May 2011 Medicaid Amendment Summary

The MSHA Healthcare committee has reviewed the amendments and concluded no significant change or impact on providers is apparent.  These amendments simply clarify policy that has already been in place.  MSHA Healthcare comments are italicized below each amendment for interpretation/clarification.

The following amendments have been proposed with the Secretary of State during the month of May.  The full text of the amendments can be viewed at http://www.medicaid.ms.gov/MsStatePlanAmendments.aspx.

CHIP#7
THE BENCHMARK DEFINITION REQUIRES THAT ANY APPLICABLE BENEFIT CHANGES MADE TO THE STATE AND SCHOOL EMPLOYEES’ HEALTH INSURANCE PLAN BE CONSEQUENTLY IMPLEMENTED WITH THE CHIP.

17744        Status: Final       Proposed: 12/20/2010         Final: 5/10/2011Notice    Full Text

MSHA Healthcare Committee Comments:

CHIP benefits and the State and School Employees’ Health Insurance Plan must coincide.  As many of you are aware neither the CHIPS program, nor the State and School Employees’ Health Insurance Plan provide coverage for habilitative pediatric outpatient speech therapy diagnoses.

SPA2011-003
THE ATTACHED STATE PLAN AMENDMENT IS BEING FILED TO ENSURE THE FINANCIAL/REIMBURSEMENT PAGE FOR THERAPY SERVICES PROVIDED IN NON-HOSPITAL SETTINGS IS COMPREHENSIVE AND MEETS ALL REQUIREMENTS OF SECTION 1902(A)(30)(A) OF THE SOCIAL SECURITY ACT. AFTER REVIEW OF THE SPA FOR EXPANSION OF SERVICES FOR ADULTS, IT WAS NOTED THAT THE CORRESPONDING FINANCIAL/REIMBURSEMENT PAGE DID NOT MEET ALL NECESSARY FEDERAL REQUIREMENTS. THIS REVISED SPA IS TO ENSURE THE MISSISSIPPI MEDICAID STATE PLAN IS IN COMPLIANCE WITH ALL FEDERAL STATUTES AND REGULATIONS AND THAT THE STATE PLAN COMPREHENSIVELY AND ACCURATELY DESCRIBES PAYMENT OF THESE SERVICES.

17735        Status: Proposed       Proposed: 5/3/2011Notice    Full Text

MSHA Healthcare Committee Comments:

SPA2011-003 was proposed to ensure that the recent expanded service coverage for adults under the MS Medicaid State Plan agrees with federal statute in terms of reimbursement.  If one reads the full text of the proposal a 5% assessment can be noted.  This assessment is not new.  It was mandated by state statute under Title XIX of the Social Security Act section 4.19B, Methods and Standards for Establishing Payment Rates.  This has been in effect for all Medicaid providers at least since 2002, according to VP: Healthcare’s research of state statute.  It is not specific to the therapies.  This amendment simply updates the “90% of the Medicare rate” rule which was listed incorrectly (because it was outdated) as “reimbursed based on an established fee schedule.”

-Christine D. Gibson, MSHA VP: Healthcare

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