Heather Skadsem
  • Also present
    • Janice Tweet, Coverage Policy Director
    • Jen Sheppard, Member Liaison
    • Monique Runnels, Tribal Liaison
    • Wendy Schmidt, Policy Analyst
• Meet & Greet
  • New member: Ashley Steele
    • What they hope to focus on with the MMEC: Helping those with kids on autism waiver, have foster kids; help navigate system.
• Icebreaker
  • Sharing of 2026 goals and first steps to take in achieving set goals.

Guest Speaker

• Public Comment and the Policy Change Process: Wendy Schmidt, Policy Analyst
  • The public comment purpose, process, and where it fits into the change process. How to initiate change, change approvals, public comment, who is notified of change and how they are notified, and what types of changes are most seen. 
    • MMEC member request made to review the SFN-905 submission process.
• MMAC Overview: Janice Tweet, Coverage Policy Director
  • The MMAC purpose, composition, agendas, Centers for Medicare and Medicaid Services (CMS) requirements and expectations, yearly calendar, and relation to policy impact.

Discussion

• Conflicts of Interest
  • No concerns were expressed
• Reminder to return documents for stipend processing
  • We are still processing November stipends as we are learning the full internal process.
• Past topic follow-ups
  • ND State Navigator information on letters.
    • We confirmed that ND State Navigator information should remain in our letters at this time.
• Interactive Discussion Topics from November 2025 meeting:
  • The MMEC rated how impactful the MMEC is on Medicaid, how heard they feel during our meetings, and their comfort level with the MMEC.
  • Reviewed our 2026 goals to identify where the MMEC fits into the change process and how to take more transformative action around policy change.
  • Identified areas of focus for 2026 to include improving the Customer Support Center experience, sharing resources and education in our meetings, supplying important government notices on our website, confirming all webpage links work, and ND Medicaid readability.
  • Shared what we would like to see happing during the Rural Health Transformation Program (RHTP).
  • Made recommendations for topics to cover in member E-News for 2026.
  • Suggested improvements for the MMEC meeting experience.
  • Members suggested 20 community-based organizations that may help us promote our open seats including medical services entities, social service authorities, employment support organizations, schools, and other suggestions.
  • Our takeaway from your feedback is that we are on the right track overall. We will continue to identify ways the MMEC can impact ND Medicaid and how that looks. We should improve how we listen to the MMEC and act on their suggestions. We will also consider an exit interview process.
• Issue Tracking
  • RHTP
    • ND was awarded $198.9 million for the first year and has a special legislative session on January 21, 2026, to discuss appropriation of funds.
  • Behavioral Health Rehabilitative Services.
    • We implemented soft limits on certain services that may be exceeded with service authorizations.
  • CHW/Community Paramedic Services
    • We are now enrolling these medical professionals to provide certain services to members who have or are at risk of developing a chronic condition or have a documented barrier that affects their health.
  • Traditional Healing Services
    • Our state plan amendment was denied by CMS, and we are forming a work group to determine next steps.
• Voting
  • How should we offer listening sessions and education to ND Medicaid members?
    • Open the end of existing MMEC meetings to add this opportunity.
    • Create an added event to host this opportunity.
  • Outcome: the majority voted to open the end of an existing MMEC meeting to the public for members to join and share. 
  • Do we still feel that two-year terms are best or should they be extended to three-year terms?
    • Keep two-year terms.
    • Extend term lengths to three years.
  • Outcome: the majority voted to extend term lengths to three years.
• Working/Not Working
  • Members shared challenges from their recent personal experiences such as conflicts between their client share and waiver, inaccurate notices through Workers with Disabilities coverage, eligibility letters, dual enrollment, and the application process.
• Q&A
  • No questions were raised.

Next Steps

• MMAC Meeting Prep
  • Topics the MMEC would like to see discussed at the next MMAC meeting include:
    • Customer Support Center efficiency and professionalism. Customers have been told information such as staff are behind on helping members and that staff will find work arounds leaving members less confident that the originating problem will actually be addressed. One member questions if the call center is really working better than the previous structure of eligibility staff at human service zone offices. 
    • How much responsibility should members have in the services approval and billing processes? What is really fair to expect the member to understand and communicate adequately between the coverage provider and the health care professional? 
• Reminder for next meeting
  • March 10, 2026, 9:30-11:30am
• Upcoming meetings
  • May 12, 2026
  • July 7, 2026
  • September 8, 2026
  • November 10, 2026

MMEC Meeting Minutes 1/6/2026

Agenda

Welcome & Icebreaker

• Roll call
• Meet & Greet
• Icebreaker

Guest Speaker

• Rural Health Transformation Program: Janice Tweet

Discussion

• Conflict of Interest
• Compensation reminder
• RHTP Update
• CHCS Panelists
• Rating your experience
• E-News suggestions
• MMEC focus suggestions
• Yearly Reflection
• Gratitude Message
• Q&A
• Working/Not Working
• Decisions

Next Steps

• MMAC Meeting Prep
• Reminder for Next Meeting
• Annual Agenda

Minutes

Welcome & Icebreaker

• Meeting called to order at: 9:30 a.m.
• Meeting adjourned: 11:15 a.m.
• Roll Call
  • Members present
    • Neha Patel
    • Kara Hanson
    • Jacqueline Frost-Hodny
    • Allison Wanner
    • Candice Swenning
    • Eldor Scheid
    • Emily Gilpin
  • Members absent
    • Heather Skadsem
    • Ashley Roulette
  • Also present
    • Janice Tweet, Coverage Policy Director
    • Jen Sheppard, Member Liaison
    • Monique Runnels, Tribal Liaison
• Meet & Greet
• Icebreaker

Guest Speaker

• Conflicts of Interest
  • No concerns were expressed
• Recognition for MMEC member attendance in the Centers for Health Care Strategies (CHCS) national webinar.
  • One MMEC member was invited to attend CHCS’ national webinar training to share their experience during CHCS learning collaborative that took place earlier this year. This member was invited based on his willingness to share openly and encourage others to share their opinions and suggestions with ND Medicaid.
• All MMEC members were sent a poll about their annual overall satisfaction with the MMEC, a survey on suggestions for the RHTP, and a survey to identify ways to improve the MMEC.
• Suggestions for topics to cover in 2026 E-News included One Big Beautiful Bill Act Medicaid requirements, covered services, promote under-utilized services, transportation, vaccine facts and myths, how to select a provider, getting covered medical supplies, and substance use disorder information.
• The MMEC reviewed its work throughout 2025. Work included producing 10 chapters in the Medicaid Member Handbook and six issues of E-News, reviewing and contributing to member notices, improving website navigation, and holding three listening sessions.
• Q&A
  • Is the ND Navigator program still running?
    • Yes. There have been funding cuts to this program, which has resulted in less staffing, but the program is still in-place.
  • How many open seats do we have and can we connect with local organizations to find more member interest.
    • There are three seats currently open. The MMEC will be asked to suggest community-based organizations in their area with whom we can connect.
• Working/Not Working
  • Concerns were shared about the lack of access to dental and vision services due to low reimbursement rates. The committee inquired about whether other factors are causing low provider enrollment rates in these areas of care.
• Sharing
  • MMEC requested a guest speaker on reimbursement rates and the provider billing process.
  • Several members shared their concerns about being able to address serious dental concerns due to the shortage in enrolled dentists.
  • A suggestion was made to visit with providers to explore barriers, solutions, and the overall billing experience to better understand how to gain and maintain provider enrollment.
  • Medicaid Medical Advisory Council (MMAC) information was shared to those members.
  • The MMEC Satisfaction Survey, a poll for suggestions about MMEC work in 2026, and a poll to gather topic suggestions for 2026 E-News will be sent via email following this meeting.  

Next Steps

• Reminder for next meeting
  • March 10, 2026 @ 9:30-11:30am
• Upcoming meetings
  • May 12, 2026
  • July 7, 2026
  • September 8, 2026
  • November 10, 2026

MMEC Meeting Minutes 11/4/25

Agenda

Welcome & Icebreaker

• Roll call
• Meet & Greet
• Icebreaker
• Working/Not Working

Guest Speaker

• Eligibility: Amy Clouse

Discussion

• Conflict of Interest
• Resignations
• Past Topic Follow-Ups
• Review Handbook Chapter
• Review Feedback Summary
• Update on One Big Beautiful Bill
• Compensation
• Q&A
• Open Discussion
• Decisions

Next Steps

• Reminder for Next Meeting
• Annual Agenda

Minutes

Welcome & Icebreaker

• Meeting called to order at: 9:30 a.m.
• Meeting adjourned: 10:50 a.m.
• Roll call of committee members in attendance:
  • Allison Wanner
  • Heather Skadsem
  • Jacqueline Frost-Hodney
  • Eldor Scheid
  • Kara Hanson
  • Ashley Roulette
  • Emily Gilpin
  • Kandy Swenning
• Members Absent:
  • Neha Patel
• Also present:
  • Krista Fremming, Assistant Director
  • Janice Tweet, Coverage  Policy Director
  • Jen Sheppard, Member Liaison
  • Monique Runnels, Tribal Liaison
  • Amy Clouse, Eligibility Policy Administrator
• Introduction and welcome to the first meeting
  • Meet & Greet
  • Icebreaker
  • Working/Not working
    • Members shared that their Customer Support Center (CSC) staff experience has been going well. Out-of-state services are still challenging. CSC staff could not answer questions about social security income during reviews. ND Medicaid services have been going well but members need clarity on where to submit claims. Two members experienced terminated coverage for children and are uncertain of the cause.

Guest Speaker

• Eligibility: Amy Clouse
  • Members learned about different coverage groups, federal laws that created Affordable Care Act (ACA) Medicaid, Non-ACA Medicaid, Basic Care, and Medicaid Expansion standards. We reviewed asset and income limits and exclusions, federal poverty level formulas, client share formulas, eligibility worker roles, eligibility review frequencies, non-citizen eligibility, coverage during incarceration, and the application process.

Discussion

• Conflicts of Interest
  • No conflicts of interest were identified.
• Past topic Follow-Ups
  • Medicaid Member Handbook Search Bar
    • Members viewed the final product for the handbook search bar. This tool expands all sections and highlights any word searched and found within its contents.
• Handbook Review
  • Pharmacy chapter
    • Members reviewed content and suggested defining specific terms. Members suggested renaming the Provider Relations call center because this title is a deterrent for member use.
• Resignations:
  • Darren Fiest resigned for personal reasons. His seat is now open.
• Member feedback summary
  • The MMEC reviewed the member feedback for Medical Services and MMEC best practices. See the full report.
• One Big Beautiful Bill Act (OBBBA) Impacts
  • Members were introduced to the new Stay Enrolled webpage with information preparing North Dakotans for changes to ND assistance programs caused by federal and state law-making.
    • Members request flyers for community partner use to promote this webpage. Members suggest mailing a notice.
      • This topic is planned to be in the Annual Medicaid Member Newsletter that will be mailed in November 2025.
• Committee Member Compensation
  • Starting August 1, 2025, Medical Services will compensate MMEC committee members at a rate of $25/half hour. Earnings from compensation must be reported to ND Assistance programs and could impact their eligibility. Members can deny compensation.
• Q&A
  • Why are certain brand vs. generic medications and supplies covered?
    • ND Medicaid will cover the least costly option of medications or supplies when both are equally effective to reduce financial burden.
  • Are members notified if their medical services or supplies are denied coverage?
    • Yes. A notice is mailed.
• Sharing
  • Does Medicaid offer information around having other insurance coverage with ND Medicaid?
    • Information was added to the Medicaid Member Handbook after this was initially suggested.
  • Can we educate members in finding in-network providers also enrolled in ND Medicaid so members aren’t unknowingly getting services that they will have to pay for?
    • Yes, we can explore adding this information into the Medicaid Member Handbook.

Next Steps

• Reminder for next meeting
  • November 4, 2025 @ 9:30-11:30am
• Upcoming meetings
  • 2026 schedule to be determined.

MMEC Meeting Minutes 9/9/25

Agenda

Welcome & Icebreaker

• Roll call
• Meet & Greet
• Icebreaker

Discussion

• Question for all: What is your biggest concern for Medicaid?
• Review Medicaid Member E-Newsletter
• Q&A
• Open Discussion
• Decisions

Next Steps

• Reminder for Next Meeting
• Annual Agenda

Minutes

Welcome & Icebreaker

• Meeting called to order at: 9:3 a.m.
• Meeting adjourned: 10:50 a.m.
• Roll call of committee members in attendance:
  • Allison Wanner
  • Heather Skadsem
  • Jacqueline Frost-Hodney
  • Eldor Scheid
  • Kara Hanson
  • Ashley Roulette
  • Emily Gilpin
  • Neha Patel
  • Kandy Swenning
  • Darren Feist
• Also present:
  • Krista Fremming, Assistant Director
  • Janice Tweet, Coverage  Policy Director
  • Jen Sheppard, Member Liaison
  • Monique Runnels, Tribal Liaison
• Introduction and welcome to the first meeting
  • Meet & Greet
  • Icebreaker
  • Working/Not working
    • Coverage is working well when going to providers. Getting answers on coordination of benefits from the Customer Support Center was difficult, especially with dental and vision coverage. Members are not aware that a provider list exists or how to find it. The Self-Services Portal (SSP) is challenging to find and use. Needing passwords to access the SSP is challenging for some members. The SSP needs more promotion. Dental and vision coverage needs expansion.
      • SSP information to be added to upcoming E-News.

Discussion

• Conflicts of Interest
  • No concerns were expressed
• Past topic follow-ups
  • Medicaid member feedback in E-News
    • An overview was added to the May issue of E-News and a summary will be added to the September issue.
  • Adding Medicaid member feedback on the HHS website
    • We are working on a draft now to share our finding on the Medicaid Member Feedback webpage.
  • Appeals information in E-News
    • Article was added information to May issue
  • Coverage during incarceration in E-News
    • Planning to have this topic in a future issue once details are finalized.
• MMAC seats
  • Two MMEC members have been seated.
  • Three of the four newest MMEC members will be selected to serve at this time.
• Feedback events
  • Listening session showed that members want improvement to the eligibility process, dental services, and non-emergency medical transportation. We are reviewing information from the member survey and focus group now and will share a summary at the September meeting.
    • Recommended adding this summary under its own heading and prominently placing it and encouraging members to use this opportunity to address concerns.
• Storytelling the MMEC experience
  • Developing verbiage to describe experience serving on MMEC for committee webpage.
    • Mention commitment length and frequency. Offer short sentences, short paragraphs, links to find expanded information, reduce jargon, and promote translation ability.
• Medicaid card design
  • Request for suggestions to redesign ND Medicaid cards.
    • Add website URL, change number to Customer Support Center, promote the SSP, use different color cards for Expansion member cards, promote translation, and consider removing date of birth.
• Voting: Meeting locations
  • Voting on having all virtual meetings yearly or adding one or more in-person meetings.
  • Majority votes, with seven votes, for all virtual meetings.
• Q&A
  • Will listening sessions be a regular activity?
    • Yes, we are planning to continue this and possibly also have them in-person and in rural locations.
  • How do community partners help enroll members who are detained during out-of-state travel?
    • Wait until they are received by a North Dakota correctional facility and apply then.
  • How does a member know that their Releases of Information (ROI) is expiring?
    • Members have to keep track or find out upon discussion with ND Medicaid.
  • Is there training on client share amounts?
    • Yes, information will be shared to new MMEC members on all past trainings.
• Sharing
  • Request for the SSP to hold Releases of Information (ROI), provide alerts as they expire, and have pre-made ROIs for HHS, BCBS Medicaid Expansion, human service zones, and guardians/authorized representatives/trusted partners.
  • We may be able to assist members with expiring ROIs if we add renewing them to the review process.
  • Request for ROIs sent through email so community partners can more efficiently serve members.
  • Request for an update at the September meeting on Federal happenings with the One Big Beautiful Bill.
  • Reduce the need to transfer callers into the Customer Support Center and train experts for certain areas of coverage.

Next Steps

• Reminder for next meeting
  • September 10, 2024 @ 9:30-11:320a
• Annual agenda
  • March 5, 2024
  • May 7, 2024
  • July 9, 2024
  • September 10, 2024
  • November 5, 2024

MMEC Meeting Minutes 7/8/25

Agenda

Welcome & Ice Breaker

• Roll Call
• Meet & Greet
• Ice Breaker
• Working/Not Working

Discussion

• Conflicts of Interest
• Past topic follow-ups
• Resignations
• Website work
• Feedback events
• MMEC Guidelines amendments
• Q&A
• Sharing
• Decisions

Next Steps

• Reminder for Next Meeting
• Annual Schedule

Minutes

Welcome & Ice Breaker

• Meeting called to order: 9:30 a.m.
• Meeting adjourned: 10:41 a.m.
• Welcome
• Roll Call
  • Members present:
    • Eldor Scheid
    • Allison Wanner
    • Jackie Frost-Hodney
    • Ashley Roulette
  • Members absent:
    • Kara Handson
    • Heather Skadsem
  • Also in attendance:
    • Jen Sheppard, Member Liaison
    • Krista Fremming, Assistant Director
    • Monique Runnels, Tribal Liaison
• Icebreaker

Discussion

• What is working/Not working with Medicaid coverage since we last met?
  • Appeals:
    • One member feels the process is lengthy and they don’t see the benefit. Another member shares that they feel the process is intentionally difficult.
    • One member said she had a good experience getting connected to someone who could assist her with a hearing.
  • Account updates:
    • One member shared how her address was incorrect in the system and caused her not to get her notices, resulting in temporary loss of coverage during an in-patient experience for a covered family member. The same member experienced an issue with confusion in a family member’s name paired with an incorrect adoption type causing delay in coverage.
    • One member shared that uploading documents every month has gone well but part of the success is due to the member figuring out what to do, not due to the Self-Service Portal being user-friendly. They expressed the desire to have a confirmation of successful document upload such as an email.
  • Referrals:
    • One member experienced difficulty returning to the specialist that has been caring for their family member. They shared that the ND specialist would not see them.
  • Medicaid Member Handbook:
    • A member shared that the handbook is easy to understand and has made it easy for members to find information.
• Past topic follow-ups
  • Out-of-state services advocates
    • Two employees assist members to navigate these services.
      • This information has been added to the Medicaid Member Handbook.
  • Member Engagement webpage review
    • Use the Customer Support Center name in the feature area.
      • This has been corrected.
  • Does our website have a feature where we can hover to get more information without seeing so much information right away?
    • Communications team is currently unaware of this capability. Ww will continue to monitor for system ability to create this feature.
• Resignation
  • Victoria Alexander has resigned from her seat on the MMEC due to personal reasons. Her seat is officially open.
• New member webpage
  • We have developed a new webpage for limited English proficiency (LEP)/new and foreign immigrant (NFI) members/families. This page is meant to explain health care to new Americans and guide them to translation features/services prior to them being redirected to the Member Engagement and Resources webpage. We are developing a flyer to advertise these efforts and direct members to this welcome page.
    • The current title is ‘Welcome to North Dakota (ND) Medicaid.
    • A proposed title is ‘Understanding health care in the U.S.’
• Renaming the Member Engagement and Resources webpage
  • HHS Community Engagement Liaisons, working with the LEP/NFI community, have expressed the need to reconsider the term ‘engagement’ in our titles. This term often translates to refer to an engagement for marriage rather than an interaction.
  • Recommended replacement words are: ‘involvement’, ‘connection’, ‘support’, and ‘contribution’.
• Virtual member listening session
  • This event is shared on our Member Feedback webpage. We are inviting members to advise us on best practices for the MMEC and to give their feedback on the ND Medicaid program.
  • 230 participants registered to attend.
  • MMEC members invited to attend this virtual event.
• Online member survey
  • We will be offering an online member survey asking for feedback on our ND Medicaid program. This survey will be open from May 1st – 30th.
• Member-based focus group
  • We are working to develop an invitation only member-based focus group on June 13 to gather recommendations for MMEC best practices and member expectations.
• MMEC Guidelines Amendments:
  • Space in the agenda will be held for conflict-of-interest disclosures as mandated by Centers for Medicare and Medicaid Services (CMS).
  • MMEC members’ membership on MMAC must be two-years without a third-year option because those seats are held for active MMEC members who serve non-consecutive two-year terms.
• Q&A
  • How will the data be used from the listening session and survey? Suggestion to create a detailed report to display on website and have a short article in E-News with a link to the report.
    • All feedback will be compiled. E-News will have a brief article for the July issue. We will explore posting a detailed report on our website. Slides are prepared to update the MMAC on the feedback received.
  • Can the state provide an attorney rather than members getting their own attorney or a member advocate to help members navigate the process?
    • This will be explored.
  • Can information for coverage for incarcerated members be revised for plain language?
    • Yes, we will work on this.
• Sharing
  • Suggestion to add a middle step in the appeals process for a staff to explain what a member can expect to experience and what other options there are to an appeal. This step should offer help to locate an alternative provider or service to the one being denied. Also consider having a mediation step before appearing before a judge.
  • One member said that they feel the MMEC is working well on issues that are relatable to the entire member community.
  • Members recommend adding article for guidance on appeals and re-entry from incarceration processes to E-News.

Next Steps

• Reminder for next meeting
  • July 8, 2025 @ 9:30-11:30 a.m.
• Upcoming meetings
  • September 9, 2025
  • November 4, 2025

MMEC Meeting Minutes 5/6/25

Agenda

Welcome & Ice Breaker

• Roll Call
• Meet & Greet
• Ice Breaker

Discussion

• Past topic follow-ups
• Member handbook review
• Community-based organization outreach work
• Q&A
• Sharing
• Feedback update

Next Steps

• Reminder for Next Meeting
• Upcoming Meetings

Minutes

Welcome & Ice Breaker

• Meeting called to order: 11:00 a.m.
• Meeting adjourned: 12:43 p.m.
• Welcome
• Roll Call
  • Members present:
    • Kara Handson
    • Ashley Roulette
    • Eldor Scheid
    • Allison Wanner
    • Jackie Frost-Hodney
  • Members absent:
    • Victoria Alexander
    • Heather Skadsem
  • Also in attendance:
    • Jen Sheppard, Member Liaison
• Icebreaker

Discussion

• Past topic follow-ups
  • Out-of-state services advocates
    • Two employees assist members to navigate these services.
    • We have identified that we are needing to better promote this resource.
    • We plan to add this information periodically to E-News.
    • This information has been added to the Medicaid Member Handbook.
  • Website eligibility calculator
    • Other states suggest that most feel this could confuse/mislead applicants.
    • We have a similar eligibility tool on our Apply for Help webpage.
    • Recommended to place this tool on the Medicaid Eligibility webpage with explanation of which assistance programs are included.
    • Include disclaimer that this tool only tests and does not guarantee eligibility.
  • Member Engagement webpage review
    • Use the Customer Support Center name in the feature area.
    • The Self-Service Portal (SSP) should clarify whether to use the member’s or the guardian’s information when creating an account.
    • The MMEC requests explanation for use of client ID numbers instead of ND Medicaid numbers.
  • Member Handbook search bar
    • This work has been approved and is in progress.
  • Simplify the client share billing process
    • Steps have been taken including updating provider forms, adjusted Therap processes, created a Provider Education team, gathering dental billing feedback, and implemented a policy feedback process.
  • Add ND Navigator information to member notices
    • Approval was given to add ND Navigator purpose and contact information.
    • Reflection on the MMEC’s place in the change management process
    • Centers for Health Care Strategies (CHCS) training and recent experiences show that the MMEC recommends change but may not be able to implement change.
    • We should identify which actions this committee can take, and which are best taken by other ND Medicaid stakeholder groups, committees, or units within Medical Services.
  • Medicaid Member Handbook review
    • Family Planning Services chapter
    • Recommendations/edits were made for what this chapter should contain.Laboratory, Radiology, and Diagnostics chapter
    • Recommendations/edits were made for what this chapter should contain.
  • Community-based organization outreach work
    • We have partnered with the Justice Well program to host a listening session and survey in May.
    • We will advertise these opportunities in the March and May issues of E-News, social media posts, and on our website.
  • Listening session invite
    • May 6, 2025 @ 3:00 p.m. – 4:30 p.m.
    • Our first listening session will be held virtually on May 6, 2025.
    • Reimbursing MMEC members for travel will not be possible until after May.
  • Medicaid Medical Advisory Committee
    • Five seats are held for MMEC members
    • Please submit applications to saker@nd.gov
    • One member expressed interest in applying to the MMAC.
  • Results from the 2023 Consumer Assessment of Healthcare Provider and Systems (CAHPS) survey
    • This survey captured an 8.1% response rate.
    • This survey reflects: access to health care services, customer service, and experience with applications and coverage ratings.
• Q&A
  • Does our website have a feature where we can hover to get more information without seeing so much information right away?
    • This will be explored.
• Sharing
  • Reduce the amount of content on the main Medicaid webpage and find places for added information. Let this page only offer pages to visit for applicants, members, and providers.
  • Correspondence times are lengthy for denials.
  • The billing process is too complicated for providers.
  • Reimbursement rates are too low for providers.
  • Member notices about coverage changes should be on colored paper or have a callout.
  • Medicaid premium payments are being processed inaccurately, and members are getting conflicting guidance.
  • Calling into the Customer Support Center resulted in immediate disconnection. Have a message that explains call wait times are high and to call back later.
  • Recent out-of-state referral experience was pleasant and helpful.

Next Steps

• Reminder for next meeting
  • May 6, 2025 @ 9:30-11:30 a.m.
• Upcoming meetings
  • July 8, 2025
  • September 9, 2025
  • November 4, 2025

MMEC Meeting Minutes 3/4/25

Agenda

Welcome & Ice Breaker

• Roll Call
• Meet & Greet
• Ice Breaker

Guest Speakers

• Client share/Recipient liability: Laura Holzworth

Discussion

• Past Topic Follow-Ups
• Member handbook review
• E-News review
• Suggestions for Appeals Member Handbook
• Member resignation
• MMEC meeting facilitation discussion
• Applying for the MMAC
• Partnership with Justice Well Program
• Q&A
• Open Discussion
• Reflection on Medicaid enrollment and billing statistics

Next Steps

• Reminder for Next Meeting
  • March 4, 2025 @ 10:30-12:30 p.m.
• Upcoming Meetings
  • May 6, 2025
  • July 8, 2025
  • September 9, 2025
  • November 4, 2025

Minutes

Welcome & Ice Breaker

• Meeting called to order: 9:30 a.m.
• Meeting adjourned: 11:00 a.m.
• Welcome
• Roll Call
  • Members present:
    • Victoria Alexander
    • Heather Skadsem
    • Kara Handson
    • Ashley Roulette
    • Eldor Scheid
    • Allison Wanner
    • Jackie Frost-Hodney
  • Members absent:
    • N/A
  • Also in attendance:
    • Krista Fremming, Assistant Director
    • Monique Runnels, Tribal Liaison
    • Jen Sheppard, Member Liaison
    • Laura Holzworth, Provider Relations Supervisor
• Meet & Greet
  • New member: Ashley Roulette
• Icebreaker

Guest Speaker

• Client share/Recipient liability: Laura Holzworth
  • High level overview of client share, how it is calculated, member responsibilities, how it is applied to medical bills, and who to contact for help or questions.

Discussion

• Past topic follow-ups
  • Search bar for member handbook:
    • We can create a search bar for just the handbook. There is cost for this work. We will publish all chapters, work toward ADA compliance, then re-visit this topic.
  • Chat Bot:
    • The state website is trialing a chat bot. This could help us understand the benefits and challenges if we get a chat bot on the hhs.nd.gov website.
• Review Member Handbook
  • Chapter review: Where to Find Health Care. The MMEC felt:
    • This chapter is useful and necessary.
    • We should explain that the facilities listed are not the only ones available in ND.
    • We should define the term ‘facilities’, define acronyms more frequently, and links to find facilities should go to directories rather than the webpage with links.  
• Develop March E-News
  • The MMEC reviewed the theme and topics for the March issue.
  • They suggested acknowledging March as colorectal health month.
• The MMEC was asked for topics for a future appeals member handbook. The MMEC suggested:
  • How to find help navigating the appeals process.
  • Offer materials or staff that can prepare members for what to expect.
    • Use storytelling to share what to expect during the appeal process.
    • Refer to ed.gov and the office of Civil Rights website for examples.
  • Members can ask providers for a letter of support for their appeal.
  • Include a link for the SFN-905 form to request coverage for a service that was denied.
  • Guide members in understanding which law/policy is impacting the decision.
  • Include a member advice section where member share their advice:
    • You can get an attorney, but it will be at your own cost.
    • Some members feel that you have more voice with self-representation.
• Member resignation
  • Jon Fettig will be stepping down from his seat on the MMEC.
• Reflection on MMEC facilitation practices:
  • How can we foster interest, attendance, and engagement?
    • Offer agenda and materials in advance.
    • Respect the designated time frame for meetings.
• Five members are encouraged to apply for the Medicaid Medical Advisory Committee (MMAC) starting February 2025.
  • Send applications to saker@nd.gov.
• ND Medicaid has partnered with the Justice Well Foundation to gather member feedback and identify potential applicants for the MMEC.
• Q&A
  • Can client share billing process be simplified to ease the pressure on providers and members?
    • This information will be brought back to the correct unit.
  • Can our website offer a calculator tool that figures client share amounts?
    • This question will be brought back to the Communications and Eligibility unit.
• Open Discussion
  • Requested information on legislative activity that pertains to ND Medicaid.
    • North Dakota Legislative Branch webpage was shared.
  • Suggestion made to connect with legislators to find MMEC applicants.
    • This will be considered throughout our partnership with Justice Wells.
  • Request for more information on the MMAC.
    • MMEC was invited to the next MMAC meeting on Tuesday, February 20, 2025.
  • Recipient liability is a confusing term.
    • We are shifting to the term ‘client share’.
  • Monthly client share reviews are too frequent and suggested reviewing quarterly.
    • This information will be brought back to the correct unit.
• So you know:
  • Updates on statistics or data from October and November 2024.

Next Steps

• Reminder for next meeting
  • March 4, 2025 @ 10:30-12:30 p.m.
• Upcoming meetings
  • May 6, 2025
  • July 8, 2025
  • September 9, 2025
  • November 4, 2025

MMEC Meeting Minutes 1/7/25

Agenda

Welcome & Ice Breaker

• Roll Call
• Meet & Greet
• Ice Breaker

Guest Speakers

• Appeals: Storm Olson, Attorney

Discussion

• Last Meeting’s Follow-Ups
  • Requesting advocates for out-of-state services coordination
• Member handbook review
• E-News review
• Review of this year's MMEC concerns and progress

Q&A

Open Discussion

Decisions

• Vote for 2-year term lengths for MMEC seats

Next Steps

• Reminder for Next Meeting
  • January 7, 2025 @ 9:30-11:30am
• Upcoming Meetings
  • March 4, 2025
  • May 6, 2025
  • July 8, 2025
  • September 9, 2025
  • November 4, 2025

Minutes

Welcome & Ice Breaker

• Meeting called to order: 9:30 a.m.
• Meeting adjourned: 11:00 a.m.
• Welcome
• Roll Call
  • Members present:
    • Allison Wanner
    • Kara Hanson
    • Victoria Alexander
    • Eldor Scheid
    • Jacqueline Frost-Hodney
  • Members absent:
    • Jon Fettig
    • Heather Skadsem
  • Also in attendance:
    • Krista Fremming, Assistant Director
    • Monique Runnels, Tribal Liaison
    • Jen Sheppard, Member Liaison
    • Storm Olson, Attorney
    • Aaron Webb, Attorney
• Meet & Greet
• Icebreaker

Guest Speaker

• Appeals: Storm Olson, Aaron Webb
  • The MMEC was informed on appeals, denials, and reduction or termination of coverage. They were told how, where, and who can file appeals. We discussed the significance of the 30 days from the mailing date on notices, filling out State Form Number-162 notice for hearing, release of information, authorized representatives, and legal counsel. The review process and next steps were explained. Resources for information on appeals was shared. The MMEC was told that the Legal division is reviewing how appeal information is provided. The Document Number-263 that is sent with notices may be revised.
  • The MMEC learned that an appeal can be filed to District Court. If members disagree with the court’s decision on an appeal, they can request a rehearing or reconsideration hearing. They must provide information as to the reason. There must be new evidence that the law was applied incorrectly. It was recommended to have an attorney represent the member; however, the system is designed for those who appear without an attorney and judges often provide some grace for those who don’t have an attorney.
  • The MMEC asked for a list of non-appealable denials and found that there is not a full list published. There are too many examples to list, and some are only appealable by a provider while others are only appealable by the recipient.
    • The MMEC recommended publishing a list of non-appealable denials.
      • A description of denial differences and examples will be added to the member handbook.  
  • The MMEC was invited to create a list of information or topics they recommend be included in public-facing appeals information.

Discussion

• Last meeting’s follow-ups
  • The MMEC requested advocates for members needing out-of-state services.
    • Two employees are in-place to assist members with questions and directives as needed.
    • Members requested contact information for the Out-of-State Services unit to members.
      • This information will be added to the member handbook and considered for a future E-news article.
• Member handbook, Emergency Health Care chapter review
  • The MMEC reviewed the full chapter and recommended adding how to address medication management concerns outside of an emergency room. The MMEC also requested adding information on necessary ambulance use for non-emergency, in-state transportation, and the option to use an ambulette.
    • This information will be added to the member handbook.
  • The MMEC had suggested prominently displaying information on translation ability for the online member handbook. They reviewed a proposed approach to added verbiage at the top of the handbook webpage. One suggestion was to not include a screenshot image of the translation tool to reduce confusion.
• E-News Review
  • The MMEC reviewed articles for the January issue and suggest adding a reminder for renewals. The committee was asked to submit suggestions for future articles. One suggestion was to cover dual special needs plans information.
• Review this year’s MMEC concerns and progress.
  • The MMEC reflected on this year’s work and recognized our progress in applying best practices for plain language in member-facing materials, website navigation, and increasing access to information through member E-News and the member handbook. We reviewed ongoing work in efficiency, member clarity for processes, member handbook development, website work, increasing coverage, and Self-Service Portal improvements.
• Q&A
  • One member asked if we have information in the member handbook about Medicaid coverage being secondary to other health insurance coverage.
    • The member handbook will have this information in a future chapter.
• Open Discussion
  • The MMEC suggested adding information into the member handbook for primary vs. secondary coverage for out-of-state services.
    • This will be considered for a future handbook chapter.
• Decision: Vote for term length of MMEC members:
  • Two-year term:
    • Four members voted for a two-year term.
  • Three-year term:
    • One member voted for a three-year term.
  • The MMEC will have seats with two-year terms. These terms will be non-consecutive to comply with Centers for Medicare and Medicaid Services (CMS) Ensuring Access to Medicaid Services final rule. This information will be updated in the MMEC Guidelines and published.

Next Steps

• Reminder for next meeting
  • January 7, 2025 @ 9:30-11:30am
• Upcoming meetings
  • March 4, 2025
  • May 6, 2025
  • July 8, 2025
  • September 9, 2025
  • November 4, 2025

Agenda

Welcome & Ice Breaker

• Roll Call
• Meet & Greet
• Ice Breaker

Guest Speakers

• Out-of-State Services: Susan Burns and Rachael Buckwitz
• MMAC: What is the MMAC, the Access Rule, and how to apply: Mandy Dendy

Last Meeting’s Follow-Ups

• Other states term lengths for member engagement committees

Discussion

• Learning and Action Series Training 
• Member Notices best practices
• Member News best practices and topics
• Q&A
• Sharing

Next Steps

• Reminder for Next Meeting
  • November 5, 2024 @ 9:30-11:30am
• Upcoming Meetings
  • January 7, 2025
  • March 4, 2025
  • May 6, 2025
  • July 8, 2025
  • September 9, 2025
  • November 4, 2025

Minutes

Welcome and Icebreaker

• Meeting called to order: 9:30am
• Meeting adjourned: 11:30am
• Welcome
• Roll call of committee members present:
  • Jon Fettig
  • Jacqueline Frost-Hodny
  • Heather Skadsem
  • Eldor Scheid
• Members absent: 
  • Victoria Alexander
  • Kara Hanson
  • Allison Wanner
• Also in attendance: 
  • Jen Sheppard (Member Liaison)
  • Mandy Dendy (Policy Director)
  • Monique Runnels (Tribal Liaison)
  • Susan Burns, Utilization Review Administrator
  • Rachael Buchwitz, Utilization Review Administrator
• Meet & Greet
• Icebreaker

Guest Speaker

• Out-of-State Services: Susan Burns
  • Brief overview of how out-of-state services and travel assistance that is offered and approved.  
  • MMEC member suggestions:
    • One MMEC member shares they had out-of-state services not approved for the Medicaid member. The time allotted to appeal the Medicaid decision was 30 days. This did not leave enough time to communicate back-and-forth with Medicaid on the appeal decision.
      • The 30 days starts over with each determination. 
      • Some providers may offer a referral even if the service can be offered in ND. This can create confusion for the member. Providers need to share a reason why an out-of-state service is necessary with Medicaid when seeking authorization for these services. 
  • MMEC member questions:
    • Can family/caregivers of Medicaid members get travel assistance?
      • Yes. ND Medicaid is enrolling family members as Non-Emergency Medical Transportation (NEMT) providers. Family members must enroll as an NEMT provider and can find out more by connecting to our Customer Support Center or the out-of-state travel specialist at 701-328-2159.
      • NEMT travel assistance may apply to out-of-state travel also.
    • Why do out-of-state services require a prior authorization?
      • This process comes from federal and state guidance. It is most cost-effective to have services offered in ND rather than outside of the boundaries. 
      • Having a provider closer to home who knows the member and their health history can improve the level of care. 
    • Why would members request out-of-state services?
      • Some members keep their ND Medicaid coverage as they relocate to college or a new foster care location near or outside of ND borders. 
      • Members may want to keep the same provider for continuation of care or remain in the same coverage network. Members can see providers up to 50 miles outside of the ND border. 
      • Depending on location, some members may need to visit an out-of-state hospital when that is the closest facility in times of urgent need.
• Medicaid Medical Advisory Council (MMAC): Mandy Dendy
  • Updates on MMAC term lengths for MMEC members, final rule requirements, open seats available to
    • MMEC members, and how the MMEC and MMAC work together were shared. 
      MMAC is made of 25 seats. Members must apply for a seat. Members outside of MMEC members serve three-year terms. Terms cannot be consecutive. This council is made of ND Medicaid members, medical professionals, legislators, and others connected to Medicaid create a well-rounded perspective. 
    • This council is notified of changes within Medicaid such as state plan amendments or waiver changes and are offered educational updates. The MMAC makes suggestions, shares ideas, and gives feedback. 
    • Five MMEC members will need to join the MMAC. Seven seats will open in February of 2025. MMEC members can apply to the MMAC by sending an email to the Medical Services Director with their reason for serving and information about themselves, their health care experiences, and their Medicaid connection.
      MMAC meetings are a combination of virtual, hybrid, and in-person. 
  • MMEC members were asked what MMAC term length would be best for MMEC members? 
    • Members feel that three years is a long commitment.
    • Members agree that two years may be best.
    • Offer a potential three-year term with an option to step down at two years. Some MMEC members may feel over-burdened with a three-year commitment while others may feel strengthened by the experience gained with a longer term limit. 
      • Mandy Dendy will take this information back to the November MMAC meeting.

Last Meeting's Follow-ups

• What term lengths have other states established for their member-based committees?
  • Nevada: 2 years
  • California: 2 years
  • Arkansas: 2 years
  • Indiana: 2 years 

Discussion

• Learning and Action Series Training:
  • Center for Health Care Strategies accepted North Dakota’s Medicaid member engagement team to a 14-month-long, nation-wide training series.
  • This training will offer peer-to-peer discussion, individual training, action plan development for member-based committees, and assistance in forming partnerships with community-based organizations to better connect with Medicaid members. 
  • This training started this July and will continue through the fall of 2025.
• Member Notice Review:
  • MMEC reviewed a recent notice to all Medicaid home oxygen therapy use members.
  • MMEC members were asked for input in the following areas:
    • Is there a clear call to action?
      • Yes, but could bold text to identify important information more easily.
      • Consider making a header with a strong statement that catches the reader’s attention.
    • Do we have information that isn’t needed?
      • No.
    • Did we miss information that should have been included?
      • Clarify that the device being offered is paid for by Medicaid.
      • Rely less on the term “covered” or “will cover” as some readers may not understand that this is related to cost. 
      • Clarify if installation of this product can be done by the member or should be done by a professional.
    • Will readers stay engaged based on length and content of the letter?
      • Length of letter is good at one page.
      • Break up sentences that introduce two main points so one point is not overlooked.
  • MMEC member suggestions:
    • Bold any links. 
    • QR codes are good and necessary.
    • Consider an even lower reading level for writing style. Aim for a fifth-grade level. 
  • MMEC member questions:
    • Do we have a way to send these letters to specific members?
      • Yes. We can identify members that have a specific diagnosis or order for oxygen/oxygen therapy supplies.
• Member News Review:
  • E-News
    • How do you feel about the current frequency of every other month?
      • This is good. More frequent delivery would reduce the likelihood that recipients will read due to an overwhelmed in-box.
  • What topics should we cover?
    • New changes.
    • Contact information.
    • Having a theme for each issue is helpful.
    • Appeal process information.
  • Printed Annual Newsletter
    • How do you feel about the current frequency of once per year in November?
      • Timing is good.
      • Avoid major holiday seasons, aim for beginning of November.
    • What topics should we cover?
      • Commonly needed contact information.
      • How to access more information. Make sure website and phone numbers are offered.
    • Other feedback:
      • QR codes are good and necessary.
      • Give members the option to receive the annual newsletter electronically to save on cost. 
• Q&A 
  • How does the MMEC feel about guest speakers attending meetings?
    • Guests may hinder members’ willingness to share their thoughts and opinions openly.
    • Guests should present their reasons for wanting to attend.
    • There should be a small, set number of guests.
    • MMEC members should be notified in advance.
    • MMEC members should be well-established on the committee (after one year of attendance for the majority).
    • The MMEC meetings should not have visitors directly after a new member has joined.
• Open Discussion
  • MMEC members request a quest speaker on the ND Medicaid appeals process.
    • Member liaison will organize requested guest speaker.
  • One MMEC member shares that out-of-state services can be confusing and complicated processes may lead to poorer health outcomes. 
  • One MMEC member suggests considering the member and/or caregivers experiencing out-of-state services. These times can be overwhelming or stressful for those involved. Explore ways to build in ways to help relieve members and/or their caregivers having to get out-of-state services. Having an assigned advocate to assist with arrangements, appeals, etc. could help relieve added pressure for this process. 
  • One member shares their experience with out-of-state services being needed and then approved and now being denied. This member expressed the frustration of this situation. 

Next Steps

• Reminder for next meeting
  • November 5, 2024 @ 9:30-11:30am
• Upcoming meetings
  • January 7, 2025
  • March 4, 2025
  • May 6, 2025
  • July 8, 2025
  • September 9, 2025
  • November 4, 2025

Agenda

Welcome and Icebreaker

• Roll call
• Meet & Greet
• Icebreaker

Guest Speaker

• Blue Cross Blue Shield Medicaid Expansion: Jared Ferguson

• Behavioral Health: Monica Haugen

Discussion

• Last meeting's follow-ups
• CMS Final Rule Review
• Medicaid Renewal Information Placement on Website
• Q&A
• Open Discussion

Next Steps

• Reminder for Next Meeting
  • September 10, 2024 @ 9:30-11:30am
• Upcoming Meetings
  • November 5, 2024

Minutes

Welcome and Icebreaker

• Meeting called to order: 9:30am
• Meeting adjourned: 11:30am
• Welcome
• Roll call of committee members present:
  • Allison Wanner
  • Kara Hanson
  • Heather Skadsem
  • Eldor Scheid
  • Jacqueline Frost-Hodney
  • Jon Fettig
• Also in attendance:
  • Jen Sheppard (Member Liaison)
  • Mandy Dendy (Policy Director)
  • Monique Runnels (Tribal Liaison)
  • Jared Ferguson (Medicaid Expansion Administrator)
  • Monica Haugen (Behavioral Health 1915(i) Administrator)
  • Bobbi Holzworth (Medicaid Data Administrator)
• Members absent:
  • Victoria Alexander
• Meet & Greet
• Icebreaker

Guest Speaker

• Blue Cross Blue Shield Medicaid Expansion: Jared Ferguson
  • High-level overview of the Medicaid Expansion program
• Behavioral Health: Monica Haugen
  • High-level overview of the 1915(i) Behavioral Health Supports and Services program

Discussion

• Last Meetings Follow-ups
  • Medicare vs. Medicaid
    • Reviewed prepared slides giving a brief overview of how Medicare and Medicaid work.
  • Self Service Portal (SSP): Tabs don’t look like they can open but can. Make this more obvious.
    • There has been a recent testing of the SSP by various users to see how we can make the SSP more user-friendly.
    • The testing results have been received and next steps are to form a plan to address concerns.
    • The concern for the tabs has been noted and will be considered in the plan to address SSP testing results.
• CMS Final Rule Review
  • Membership terms:
    • CMS final rule states MMEC members cannot serve consecutive terms.
    • How long should each MMEC term be?
      • Majority of MMEC members agreed on two-year terms.
      • MMEC requests research on other states’ practices.
        • Member Liaison will research this before next meeting.
    • How many nonconsecutive terms should MMEC members be able to serve?
      • MMEC members recommend between 2-4 terms.
  • MMEC is required to hold one in-person meeting plus one hybrid meeting option per year.
    • Where should this meeting take place?
      • Bismarck unless a more central location can be identified based on current members.
  • Medicaid Medical Advisory Council (MMAC) attendance and reporting out.
    • Seven MMAC seats will open by February of 2025 and five are required for MMEC members.
    • MMEC members will rotate to attend quarterly MMAC meetings.
    • MMAC is required to hold one in-person meeting plus one hybrid meeting option per year.
    • How long should MMEC member terms be on the MMAC?
      • MMEC recommended the term lengths should reflect MMEC term lengths.
    • Interest in serving on MMAC was shown by:
      • Jacqueline Frost-Hodney
      • Eldor Scheid
      • Allison Wanner
• Medicaid renewal information must be moved to a permanent location on our webpage
  • What information will we display?
    • Descriptive language that tells what a renewal is and how often it happens.
    • Make information stand out on webpage using contrast, color, etc.
    • Reduce amount of information being displayed on a single page.
  • Where will this information be located?
    • Add a new card on the member webpage that leads to a page that offers information about managing your Medicaid coverage.
  • Reviewed other states’ approaches:
    • Pennsylvania’s button at top of website.
    • Virginia’s section for updating contact info.
    • Arkansas’s warnings at top of website.
• Q&A
  • What are we doing to address the provider shortage in ND?
    • Outside of ND Medicaid, state licensing boards are looking at provider scopes of practice, licensure requirements, and reciprocity.
    • ND Medicaid can reimburse lower-level certifications in behavioral health such as mental health technicians and peer supports, which broadens the provider pool and results in greater access to care for our members. Community health workers are also coming into Medicaid.
    • We look to partner and support efforts to increase the healthcare workforce across North Dakota.
• Open Discussion
  • Concern was shared for lower reimbursement for dentists.
  • Concern was shared for lower reimbursement and difficulty billing for speech therapists.
  • Website critique
    • There is too much content per page.
    • The main drop-down menu is overwhelming.
    • The website is challenging to navigate.
  • Concern was shared for out-of-state referrals being denied.
    • Members believe there is not a provider within ND that can offer the treatment needed and do not understand their denial.
      • MMEC members request a defined escalation process and/or specialized staff to handle these issues.
      • MMEC members recommend assigning a staff member to avoid being assisted by a different person every time.
  • Concern was shared for referrals for treatment being made by providers but then deemed not medically necessary by ND Medicaid
    • Members recommend having an assigned staff member who can explain the how’s and why’s of the referral and denial processes per case.

Next Steps

• Reminder for next meeting
  • September 10, 2024 @ 9:30-11:30am
• Upcoming meetings
  • September 10, 2024
  • November 5, 2024

Agenda

Welcome and Icebreaker

• Roll call
• Meet & Greet
• Icebreaker

Discussion

• Last meeting's follow-ups
• New topics
• Q&A
• Open Discussion

Next Steps

• Reminder for Next Meeting
• Annual Meetings

Minutes

Meet & Greet and Icebreaker

• Meeting called to order: 9:30am
• Meeting adjourned: 11:30am
• Roll call of committee members in attendance:
  • Victoria Alexander
  • Kara Hanson
  • Eldor Scheid
  • Jacqueline Frost-Hodney
  • Heather Skadsem
  • Allison Wanner
• Members Absent:
  • Jon Fettig
• Also in attendance:
  • Mandy Dendy, Policy Director
  • Monique Runnels, ND Medicaid Tribal Liaison
• Introduction and welcome for new members
• Icebreaker

Discussion

• Last meeting's Follow-ups
  • MMEC made suggestions for staffing and features to enhance communication between members and ND Medicaid. They asked:
    • Can we create a chat box on our website that can assist visitors with website navigation and general Medicaid questions?
      • We are looking into this.
    • Can a search bar for just the Medicaid Member Handbook be created within the handbook or its webpage?
      • We are looking into webpage-specific search bars.
    • Can specific words be typed into the main search bar to lead visitors directly to handbook?
      • We are looking into this.
  • MMEC raised concerns about coverage of specific services.
    • Can members pay for the difference between a non-transition bifocal and a transition bifocal because this lens is not covered by ND Medicaid?
      • Discussed medical necessity and Medicaid coverage of items that meet a member’s needs and currently this is not an option.
      • An SFN form to request increases to coverage for specific items was shared.
      • We reviewed ways for members to more easily access information through the handbook.
    • MMEC recommends increasing reimbursement for transportation.
      • Provider rates will be increased effective July 2024
      • There will be an article on non-emergency transportation in a future E-Newsletter issue.
  • MMEC recommends offering a Care Specialist/Guide Position for members with complex health needs to help guide them in finding the right care.
    • MMEC was asked,” What members would need this position outside of members who are assigned a case manager?”
      • No MMEC members have had experience having a case manager with Medicaid, though several are caregivers of members with complex health needs.
    • MMEC discussed best practices by commercial insurance companies such as auto-assignment of a case manager and frequent check-in’s by case manager.
    • MMEC suggests ND Medicaid could auto-assign a case manager based on a member’s diagnoses or medical treatment frequency.
    • MMEC suggested that case managers could reduce cost to ND Medicaid by assisting members in knowing where to go for treatment vs. seeing multiple providers to find the care they are needing.
    • MMEC was asked if primary care providers could fill this care coordination role and members thought this wasn’t always an option.
  • MMEC reviewed the ND Medicaid provider list and asked questions.
    • How often are provider lists updated?
      • These lists are updated monthly.
    • What will be the layout of the provider lists now that the Primary Care Case Management (PCCM) program has ended?
      • We are currently working on improving the user-friendliness for these lists.
• New topics
  • We reviewed the purpose of the MMEC and how we can impact ND Medicaid members.
    • MMEC should focus on topics that affect the majority of ND Medicaid members.
    • MMEC can increase member knowledge of ND Medicaid practices.
  • MMEC members were asked to test the hhs.nd.gov website and reported:
    • Some found use and navigation easy while others were confused and unintentionally re-directed to other locations on the website.
    • Not all MMEC members were able to complete this task.
    • Members didn’t identify any shared areas of concern at this time.
  • MMEC reviewed the last issue of the E-Newsletter and recommends:
    • Short length, enticing titles, keeping imagery, and keeping links.
    • Placing a URL on the E-Newsletter flyer.
    • Social media posts of E-Newsletter articles would be beneficial.
    • MMEC was asked suggest topics for future E-News articles.
  • MMEC reviewed the Medicaid Member Handbook (chapters 1-4) and made the following recommendations:
    • Add directions/links for members of Medicare and BCBS Expansion to find correct webpage.
    • Language translation should be more prominently displayed on the webpage or in the handbook.
    • Add a ‘close’ button under each section to avoid scrolling back up to close sections.
    • Keep less content in chapters and use links for more information when needed.
    • Add more detailed information on covered services in this document, reducing need to use the call center to find information.
      • We are exploring ways to strike a balance between too much information and not enough information.
    • Include a list of non-covered services.
    • Include a pdf version for printing capabilities.
    • Add general Non-Emergency Medical Transportation information and rates to reduce calls into call center.
    • Add instructions for viewers of the Provider Directory to call their chosen provider to see if they are taking new patients and accepting Medicaid.
      • Additions have been made to the handbook draft.
• Q&A
  • Do Medicaid and IHS work together or separate?
    • Monique Runnels briefly described how tribes bill differently, how referrals work, and tribal care coordination.
  • Is there a way to request a case manager?
    • We are looking into this.
  • What does Medicaid offer for guide/support?
    • We are looking into this.
• Open Discussion
  • MMEC shares that there needs to be more information on Medicaid and IHS for members.
    • Monique shares that we are conducting tribal consultations and care coordination agreements are in place.
    • We will work on future content within the handbook and E-Newsletter.
  • MMEC shared that members need help and guidance with appeals. They shared:
    • The process is intimidating and confusing for members.
    • Past experience showed that there was no advocate present for members during appeals.
    • Requesting documentation takes up to 30 days but you only have 30 days to file an appeal. The window of opportunity could close before documentation is ever received.
    • There needs to be clearer, more encouraging, helpful explanation of the appeals process.
    • MMEC recommends exploring best practices for appeals processes for commercial insurance companies.
  • MMEC shared Self Service Portal concerns.
    • Tabs in the SSP look like they can’t open but they do. MMEC recommends making this feature more obvious.
  • Coverage concerns
    • MMEC recommends that hearing aids, frequency of cleanings, and equipment have more coverage.
      • Recent audiology policy update, effective 4/1/24, addressing age, diagnoses, removal of PCP referral requirement, and more was shared with MMEC. Leadership shared with the MMEC that policy changes were made after surveying audiology providers.
    • Information about Non-Emergency Medical Transportation (NEMT) providers needs to be more easily accessible to members, promoted more, and easier to understand.
      • We will have content in the handbook and will consider an article for the E-Newsletter.
    • MMEC expressed concerns for providers experiencing difficulties with length of wait for reimbursements. They feel this deters providers from partnering with ND Medicaid.
  • Do we want to request a guest speaker?
    • Out-of-State Coverage
    • Behavioral Health
    • Medicaid and BCBS Expansion
    • Recipient liability
    • Medicare and Medicaid dual coverage

Next Steps

• Reminder for next meeting
  • July 9, 2024 @ 9:30-11:320am
• Upcoming meetings
  • September 10, 2024
  • November 5, 2024

Agenda

Welcome & Icebreaker

• Roll call
• Meet & Greet
• Icebreaker

Discussion

• Question for all: What is your biggest concern for Medicaid?
• Review Medicaid Member E-Newsletter
• Q&A
• Open Discussion
• Decisions

Next Steps

• Reminder for Next Meeting
• Annual Agenda

Minutes

Welcome & Icebreaker

• Meeting called to order at: 9:32am
• Meeting adjourned: 10:50am
• Roll call of committee members in attendance:
  • Eldor Scheid
  • Allie Browning
  • Victoria Alexander
  • Kara Hanson
  • Jacqueline Frost
• Members Absent:
  • Heather Skadsem
• Introduction and welcome to the first meeting
  • Meet & Greet
  • Icebreaker

Discussion

• Question for All: What is your biggest concern with Medicaid?
  • Eldor: The change from county representatives to state workers. When calling in, members do not get the same worker and notes are not summarizing the last call to save the member from repeating information. Appeal experience is not pleasant. Medicaid does not seem responsive.
  • Kara: Information availability: What does Medicaid cover such as equipment? Increased clarity on covered and non-covered services.
  • Victoria: The lack of services I am getting such as glasses options, dentist availability, etc. These are my basic needs that are not being met.  
  • Jacqueline: Medicaid is so limiting. The whole picture is not considered. Denials for out-of-state specialist are a large barrier. Specific equipment is not always covered.
  • Allison: The lack of dental, vision, and transportation. There is a lack of providers for transport. Client share is too high to work with.  
• Review E-News
  • Members will review January E-Newsletter and attend the next meeting with notes.
• Q&A
  • Is the website able to search just the Medicaid Member Handbook?
    • Jen to follow up with Communications department.
  • Can a chat box be developed for the website to offer live assistance with navigating the website and answer general Medicaid questions (alternative to calling and experiencing long wait times with call center)?
    • Jen to follow up with Communications department.
  • Can we program the HHS website so that if certain words are searched it will lead to the Medicaid Member Handbook?
    • Jen to follow up with Communications department.
  • How often does the Provider Directory get updated? What are the future plans for these documents with the PCCM program ending?
    • Jen to follow up.
• Open Discussion
  • What are our main focuses?
    • Navigating coverage
      • Increase coverage information
        • What is covered
        • When coverage is allowed
      • Specialist/guide/health care coach to assist members in understanding how to organize complex health care needs:
        • Specialty/complex health care needs: Out-of-state referrals, billing, referrals, covered services, and equipment, appeals, etc.
        • Help from specialist could be by appointment, with notes, and ability for members to return to the same specialist
        • Initiated in welcome letter and Health Tracks initial contact.
    • Navigating website
      • Chat box for live assistance in website navigation or general Medicaid questions to avoid long wait times when calling into call centers
      • Finding providers, user friendly provider lists
      • Can our searches lead to the Medicaid Member Handbook based on frequently used words (find a dentist, coverage, etc.)?
    • Medicaid coverage
      • Transportation
      • Reimbursement to driver per person not per ride
      • Coverage for glasses/vision to include transition (no line) bifocal lenses. Allow for Medicaid to cover set cost for frames/lenses and member to choose to pay for remaining cost of frames/lenses they desire.
  • What are our current tasks?
    • Medicaid Member Handbook review
      • Details on finding a dentist, vision, etc. to include www.insurekidsnow.gov
        • Instructions to ask if provider is currently accepting Medicaid and taking new clients
        • Links to provider lists
    • Medicaid Member E-News review
      Find a person, with limited/no exposure to www.hhs.nd.gov to navigate website to Medicaid information and give honest feedback
• Decision
  • Current focus
    • Navigating coverage
    • Navigating website
    • Medicaid coverage expansion
  • Current tasks
    • Handbook review
    • E-News review
    • Website navigation testing

Next Steps

• Reminder for next meeting
  • May 7, 2024 @ 9:30-11:320a
• Annual agenda
  • March 5, 2024
  • May 7, 2024
  • July 9, 2024
  • September 10, 2024
  • November 5, 2024

MMEC Meeting Minutes 11/5/24

MMEC Meeting Minutes 9/10/24

MMEC Meeting Minutes 7/9/24

MMEC Meeting Minutes 5/7/24

MMEC Meeting Minutes 3/5/24

ND Medicaid values member and family participation in improving the Medicaid member experience. The Medicaid Member Engagement Committee (MMEC) is a way for members to share their lived experience, give input, and bring positive change to ND Medicaid.

The MMEC is designed to meet the following objectives: 

• Prioritize person and family centeredness, which means we respect and value individual strengths, preferences, and contributions, and work with members, not doing things to or for them.
• Provide opportunities for collaboration between ND Medicaid and members with the goal of improving member experience and the relationship between ND Medicaid and all members.
• Provide a way for ND Medicaid to test if programs, policies, and materials are working as designed and having the desired outcome.

Discussion and recommendations from the MMEC will help guide ND Medicaid and will be shared with the Medicaid Medical Advisory Committee, ND Medicaid Leadership, and ND Department of Health and Human Services Leadership. 

The MMEC will have 12 members. ND Medicaid seeks to have members with different backgrounds, geographical areas, and with different life experiences and situations represented on the MMEC. ND Medicaid encourages all Medicaid members interested in serving on the MMEC to apply. 

Who Should Apply

ND Medicaid encourages current Medicaid members, people who have had Medicaid within the last three (3) years or are caring for a Medicaid member to apply for the MMEC. 

Note: Medicaid Expansion members are not eligible to serve on the MMEC but can share their views on Medicaid Expansion with the Medicaid Expansion Member Advisory Committee. 

Medicaid is also different than Medicare. There are many people who have both Medicare and Medicaid, and we will welcome those members if they have experience with Medicaid. 

How to Join the MMEC

People applying to join the MMEC are called applicants. All applicants will apply to the MMEC by submitting an application. If you need help with the application, you can ask the Member Liaison for help by calling 701-328-8666 or emailing jsheppard@nd.gov 

Selecting a New Member to be on the MMEC

ND Medicaid will review applications and interview selected applicants to ensure membership is diverse and represents the ND Medicaid population.  Applicants will meet with the Member Liaison for a short interview. The Member Liaison will recommend applicants for the MMEC to the Medicaid Director. The Medicaid Director will appoint members to the MMEC.
LEARNING ABOUT THE MMEC
All new members of the MMEC will meet with the Member Liaison. The Member Liaison will review what to expect at MMEC meetings, show individuals how to use technology to participate in MMEC meetings, and go over recent topics discussed at MMEC meetings. 

Membership Terms

The time a member serves on the MMEC is call a term. Each member will serve a two (2)-year term.  A member can serve up to two (2) terms. Terms cannot be served in a row. This allows other Medicaid members to bring new perspectives to the work of this committee.

If a member wants to serve a second term, they will need to apply and will be evaluated alongside other applications. 

Medicaid Medical Advisory Committee Membership

The Medicaid Medical Advisory Committee (MMAC) is made of members who are representatives of state or local consumer advocacy groups, clinical providers, representatives of managed care plans, legislators, tribal leaders, and members. 

This committee reviews recommended policy changes and state plan amendments, discusses Medicaid initiatives and activities, and reviews quality, access, and expenditures.

Federal regulation requires that a portion of the MMAC be made of members serving on the MMEC. 

Medicaid Member Engagement Committee Members serving on the MMAC shall serve a term of two (2) years from the date of appointment unless they resign, or their membership is terminated. Only active MMEC members may fill the five (5) designated MMEC seats. Former MMEC members may apply to serve a three (3) year MMAC term as a non- MMEC Medicaid member.

Chairperson

A chairperson may be chosen from current MMEC members during their two-year term. The chairperson will: 

• Help the Member Liaison organize and plan meetings,
• Find guests to share information, and
• Run the meeting. 

Resignation and Removal

Resignation is when a member feels they need to leave the MMEC before their term is ending. If a member cannot be on the MMEC anymore, a seat will be opened.  

Members may be removed from their seat on the MMEC for good cause. Examples of good cause are: 

• Excessive absences from MMEC meetings.
• Misconduct during MMEC meetings.

Benefits

We value our MMEC members! While you are on the committee:

• Medical Services offers members direct access to our resources and staff while they serve their term. Please contact the Member Liaison to learn more.

MMEC members that fulfill their commitment:

• Will be able to ask for a letter of recommendation from our Member Liaison
• Can use the Member Liaison as a professional reference. 

These are helpful when you are applying for a job or other committee-like work.

Release of Information

ND Medicaid may request that members sign a release allowing a picture, the name, and/or basic information about the member to be published on the www.hhs.nd.gov website.

The MMEC will meet online every other month. Meetings will be held on Teams with an option for individuals to join the meeting by phone. Meetings will last no more than two (2) hours and are closed to the public. This means that only those invited to the meeting can attend. We have closed meetings to maintain a safe space for our members to honestly and openly share their stories and suggestions. Additional meetings will be held as needed when requested by committee members.

ND Medicaid will publish a yearly schedule for MMEC meetings. The meeting schedule will be posted on the MMEC website. 

Attendance

ND Medicaid encourages members to attend every meeting to the best of their ability. ND Medicaid asks each MMEC member to commit to attending at least four (4) meetings a year. 

If a MMEC member misses more than three (3) meetings per calendar year, ND Medicaid may work with the member to determine if they are able to participate or if another Medicaid member should attend the MMEC in their place.

MMEC members may attend quarterly MMAC meetings to observe, give member-based input, and share MMEC progress and/or concerns. 

Meeting Minutes

Meeting minutes are notes of what was talked about at a meeting. Minutes will be taken at every meeting. ND Medicaid will summarize topics, suggestions, and follow up on progress. Minutes will be posted on the MMEC website. 

Official Membership Roles

The MMEC has a communal leadership structure without official roles such as a chair or co-chair. All members hold an equal number of responsibilities. If current MMEC members choose to consider designating official roles, a vote will be held to decide whether official roles will be put into place. The committee will discuss and approve these positions and their duties with a majority vote. 
Members may volunteer or accept nomination for an official position. Members will then select a volunteer or nominee for the official position with a majority vote. 

Disability and Other Accommodations

ND Medicaid will assist members with accommodations such as American Sign Language (ASL) translation, captioning, and caregiver participation for members with barriers. ND Medicaid encourages members to tell the Member Liaison about any assistance they will need to attend and participate in the MMEC meetings. 

ND Medicaid will also make accommodations for written or recorded materials presented at meetings such as translation, captions, descriptions of pictures, etc.

Conflict of Interest

The MMEC is meant to improve the ND Medicaid experience for the entire member body. MMEC members should not benefit from their membership beyond the benefits gained by all ND Medicaid members. A conflict of interest is:

• A circumstance where a member, entity, or individual closely affiliated with the member could financially benefit from the member’s participation in or connection to the MMEC.
• A situation where a member cannot separate their personal agenda from their service on the MMEC.
• A member’s personal relationships, activities, or interests that cause conflicting goals, impair a member’s participation, or inappropriately influence their decisions or actions.

Time will be held at every meeting to allow members to express potential conflicts of interest. When a potential conflict is expressed, the remaining, present members will determine whether the situation is to be considered a conflict of interest. A conflict of interest exists if the conflicted member’s participation, voting, or further actions related to the matter result in that member benefiting or being impaired as described above.

If the remaining, present members find there is a conflict of interest, the conflicted member should excuse themself from conversations, voting, and further actions on matters related to the conflict. If the remaining, present members find the potential conflict of interest not a conflict, the potentially conflicted member may resume regular participation.

Disclosures of conflicts will be recorded in the meeting minutes. 

Compensation

Stipend for Committee Members for Scheduled Meeting Attendance 

North Dakota Health and Human Services (HHS) or a contracted designee may pay committee members for their time spent serving on a committee for a program administered or under the supervision and direction of HHS. Stipend may be available for time spent attending committee meetings and orientation training. If a stipend is paid, it will be made out to the individual committee member.

Rate and Attendance Requirements

HHS or a contracted designee may pay committee members at a set rate within the limit of legislative appropriation. Use of federal funds to pay for any portion of the set rate for the stipend must also comply with any federal funding requirements, if applicable. The set rate is up to twenty-five dollars ($25) per thirty (30) minutes, for scheduled committee meeting attendance. The committee member may receive a stipend for attending a regular committee meeting if they have been present for at least thirty (30) minutes. The committee member may be paid for the next thirty (30) minutes if they are present for twenty (20) of the next thirty (30) minutes, and so on, for the length of the meeting. Travel time to and from meetings and meal breaks are not considered part of meeting attendance.

Issuance of Payment

HHS or a contracted designee may issue a stipend to the recipient in the form of electronic funds transfer (EFT) or paper check to be sent via standard mail. Committee members receiving stipend from HHS must complete and submit the SFN-10230 and a W-9. If the committee member chooses to have an EFT, they will also need to submit a blank check and/or have a letter of direct deposit issued from their bank. The letter of direct deposit must be produced on the bank’s letterhead and contain the account holder’s name, account number, and routing number, and the bank representative’s name, signature, and contact information. 

Process of Requesting Payment

Committee members may request a stipend for each scheduled committee meeting or orientation training they attend by working with the committee facilitator to complete and submit SFN 10230. Requests for a stipend will be processed within one week of the meeting attended.

Member Eligibility for Payment

Committee members may be eligible to receive a stipend for attending scheduled committee meetings if they:
Agree to receive a stipend and are active committee members; and
Are receiving assistance or services under a program administered by or under the supervision and direction of HHS and related to the committee’s focus; 
Are a provider of a recipient receiving assistance or services under a program administered by or under the supervision and direction of HHS and related to the committee’s focus; or 
Are a legal representative of an individual receiving assistance or services under a program administered by or under the supervision and direction of HHS and related to the committee’s focus. A legal representative is considered a recipient for the purpose of being eligible to receive a stipend.
Committee members are not eligible to receive a stipend for attending scheduled committee meetings if they:
Refuse to receive a stipend;
Are working for a contracted designee during scheduled committee meeting attendance;
Are attending a scheduled committee meeting as a part of paid employment duties; or
Are a legislative member, as prohibited by 2025 Senate Bill No. 2113.

Member Responsibilities for Payment

Members receiving a stipend are responsible for reporting this stipend as income to the Internal Revenue Service (IRS). Members are also responsible for reporting this income to any assistance programs provided by HHS.

Key Advice

Eligible committee members will be made aware that the acceptance of a stipend for committee meeting attendance can impact their eligibility for assistance programs. Eligible committee members have the right to refuse a stipend and should notify the committee facilitator, in writing, of their desire to refuse a stipend.

ND Medicaid values the feedback of Medicaid members and their families. The MMEC asks members to share their lived experiences with each other and others attending MMEC meetings and give all members a chance to be heard. ND Medicaid asks members of the MMEC to act in good faith with each other and agree to a set of guidelines for how the MMEC will interact with each other. This includes being honest and not doing things that will harm the MMEC. It also includes behavior outside of meetings. Expectations include:

• Members should try to attend and actively participate in all meetings. If members cannot attend a meeting, they are requested to advise the ND Medicaid Member Liaison. After missing a meeting, the member should plan to meet with Member Liaison to go over what happened at the meeting.
• Members agree to be respectful of other MMEC members, ND Medicaid staff, and other presenters. They will listen to each other and seek to understand the other’s perspectives, even if they disagree.
• Members agree to make every effort to share their feedback and experience and bring forward any concerns. 
• Members agree to refrain from personal attacks, purposefully harming the MMEC, and publicly criticizing or mis-stating information shared by other MMEC members during the meeting.
• Any written communications, including emails, blogs, and other social networking media (Ex. Facebook, Instagram), will follow these same guidelines and will maintain a respectful tone even if highlighting different opinions.

Member Liaison
Jen Sheppard
jsheppard@nd.gov | 701-328-8666

Alternative Contact
Janice Tweet
jtweet@nd.gov

The MMEC Guidelines inform members of this committee's purpose, how our meetings are held, and what membership looks like.