Health Care Policy Report™ offers the inside story on health care regulation and policy, with behind-the-scenes news and analysis of developments in Congress, the federal agencies, and the...
States must be in compliance beginning June 1 with a provision of the health reform law that prohibits them from paying institutions or entities located outside of the United States for Medicaid items or services, the Centers for Medicare & Medicaid Services said Dec. 30.
In a letter to state Medicaid directors, CMS said that states must submit a state plan amendment (SPA) to show they are operating in accordance with the new requirement, which was included in the Patient Protection and Affordable Care Act. While the prohibition was effective Jan. 1 (with some possible exceptions), CMS said any claim audits to assure compliance would begin no earlier than June 1 and would only apply to claims submitted on or after that date.
Along with the letter CMS included a draft template for an SPA that states can use to certify their compliance with the prohibition. States must submit an SPA no later than June 30, with an effective date of June 1, according to the letter.
The letter said that for purposes of the new rule the term United States includes the District of Columbia, Puerto Rico, the Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa.
In addition, the letter specifies that the prohibited payments refer to payments for medical assistance for which the state claims federal funding. The prohibition does not apply to payments for tasks that support the administration of Medicaid, such as information processing or call centers.
If a state must make changes to its Medicaid Management Information System to comply with the prohibition, it can qualify for additional federal funding, according to CMS.
The letter is available at http://www.cms.gov/smdl/downloads/SMD10026.pdf.
All Bloomberg BNA treatises are available on standing order, which ensures you will always receive the most current edition of the book or supplement of the title you have ordered from Bloomberg BNA’s book division. As soon as a new supplement or edition is published (usually annually) for a title you’ve previously purchased and requested to be placed on standing order, we’ll ship it to you to review for 30 days without any obligation. During this period, you can either (a) honor the invoice and receive a 5% discount (in addition to any other discounts you may qualify for) off the then-current price of the update, plus shipping and handling or (b) return the book(s), in which case, your invoice will be cancelled upon receipt of the book(s). Call us for a prepaid UPS label for your return. It’s as simple and easy as that. Most importantly, standing orders mean you will never have to worry about the timeliness of the information you’re relying on. And, you may discontinue standing orders at any time by contacting us at 1.800.960.1220 or by sending an email to email@example.com.
Put me on standing order at a 5% discount off list price of all future updates, in addition to any other discounts I may quality for. (Returnable within 30 days.)
Notify me when updates are available (No standing order will be created).
This Bloomberg BNA report is available on standing order, which ensures you will all receive the latest edition. This report is updated annually and we will send you the latest edition once it has been published. By signing up for standing order you will never have to worry about the timeliness of the information you need. And, you may discontinue standing orders at any time by contacting us at 1.800.372.1033, option 5, or by sending us an email to firstname.lastname@example.org.
Put me on standing order
Notify me when new releases are available (no standing order will be created)