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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.
Increases available services to members on the basic benefit package. In particular, denture related services were added. During the SFY19 it was revealed that members with dentures in the basic benefit tier did not have access to the needed services.
This amendment to the MInnesota Medicaid state plan:
Reduces the rate to reflect the change in the MinnesotaCare provider tax on January 1,2020.
Adds a policy adjustment factor for specialty mental health services, and revises the policy adjustment factor for: burns; pre-major diagnostic category; transplants; and trauma.
Summary: Revises methodologies and standards for Inpatient Hospital rates. Specifically, this amendment:
. Reduces the rate to reflect the change in the MinnesotaCare provider tax on January 1,2020.
. Adds a policy adjustment factor for specialty mental health services, and revises the policy adjustment factor for: burns; pre-major diagnostic category; transplants; and trauma.
. Revises the charge limit.
. Revises the base year to 2016 for hospital costs.
Summary: re-bases Nursing Facility and Nursing Facility for Mental Health payment rates for state fiscal year 2020. Also updates charts and exhibits with the State plan that demonstrate the revised factors and limits applicable to the rate period beginning with SFY 2020.
Summary: Adds an Alternative Payment Model (APM) to the Physician Service reimbursement page in Attachment 4. 19- 13: Methods and Standards for
Establishing Payment Rates
Summary: Describes the organization of New Mexico's Single state Agency, the New Mexico Department of Human Services, and the administration of the state's Medicaid
program
Summary: Revises the State Plan to add Applied Behavioral analyst, certified behavior analyst assists under the supervision of licensed behavior analyst, or other individual specified under article one hundred sixty-seven of New York State education law, and update service type/fee schedule accordingly