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This SPA proposes to deny payment for Provider-Preventable-Conditions including Health Care-Acquired Conditions and other Provider Preventable Conditions.
This SPA proposes to provide supplemental payments to the non-state government and private hospital's up to the Medicare upper payment limit, eliminate the CPE funding method for Medicaid services provided by non-state government hospitals and implement a provider assessment.
Revises the payment methodology for Head Injury beds, Ventilator Nursing beds and Nursing Facilities. Specifically, this amendment proposes to increase payment rates by 2.15% for Nursing Facilities effective January 1, 2011 and freeze provider rates at the level in effect as of June 30, 2011.
This SPA proposes to limit the number of outpatient pharmacy prescriptions for all recipients, with certain class exemptions, to five total drugs per month per adult recipient.