Update References to the Per Case Rate Medicaid State Plan Amendment 19-0028 Public Notice
Notice: Update References to the Per Case Rate Medicaid State Plan Amendment 19-0028 Public Notice is now available online.
Description: The Health Care Authority intends to submit Medicaid State Plan Amendment (SPA) 19-0028 to update references to a former inpatient hospital payment methodology known as the “per case rate.” HCA eliminated this payment methodology in favor of the Diagnosis-Related Group (DRG) methodology, effective October 1, 2018. In order to ensure clarity regarding when this methodology was effective, SPA 19-0028 adds the effective dates to each reference to the per case rate. The Centers for Medicare and Medicaid Services (CMS) approved eliminating the per case rate methodology in SPA 18-0029, approved in December 2018.