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.

Increases nursing facility (NF) and HIV NF per diem rates by $1.61 effective for dates of service beginning August 1, 2019. Then, for dates of service beginning July 1, 2020, the per diem increase is reduced to an increase of $1.49 per day.

APG updates to Hospital Outpatient (FMAP=50%)

temporary rate adjustments for the outpatient services of specified critical access hospitals.

Payment for Services: Intermediate Care Facility for lndividuals with Intellectual Disabilities (lCF-llD) Payment Changes.

changes to Hospital Presumptive Eligibility (HPE), modifications to Presumptive Eligibility (PE) for Pregnant Women, the Eligibility Process Reviewable Unit, and the state’s election to end the option to provide Presumptive Eligibility to children under age 1.

Medically Needy Income Modification

Updates the fee schedule effective dates for several Medicaid programs and services

revise the not to exceed limits to align with services for consumers receiving through DHS or ODDS.

The purpose of this SPA is to revise eligibility criteria to ensure children who were receiving support services under Idaho’s expired 1915(c) waivers (ID-0887 and ID 0859) can continue to receive support services under Idaho’s 1915(i) benefit for Children with Developmental Disabilities (Supplement 1 to Attachment 3.1-A).