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 pro

Which proposes to revise home health aide services, Adult Day Health Care services, and reimbursement effective date language.

The State is attesting that it will establish a Medicaid Recovery Audit Contractor (RAC) program by December 31, 2010, with an effective date of April 1, 2011, as required by the Affordable Care Act.

To come into compliance with the requirements of sections 1902(a)(80) of the Social Security Act as amended by Section 6505 of the Affordable Care Act. This amendment prohibits payments to institutions or entities located outside of the United States.

To make changes and additions to the Comprehensive Day Rehabilitation Services and Comprehensive Substance Treatment and Rehabilitation (CSTAR) services as recommended by CMS to comply with 42 CFR 440.112(d) to ensure services are coverable rehabilitative services.

Which provides for smoking cessation program services covered for all participants who smoke when prescribed by a physician or health care professional with prescribing authority including smoking cessation products with behavioral intervention services provided by a wide range of healthcare provider specialties.

Amends MO HealthNet's reimbursement of outpatient radiology procedures to be reimbursed from a Medicaid fee schedule, effective for service dates beginning October 1, 2011, for all MO HealthNet enrolled hospitals. This amendment also provides a 5% increase to the prospective outpatient rate for federally-designated Critical Access Hospitals for service dates October 1, 2011 through June 30, 2012.

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.

This SPA clarifies Nurse Practitioner Services to comply with 42 CFR 440.166 and adds language which documents the reimbursement methodology used to pay for services rendered by nurse practitioners.

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.