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A Medicaid and CHIP state plan is an agreement between a state and the Federal government describing how that state administers its Medicaid and CHIP programs. It gives an assurance that a state will abide by Federal rules and may claim Federal matching funds for its program activities. The state plan sets out groups of individuals to be covered, services to be provided, methodologies for providers to be reimbursed and the administrative activities that are underway in the state.
When a state is planning to make a change to its program policies or operational approach, states send state plan amendments (SPAs) to the Centers for Medicare & Medicaid Services (CMS) for review and approval. States also submit SPAs to request permissible program changes, make corrections, or update their Medicaid or CHIP state plan with new information.
Persons with disabilities having problems accessing the SPA PDF files may call 410-786-0429 for assistance.
Summary: This amendment provides for additional reimbursement to nursing facilities participating in the Invasive Ventilator Program for services provided to ventilator dependent MO HealthNet participants beginning on and after January 1, 2013.
Summary: Adds language to increase payments to certain physician specialties for primary care evaluation and management (E/M) healthcare common procedure coding system (HCPCS) codes as required by Section 1202 of the Affordable Care Act.
Summary: Services (CMS) received Missouri's State Plan Amendment (SPA) transmittal #12-15, which reflects an increase in the Personal Needs Allowance from $30 to $35 for individuals and from $60 to $70 for couples.
Summary: This amendment provides for a per diem increase to nursing facility and HIV nursing facility reimbursement rates by granting a trend adjustment resulting in an increase of six dollars and zero cents ($6.00) effective for dates of service beginning Jul 1, 2012.
Summary: Increases the overall outpatient rates for services provided in federally designated critical access hospitals (CAHs) by 5% and state designated CAHs by 3%.
Summary: Establishes a supplemental payment under the Upper Payment Limit using Medicare payment principles to reimburse Community Mental Health Center clinics.
Summary: Amends MO HealthNet's reimbursement of outpatient radiology procedures to be reimbursed from a Medicaid fee schedule, effective for service dates beginning October 1, 2011, for all MO HealthNet enrolled hospitals. This amendment also provides a 5% increase to the prospective outpatient rate for federally-designated Critical Access Hospitals for service dates October 1, 2011 through June 30, 2012.
Summary: This ammendment provides the State Fiscal Year (SFY) 2012 trend factor; clarifies new federal audit and record retention requirements in accordance with federally mandated DSH audit standards; references new payment methodologies relating to Disproportionate Share (DSH) and Upper Payment Limit (UPL) payments; and revises when Enhanced Graduate Medical Education (GME) payments are paid to hospitals.
Summary: This amendment provides for a per diem increase to nonstate-operated ICF/MR facilities reimbursement rates by granting a trend adjustment of one and four tenths percent (1.4%) increase of the prospective rates effective for dates of service beginning October 1, 2011.