Updates the behavioral health fee schedule

Proposes to establish qualifying criteria and a for disproportionate share hospital (DSH) payment methodology for West Jefferson Hospital, a major medical center located in southeastern area of Louisiana

Proposes to allow the state to comply with the Medicaid Drug Utilization Review (DUR) provisions included in Section 1004 of the Substance Use-Disorder Prevention that promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act

Adds facilities to which originating site fees can be paid, specifically Federally Qualified Health Centers and School Based Wellness Centers, for telemedicine services

Updates the nursing facility Differential Adjusted Payment (DAP) program effective October 1,2019

Updates All Patient Refined Diagnosis Related Group (APR-DRG) reimbursement for inpatient hospital services

Includes new drug review and utilization requirements set forth in section 1902(oo) of the Act. Specifically, Maryland is updating language to identify claim review limitations on safety edits and retrospective reviews, programs to monitor antipsychotic medications to children and fraud and abuse identification requirements

Proposes to implement changes to the per Medicaid day quality payment rate, add a new quality incentive payment, and change payment for low resource utilization residents.

Provider Enrollment & Screening

Reimbursement update for Drug Utilization Review