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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: Increase the income standard for the Parents and Other Caretaker Relatives eligibility group from 150% of the Federal Poverty Limit (FPL) to 155% of the FPL.
Summary: update the home health services fee schedule by increasing the rates by one percent (1 %) for Health Care Procedural Coding System (HCPCS) codes Tl00 4 (Services of a qualified nursing aide, up to 15 minutes) and Tl021 (Home Health aide or certified nurse assistant, per visit) provided by licensed home health agencies.
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: incorporates various Healthcare Common Procedure Coding System (HCPCS) updates to the Physician Office & Outpatient, Physician-Radiology, Physician-Surgery, Psychology and Autism Spectrum Disorder Services fee schedules. In accordance with section 12 of Attachment 4.19-B of the State Plan, this SPA also updates the
physician fee schedule and incorporates the required annual update for reimbursement of physician administered drugs, immune globulins, vaccines and toxoids.
Summary: This amendment provides a 2% rate increase for fiscal year 2020 and 1% effective July 1, 2021 and thereafter to nursing facilities to be applied to wages or salaries, health/dental benefits and retirement plans and/or a combination.
Summary: SPA modifies Attachment 4.19-D of the Medicaid State Plan to freeze the rates for private intermediate care facilities for individuals with intellectual disabilities (lCF/llDs) for the state fiscal years.
Summary: Enhance the delivery of behavioral health home services for adults with serious mental illness and children/youth experiencing emotional disturbances.