MT-22-0001
This amendment establishes compliance with the mandatory coverage and reimbursement of routine patient costs furnished in connection with participation in qualifying clinical trials under Section 1905(gg) of the Social Security Act.
MO-22-0017
This State Plan Amendment adds coverage of the routine patient costs furnished in connection with pai1icipation in clinical trials as outlined in Section 1905(gg) in the Social Security Act for the population currently served in Missouri’s Alternative Benefit Plan (ABP).
CMS Technical Instructions: Reporting Sub-capitation Payments and Encounters Associated with Sub-capitation Payments from Managed Care Plans
This technical instructions document identifies the challenges states have faced when reporting payments by managed care plans to sub-capitated entities (referred to as “sub-capitation payments” below) for the management or provision of specific enrollee services as well as the associated encounter records for the services provided. The state T-MSIS technical instructions below explain how to report sub-capitation payments, the associated sub-capitated encounter records, and sub-capitated provider affiliation to T-MSIS, including the T-MSIS file to which they should be mapped and how key data elements should be populated.
Collections:
NH-22-0005
Updates the nursing facility reimbursement rate budget adjustment factor.
CO-21-0047
Adds clarifying language specific to Disproportionate Share Hospital (DSH) payments as well as updates the hospital quality incentive payments available for qualifying providers.
CT-22-0009
Incorporates the January 2022 federal Healthcare Common Procedure Coding System (HCPCS) changes (additions, deletions and description changes) to the dental fee schedules for adults and children.
CT-22-0006
Makes updates to the radiology and laboratory fee schedules.
AR-22-0002
Removes non-emergency ambulance services from the exceptions to the emergency medical transportation payments.