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Medicaid State Plan Amendments
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: 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: Adds comprehensive assessment, treatment coordination and peer recovery support services for the treatment of substance use disorder and allows licensed professionals to bill the Medicaid program for substance abuse services.
Summary: Revises supplemental payments to certain safety-net hospitals for physician and dental services by including the University of Minnesota as an eligible provider. Also revisessupplemental payments for ambulance services to include non-state, government-owned providers.