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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 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 ($6.00) effective for dates of service beginning October 1, 2011.
Summary: Designation of community mental health centers as health homes for individuals with a serious and persistent mental health condition and at least one other chronic condition.
Summary: To implement Section 6035 the Deficit Reduction Act. This provision required that States have laws that mandate health insurers or other parties legally responsible for payment of a claim for a health care item or service to provide the State with information that enables the State Medicaid agency to determine the existence of third party coverage for Medicaid recipients. These laws were passed in Missouri during the 2010 legislative session and became effective on August 28, 2010.
Summary: This amendment provides the State Fiscal Year (SFY) 2011 trend factor and specifies that it will not be applied in determining payments; clarifies the per diem rate, Direct Medicaid payments and uninsured payments for facilities that do not have a fourth prior year base cost report and facilities previously certified for MO HealthNet that had terminated and are reopening; indicates the Missouri Specific Trend Factor will not be applied in determining payments; clarifies the safety net adjusment relating to the uninsured payment for DEpartment of Mental Health facilities; and, specifies the process to be used in finalizing DSH payments as a result of the findings of the federally-mandated DSH audits.
