DELIVERY SYSTEM AND PROVIDER PAYMENT INITIATIVES i. Rate Development Standards Consistent with guidance in 42 CFR §438.6(c) and with the CY 2019 MMC capitation rates, the CY 2020 rates reflect consideration of the following delivery system and provider payment initiatives: Care Innovation and Community Improvement Program (CICIP) Supplemental Pharmacy Dispensing Fee
DELIVERY SYSTEM AND PROVIDER PAYMENT INITIATIVES. Consistent with the Original certification, the amended rates effective January 1, 2022 include consideration for the following delivery system and provider payment initiatives: • Hospital Additional Payment (HAP) • Care Innovation and Community Improvement Program (CICIP) • Minimum fee schedule for COVID-19 diagnostic testing • Supplemental pharmacy dispensing fee The report CY 2021 Medicaid Managed Care Capitation Rate Amendment, dated July 22, 2021, includes full documentation consistent with the CMS managed care rate setting guide. Where applicable, we understand amended preprints have been developed and submitted by ODM to reflect the extension of the rating period to June 30, 2022. For this amendment, projected amounts for each of these arrangements have been updated to apply to the 1H 2022 rating period.
DELIVERY SYSTEM AND PROVIDER PAYMENT INITIATIVES. This section is not applicable because there are no payment incentives for the MyCare program as defined by the CMS Rate Setting Guide.
DELIVERY SYSTEM AND PROVIDER PAYMENT INITIATIVES i. Rate Development Standards The CY 2018 MMC capitation rates do not reflect delivery system or provider payment initiatives.
DELIVERY SYSTEM AND PROVIDER PAYMENT INITIATIVES i. Rate Development Standards Consistent with guidance in 42 CFR §438.6(c), the CY 2019 MMC capitation rates reflect consideration of the Care Innovation and Community Improvement Program (CICIP).
DELIVERY SYSTEM AND PROVIDER PAYMENT INITIATIVES. In the MyCare program, the MCOPs are required to pay nursing facilities at Medicaid fee schedule rates used by ODM for FFS claims. A state directed payment preprint is not required for this arrangement. There are no other state directed payments for the MyCare program as defined by the CMS Rate Setting Guide.
