Amends methods of Implementation for Nursing Home Payment Rates

Reimbursement update for Medical Supplies and durable medical equipment (DME) Re-basing

Reimbursement update for Breast-Cervical Cancer Cost Sharing

Reimbursement update for Inpatient Hospital APR-DRG

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.
• Revises the charge limit.
• Revises the base year to 2016 for hospital costs.

This Spa updates the government provider Disproportionate Share Hospital (DSH) pool. The purpose of the pool is to assure funding for costs incurred by public facilities providing inpatient hospital services which serve a disproportionate number of low-income patients with special needs.

The SPA updates the reimbursement methodology for specific Durable Medical Equipment, Prosthetics,
Orthotics, and Supplies (DMEPOS) services. (corrected CMS 179)

This amendment will authorize the District to reimburse the Medicaid RACs up to the highest contingency fee used under the Medicare RAC Program.