Reimbursement update for Clinic Services

Reimbursement update for Clinic Services.

Provides annual assurance of the pharmacy program adherence to the requirements of federal regulation for the time period of October 1, 2018 through September 30, 2019.

Adds a procedure code to cover certain emergency services when a participant is treated on-site rather than being transported to an emergency department.

Enhance the delivery of behavioral health home services for adults with serious mental illness and children/youth experiencing emotional disturbances.

Updates to various managed care sections of the State Plan.

Updates nursing facility cost reporting audit & reimbursement process.

Takes five reimbursement rates for Emergency Room Faculty claims that were blended by the State into one rate. This results in a savings due to ER Facilities not being able to "upcode"

Updating the reimbursement rate for dental services.

Updating the reimbursement rate for Autism related State Plan services that were increased by the State.