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  • Department of Social Services

    MO HealthNet Division

    Fiscal Year 2019 Budget Request

    Book 6 of 6

    Steve Corsi, Psy.D., Acting Director

  • Table of Contents

  • TABLE OF CONTENTS

    MO HEAL THNET DIVISION - VOLUME 1

    Department Request Summary ...................................................................................................................................................... 1

    Increase- HB 1565 Asset Limit Increase- 1 Yr. Costs to Continue ........................................................................................... 10

    Increase - HB 1565 Asset Limit Increase - Yr. 2 Phase In ......................................................................................................... 23

    Increase - MHD Cost to Continue ................................................................................................................................................ 36

    Increase - GR Pick-Up ................................................................................................................................................................. 52

    Increase - Pharmacy PMPM Increase - Specialty ...................................................................................................................... 57

    Increase - Pharmacy PMPM Increase - Non-Specialty .............................................................................................................. 64

    Increase - Managed Care Actuarial Rate Increase ..................................................................................................................... 71

    Increase - Managed Care Health Insurer Fee ............................................................................................................................. 81

    Increase - Managed Care Withhold Release .............................................................................................................................. 90

    Core - MO Health Net Division Administration ............................................................................................................................. 99

    Core - Clinical Services Program Management ......................................................................................................................... 113

    Core - Women and Minority Health Outreach ........................................................................................................................... 122

    Core - Third Party Liability (TPL) Contracts .............................................................................................................................. 131

    Increase - Third Party Liability (TPL) Contracts Increase ......................................................................................................... 141

    Increase - Information Systems .................................................................................................................................................. 146

    Increase - Contract Extensions .................................................................................................................................................. 157

    Core - Electronic Health Records Incentives .............................................................................................................................. 162

    Core - Money Follows the Person Grant .................................................................................................................................... 170

    Core - Pharmacy ......................................................................................................................................................................... 179

    Core - Pharmacy Medicare Part D "Clawback" .......................................................................................................................... 196

    Increase - Pharmacy Medicare Part D "Clawback" Increase ..................................................................................................... 206

    Core - Missouri Rx Plan .............................................................................................................................................................. 210

    Core - Pharmacy Reimbursement Allowance (FRA) Payments ................................................................................................. 219

    Core - Physician Related ............................................................................................................................................................ 227

    Core - Dental .............................................................................................................................................................................. 250

    Core - Premium Payments ......................................................................................................................................................... 262

    Increase - Medicare Premium Increase .................................................................................................................. .................. 276

  • TABLE OF CONTENTS MO HEAL THNET DIVISION - VOLUME 2

    Core - Nursing Facilities ............................................................................................................................................................. 282 Core - Home Health .................................................................................................................................................................... 296 Core - Long Term Support Payments ......................................................................................................................................... 305 Core- Rehab and Specialty Services ......................................................................................................................................... 312 Increase - Hospice Rate Increase .............................................................................................................................................. 329 Core - Non-Emergency Medical Transportation (NEMT) ........................................................................................................... 333 Increase - NEMT Actuarial lncrease ........................................................................................................................................... 344 Core - Community Health Access Programs (CHAPs) .............................................................................................................. 349 Core - Ground Emergency Medical Transportation (GEMT) ...................................................................................................... 356 Core - Complex Rehab Technology ........................................................................................................................................... 364 Core - Managed Care ................................................................................................................................................................. 37 4 Core - Hospital Care ................................................................................................................................................................... 393 Core - Physician Payment for Safety Net Hospitals .................................................................................................................. .408 Core - Federally Qualified Health Centers (FQHC) Distribution ................................................................................................ .416 Core - FRA Health Care Home .................................................................................................................................................. .426 Core - Federal Reimbursement Allowance (FRA) ..................................................................................................................... .434 Core - IGT Safety Net Hospitals ................................................................................................................................................ .443 Core - IGT DMH Medicaid Program ........................................................................................................................................... 451 Increase - IGT DMH Increased Authority ................................................................................................................................... 459 Core - Children's Health Insurance Program (CHIP) ................................................................................................................ .463 Core - Show-Me Healthy Babies ............................................................................................................................................... .478 Core - Nursing Facilities Reimbursement Allowance Payments (NFFRA) ................................................................................ .488 Core - School District Claiming .................................................................................................................................................. .499 Core- Blind Pension Medical ..................................................................................................................................................... 510 Core - MHD Non-Count Transfers .............................................................................................................................................. 519

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