FY 2011 SPA SUBMISSION

MAC Report: July 2011

STATE PLAN AMENDMENT / Section / Pages Impacted / PURPOSE / SUBMITTED TO CMS / APPROVED
11-05
Utilization Control / Pg 46
p. 47a
p. 48
p. 50 / p.50a
At 4.14A
Att 4.14C / To update the utilization control section of the State plan to reflect current practices and language detailing utilization control efforts. / 5/12/2011
11-06
Section 1 Updates / P. 20
P. 20c
P. 42-43
p. 57 / p. 66b
p. 74c
p. 79c
p. 89 / To update Section 1 of the State plan to reflect current practices, update names of agencies, and to update letter of Governor’s review by current DHMH Secretary. / 5/13/2011
11-07
Co-pay language / P. 56f & g
Att 4.18A
Att 4.18C / UpdateState plan to reflect current practices, removal of co-pay for emergency visits for categorically and medically needy and language regarding co-payments in hospital settings. / 5/13/2011
11-08
State Plan Updates / 1.1A – 1.2D
(updates originals 1974) / Updates to the State plan to reflect current organizational structure, org charts and eligibility practices. / 6/17/2011
11-09
State Plan Updates / pp. 87
Att 7.2 p1-4
Att 3.1C 1-5 / Att 3.1D p1
4.19A&B p.12,33
Att 4.19E / Updates to the State plan to reflect current practices and updates to policy. / 6/17/2011
11-10
Accordance w/ Section 2302 / Att 3.1A Page 7 / To document Maryland’s accordance with Section 2302 of the Affordable Care Act – concurrent hospice care for children in Medicaid and CHIP / 6/17/2011 / (about to be cleared as of 7/5 – one correction made)
11-11
Overpayment reallocation / Att 4.19 A&B Page 3 (95-13) / To allow the Program to reallocate funds after the completion of a year end. / 6/30/2011
11-12
Provider Rates / Links / Att 4.19B Pages:
p.5-11, 14 (09-08)
p. 18-23 (10-04) / Update links to provider rate schedule and reduce rates to 75% of Medicare. / 7/1/2011
11-13
HIV TCM / Supp 3 to Att 3.1A pp: 1-2 (89-10) 3-7 (92-02) p. 8 (New) / 4.19 A&B pp. 23-24 (92-02); 4.19B p.16A (New) / To update the State plan to reflect Maryland’s practice of and reimbursement for HIV targeted case management. / 7/13/2011